Valium prescription - what to do?

barefoot

Sponsor
So, in my experience, it can be difficult getting GPs to prescribe valium beyond a few tablets very occasionally as they are (understandably) worried about patients getting addicted.

For the last few years, my now GP has been great. She understands how I use it, trusts how I use it and can see that I’m not addicted as a prescription of 28 x 5mg tablets lasts me 6 months or more. We don’t really discuss my mental health much but she knows I see a therapist.

I got a new prescription a few weeks ago, ahead of an invasive medical procedure.

Due to a number of stressors over the past couple of months:
- the medical procedure
- some family situations
- stress about work (not having enough work/income, which feels worrying…and having high anxiety about the work I do have…it’s like I’m experiencing a crisis of confidence in my ability to do my job at the moment, for some reason)
- on-going health issues 21 months on post-Covid
- a rupture with my therapist (still not fully resolved and I’ve decided to take a break for a month but haven’t communicated this to her yet)
- the three year anniversary of my mum passing away, which for some reason I found particularly difficult this year
- a friend’s son dying very suddenly and tragically
- hearing today that a very close friend died yesterday, which is devastating. My heart is aching so much

^^^ due to these things, I don’t feel in a great place and I have already taken almost half the tablets in my valium prescription, which I’ve only had in my possession for about a month.

I have taken a few in daytimes if I am triggered/if anxiety is so high I cannot down regulate using other tools (only one tablet in a day max) But I am mainly taking them to help me get to sleep (not every night) - I realise they’re not really supposed to be used for this but, in the absence of anything else, they help. (By that I mean that I don’t take any other meds for my mental health. I do take melatonin but that’s for controlling night terrors, not for getting to or staying asleep)

I am getting concerned that I have got through so many in this amount of time. I’m not concerned that I have taken too many/that I’m addicted etc. Just that, I have more stressful things coming up (a family visit, the above two funerals, my Dad wanting conversations around my mum’s belongings and what to do with her ashes etc) and I feel I am unravelling a bit. And I feel I will need to take a valium to take the edge off at least some these things. But if I get through them all too quickly, I am worried that my GP won’t give me more.

I’m worried she’s going to think I have become dependent. But I really haven’t - I’m just struggling because there’s a lot at the moment and I’m finding it hard to cope. Because there’s such a cluster of stuff that’s all come closer together, I’m spiking more and therefore taking a valium the way I always do…but it’s more often (not daily) because there are so many different stressors.

I don’t know what to do about this.

I’m worried that my GP won’t give me more as it hasn’t been long enough between prescriptions (I don’t need more right now…but at this rate, they’re not going to last me anywhere near 6 months)

I don’t want to run out.

I don’t want my GP thinking I’m in a muddle - either with my mental health generally at the moment or in terms of her thinking I’ve got myself hooked on benzos.

Feeling super stressed about this on top of everything else.

I really like my GP and she is supportive and easy to talk to and I suppose I trust her more than any other doctor I’ve ever had and feel the most comfortable with her by far. I just don’t want to tell her about getting through my prescription quickly and end up shooting myself in the foot so she won’t prescribe me any more.

If anyone has any other thoughts on other medication, I’d also be keen to hear. I’m not especially keen to start taking anti depressants. Also have to be careful because some meds including some antidepressants counteract my melatonin so my night terrors go wild.
I take the valium to help my head feel calm rather than something like propranolol which is to calm physical symptoms like racing heart, which isn’t what I need.

I don’t even really know why I’m posting and what anyone is going to be able to help with. I just feel in a real panic about running out of valium/somehow saying the wrong thing to GP, on top of already feeling emotionally dysregulated about the other stuff going on.

ETA: I’m in the UK

Would I be better off asking GP for some sleeping tablets to help in the short term and not mention the valium? (I know they don’t dish out sleeping pills very easily either, again, because of addiction risks)
 

joeylittle

Administrator
Would I be better off asking GP for some sleeping tablets to help in the short term and not mention the valium?
Someone from the UK will probably have a smarter answer - but yes, I think you should work on sleep alternatives. And, before you request sleeping pills, you should give the gentler options a try - melatonin, diphenhydramine (ZzzQuil), bedtime ritual, listening to something, etc...

I'd recommend just talking with your doc about all of it - because you may need a valium refill earlier than is typical, and also it'd be better to tell them you're ahead of your normal usage because of sleep issues specifically, not daytime over-use. Better to be upfront.

BUT - I'm sure there's a health-care culture to consider, and personally I've only got experience in the US. Hopefully some UK members will chime in.
 

Sideways

Moderator
I definitely think you can, and should be open with your prescribing doctor. If you have an established relationship, it's so incredibly helpful to capitalise on that relationship in exactly these sorts of situations.

Because you have been through a hellride recently, and it makes perfect sense that you'd be using extra prn right now. That's what prn is for.

I have more stressful things coming up
Plan ahead. Aside from the addictive issues, there's the psychological crutch that goes along with these meds. And it's not to be underestimated.

In addition to each of those tablets having less effect when you take them, it really quickly spirals into "I won't cope if I don't have..." territory. Anticipatory anxiety. Not coping with the prospect of potentially not coping.

Before you go back to your doctor, go through the other tools you have in your coping toolbox - strategies that you know (a) improve your sleep quality; and (b) help you manage your anxiety levels. What other strategies do you have, that you will be using aside from the valium? Use all of them.

So with sleep - can you increase your daily exercise at all? Can you reduce caffiene, nicotine and alcohol intake? Can you add in a guided relaxation before bed? Switch your phone to time out mode at a certain time each evening? Add a chamomile tea before bed? Reduce processed sugar intake? Anything you can think of to improve sleep quality. And simply note it down, and try.

And anxiety? Much the same. What are your go-to anxiety management strategies aside from the valium? And Max. Them. Out.

With diazepam (which I also use as prn), I have a max amount I take each 14 days, and I make sure I have at least 3 straight days every fortnight where I don't use any. Simply because I need my prn to be effective when I desperately need it.

You got this. Try not to make valium another crisis in your mind before it even becomes one, because it isn't currently a crisis, and won't necessarily become one if you work in partnership with a good doctor.
 

barefoot

Sponsor
, I think you should work on sleep alternatives. And, before you request sleeping pills, you should give the gentler options a try - melatonin, diphenhydramine (ZzzQuil), bedtime ritual, listening to something, etc...

I take 4mg of melatonin every night anyway, prescribed by a sleep clinic to help reduce my parasomnias inc night terrors.

I had to Google diphenhydramine! In the past, things like Nytol didn’t do anything. But I haven’t tried it for ages, and not alongside melatonin, so that might be something to try…

Bedtime rituals etc…I’m generally pretty good with that as had to get into those habits to help with parasomnias before I started taking melatonin, and those sorts of things have just stuck. But there’s probably more I could do inc more breathing exercises. I just find them very hard to do when I really need them!

I'd recommend just talking with your doc about all of it - because you may need a valium refill earlier than is typical, and also it'd be better to tell them you're ahead of your normal usage because of sleep issues specifically, not daytime over-use. Better to be upfront.

Yeah…I have increased daytime use too, but it is mainly at night for sleep.


Because you have been through a hellride recently, and it makes perfect sense that you'd be using extra prn right now. That's what prn is for.

Yes…I do feel like I’m taking it properly still…I’m not just reaching for it for something low level/without trying to manage it without it. But lots of things happening together… :(

Before you go back to your doctor, go through the other tools you have in your coping toolbox - strategies that you know (a) improve your sleep quality; and (b) help you manage your anxiety levels. What other strategies do you have, that you will be using aside from the valium?

I could get back into the habit of doing more breathing exercises in the day and before bed. I find it difficult doing this/making any good habit when I feel like this. But I can try.

So with sleep - can you increase your daily exercise at all? Can you reduce caffiene, nicotine and alcohol intake? Can you add in a guided relaxation before bed? Switch your phone to time out mode at a certain time each evening? Add a chamomile tea before bed? Reduce processed sugar intake? Anything you can think of to improve sleep quality. And simply note it down, and try.

Exercise is difficult as I have long Covid and fatigue is a key symptom I’m left with. But I have started doing some gentle yoga poses/stretches and am starting a short tai chi course this year.

Don’t do caffeine or nicotine. Not really fancying alcohol anyway.

I do need the reduce sugar ( I need to lose some weight) But, again, it’s a challenge when I’m feeling like this, as that makes me crave sweet things more.

I used to use a sleep meditation and have fallen out of the habit as didn’t need it anymore, and was more in need of effective ear plugs to block out partner’s snoring! Perhaps I need to get some new ear buds, which are noise cancelling and comfortable enough to sleep in.

Have also deliberately been watching gentler tv programmes before bed - realised Squid Game wasn’t helping my dreams!

Try not to make valium another crisis in your mind before it even becomes one, because it isn't currently a crisis, and won't necessarily become one if you work in partnership with a good doctor.

Yes, good point.

I suppose what it comes down to is that I really don’t feel very good. I feel very anxious and very low. And perhaps that’s part of the concern/avoidance of talking to GP about it…that I probably can’t have a proper conversation about the valium prescription/any sleep alternative without admitting that I’m struggling at the moment 😞
 

DharmaGirl

MyPTSD Pro
Can you print off your first post in this thread and give it to the doc to read? It says a lot and I would think it would show that you are not becoming addicted. That way you get to say everything you need to without being interrupted.
 

barefoot

Sponsor
Can you print off your first post in this thread and give it to the doc to read? It says a lot and I would think it would show that you are not becoming addicted. That way you get to say everything you need to without being interrupted.
GP appointments are only phone calls at the moment here, because of Covid. So, I could read it out, but not hand her a print out.

Just spoken to my partner about it. She thinks I should speak to GP ASAP to give her a heads up, even if I don’t need to ask for more valium just yet.

She thinks I’m being paranoid about looking like I’m addicted…she thinks GP will trust I’m not and that GP would be supportive that I’m having a tough time at the mo and will want to hear about how I’m doing to see whether she can help. I just…don’t find it easy to talk about mental health issues…the thought of it is worrying. I worry about what notes GP will make. And what that might mean. And then worry that I’m being paranoid.

Worry, worry, worry…
 

barefoot

Sponsor
Spoke to GP today on the phone.

Said how anxious and low I’m feeling, and that I’m not sleeping well, and about all the stressors.

She said she would give me another valium prescription for valium within six months because I have a lot going on. But that she wouldn’t be prepared to give me more than two prescriptions in any six month period. A prescription is 28 tablets, and I’ve had mine for six weeks and am about halfway through them.

So this was sort of reassuring that I could get one more. But also not really as, if it takes a while to settle, two prescriptions may easily not last me 6 months and she has said she won’t give me another one after that. But trying not to get ahead of myself.

I asked if there was anything I could take to help me get to sleep and stay asleep - something to help me reset good sleep patterns in the short term. She was about to give me some sleeping pills, then said I shouldn’t take them with my melatonin (which I use to control night terrors) So, that didn’t really work. So she’s suggested I up my melatonin dose to 6mg per night for a week or so to see if that helps.

She also asked if I was open to starting antidepressants. I said no, gave her a few reasons, and she said that made sense and didn’t push it.

Then there was a lot of ‘be kind to yourself’, ‘do nice things’, ‘go for a walk’ etc. Which felt a bit…basic…but if I don’t want to take anti-depressants, I guess these are the only sorts of things she can suggest.

Feel a bit stupid for having the appointment now. It’s obvious that I (or anyone!) would not be feeling good, with everything that’s going on, esp a recent behaviours. So, I don’t know what I expected/hoped GP can do. Except that I at least know she’ll do one more prescription for my over the next few months if needed.
 

Sideways

Moderator
She said she would give me another valium prescription for valium within six months because I have a lot going on.
So, to me personally, this sounds like her keeping within her professional purview: she's a GP, and happy to prescribe valium intermittently, but if there's a bigger mental health issue requiring management, she's not willing to step into that role..?
go for a walk’ etc. Which felt a bit…basic…
Fwiw? Going for a walk each day is more effective than any antidepressant on the market👍
 

Skywatcher

MyPTSD Pro
I would use this time to find something else that helps you. I think that Dramamine works better than Xanax for me. Look into trileptal or lamictal. I take mine at night for my anxiety. It acts as a sedative. I also take daily walks. ;-)
 

TruthSeeker

MyPTSD Pro
So, in my experience, it can be difficult getting GPs to prescribe valium beyond a few tablets very occasionally as they are (understandably) worried about patients getting addicted.

For the last few years, my now GP has been great. She understands how I use it, trusts how I use it and can see that I’m not addicted as a prescription of 28 x 5mg tablets lasts me 6 months or more. We don’t really discuss my mental health much but she knows I see a therapist.

I got a new prescription a few weeks ago, ahead of an invasive medical procedure.

Due to a number of stressors over the past couple of months:
- the medical procedure
- some family situations
- stress about work (not having enough work/income, which feels worrying…and having high anxiety about the work I do have…it’s like I’m experiencing a crisis of confidence in my ability to do my job at the moment, for some reason)
- on-going health issues 21 months on post-Covid
- a rupture with my therapist (still not fully resolved and I’ve decided to take a break for a month but haven’t communicated this to her yet)
- the three year anniversary of my mum passing away, which for some reason I found particularly difficult this year
- a friend’s son dying very suddenly and tragically
- hearing today that a very close friend died yesterday, which is devastating. My heart is aching so much

^^^ due to these things, I don’t feel in a great place and I have already taken almost half the tablets in my valium prescription, which I’ve only had in my possession for about a month.

I have taken a few in daytimes if I am triggered/if anxiety is so high I cannot down regulate using other tools (only one tablet in a day max) But I am mainly taking them to help me get to sleep (not every night) - I realise they’re not really supposed to be used for this but, in the absence of anything else, they help. (By that I mean that I don’t take any other meds for my mental health. I do take melatonin but that’s for controlling night terrors, not for getting to or staying asleep)

I am getting concerned that I have got through so many in this amount of time. I’m not concerned that I have taken too many/that I’m addicted etc. Just that, I have more stressful things coming up (a family visit, the above two funerals, my Dad wanting conversations around my mum’s belongings and what to do with her ashes etc) and I feel I am unravelling a bit. And I feel I will need to take a valium to take the edge off at least some these things. But if I get through them all too quickly, I am worried that my GP won’t give me more.

I’m worried she’s going to think I have become dependent. But I really haven’t - I’m just struggling because there’s a lot at the moment and I’m finding it hard to cope. Because there’s such a cluster of stuff that’s all come closer together, I’m spiking more and therefore taking a valium the way I always do…but it’s more often (not daily) because there are so many different stressors.

I don’t know what to do about this.

I’m worried that my GP won’t give me more as it hasn’t been long enough between prescriptions (I don’t need more right now…but at this rate, they’re not going to last me anywhere near 6 months)

I don’t want to run out.

I don’t want my GP thinking I’m in a muddle - either with my mental health generally at the moment or in terms of her thinking I’ve got myself hooked on benzos.

Feeling super stressed about this on top of everything else.

I really like my GP and she is supportive and easy to talk to and I suppose I trust her more than any other doctor I’ve ever had and feel the most comfortable with her by far. I just don’t want to tell her about getting through my prescription quickly and end up shooting myself in the foot so she won’t prescribe me any more.

If anyone has any other thoughts on other medication, I’d also be keen to hear. I’m not especially keen to start taking anti depressants. Also have to be careful because some meds including some antidepressants counteract my melatonin so my night terrors go wild.
I take the valium to help my head feel calm rather than something like propranolol which is to calm physical symptoms like racing heart, which isn’t what I need.

I don’t even really know why I’m posting and what anyone is going to be able to help with. I just feel in a real panic about running out of valium/somehow saying the wrong thing to GP, on top of already feeling emotionally dysregulated about the other stuff going on.

ETA: I’m in the UK

Would I be better off asking GP for some sleeping tablets to help in the short term and not mention the valium? (I know they don’t dish out sleeping pills very easily either, again, because of addiction risks)
Yeah....I use Lorazapam and have similar concerns, I don't use the "big guns" unless anxiety is keeping me awake and I've tried all other methods. As a regular bedtime prep, I take 2 magnesium which cause drowsiness. I do the sleep routine, warm /shower or bath, no computer/phone/games/TV for 2 hrs before bedtime......and I won't take the Lorazapam until I've tried the "non-medication ways" plus I eat a very small meal, always a small carbohydrate like a thin piece of toast and peanut butter before bed with 1/2 glass of milk which helps induce a feeling of satisfaction....... before going to bed. If hydroxyzine is needed and none of that worked, then I bring in the big guns..... (antihistimine) it will usually knock me out. I save the Lorazapam for serious anxiety and where I've gone into rumination.........it is easy to get a prescription for hydroxyzine (antihistimine) for sleep. I don't want Benzo's to become "important" and have to be counting the pills and stressing over the issue you have at hand, but really does help when there is a death or you've had to deal with your dysfunctional family. You can also cut your dose, I have used 1/2 a Lorazapam and found that combined with Aleve and a small dose of carbs as just as effective for getting me to sleep.
 

ruborcoraxxx

Sponsor
I’m having a problem similar to yours here. Never I took lorazepam more than 2.5mg a day, except for today I took 8mg, which is above what is recommended.

This happened because I have another anti-anxiety drug missing (pregabalin) and I just frost in bed as if there was a war. Only way I found to reduce suffering was a substance, and it’s a mindset I recognise as being substance abuse. It’s the fact of feeling trapped that makes me choose a substance over other self-soothing activities such as walking and tea and so. As my brain starts to identify everything as a threat, I feel like I can’t cope if I don’t cut the edge of it, that is taking a lorazepam. Obviously doing this several days in a row reduces its effects so prompts you to take more. It’s important to shuffle them otherwise they won’t work well when you really really need them. But I get stuck in a loop of "if I don’t take it then I won’t" make it, and the problem is that it’s sometimes true. Or I’d suffer instead of just cruising.

Now that my other drug finally came back after a festival of problems, I hope to reduce the lorazepam. Gradually.

Medications are a weird cocktail. Perhaps it would be worth considering the question with a psychiatrist and find a more adequate combination that works for you in the day to day and also knowing how to modulate when you overflow.

Would it be possible to refer you to a psychiatrist? It is good to have a GP but they will have an approach that is first-line and trying to maintain it. For what you’re saying this hasn’t been really sufficient given the complexity of your problems.

What I find as well is that doing group activities that don’t require a lot of computing power such as walking together and go for a picnic really are excellent antidepressants. As well as getting pissed at someone lol.

Hold on you’ll get out of this. Take care. Try to replace the reflex of taking it with something that helps you in another way.
 

barefoot

Sponsor
this sounds like her keeping within her professional purview: she's a GP, and happy to prescribe valium intermittently, but if there's a bigger mental health issue requiring management, she's not willing to step into that role..?
Well, yeah…I think the issue is in the limit GPs are prepared to prescribe. I feel luck that GP ‘trusts’ in terms of how I use it to prescribe me 28 tablets at a time. They usually only want to give 7 tops as they all seem terrified of getting patients addicted. Which I get…it’s a potentially addictive drug and no one needs a benzo addiction to deal with because a GP hasn’t been cautious on that front!

She would have happily prescribed some antidepressants if I’d wanted them, and that never sits well with me how quickly and easily GPs willl dish those out. They may not be an addictive substance like diazepam but I’ve known a number of people who stay on them for years/forever because they’ve become psychologically dependent and don’t believe they can cope with life without them. My sister was put on antidepressants after my mum died three years ago - she has never had a review conversation with the GP since then, she just keeps taking the pills.

I’m not knocking antidepressants/long term use per se at all. I just find it baffling how GPs can dish them out like sweets - seemingly just because ‘they’re not addictive’.

Going for a walk each day is more effective than any antidepressant on the market

I wasn’t meaning they weren’t solid suggestions. I just mean that, after years of my working on managing my mental health, it seemed pretty basic input to suggest colouring or a walk because I already know what tends to help or not…but, at the moment, not a whole lot is helping. Which is why I’ve taken a few more valium than usual, which is why I’m having the conversation with her.

But, I suppose, I’d declined the antidepressant option she suggested, so there probably wasn’t really anything else she could do except reiterate some of these basics.

. I think that Dramamine works better than Xanax for me. Look into trileptal or lamictal.

Haven’t heard of these so will look them up, thanks.

, I don't use the "big guns" unless anxiety is keeping me awake and I've tried all other methods.

Same here.
I do the sleep routine, warm /shower or bath, no computer/phone/games/TV for 2 hrs before bedtime......and I won't take the Lorazapam until I've tried the "non-medication ways"

Yep, have spent years on sleep hygiene and trying to manage sleep better as have had parasomnias since I was a teen. So, I have a lot of stuff I do/don’t do to help create more restful sleep. But, again, they are not working so well at the moment or a couple of things that sometimes help (eg breathing exercises) I can’t tolerate at the moment.

I’m not just reaching for pills.

‘it is easy to get a prescription for hydroxyzine (antihistimine) for sleep’

I forgot about asking about an antihistamine. Drat!

I don't want Benzo's to become "important" and have to be counting the pills and stressing over the issue you have at hand,

Well, I don’t usually have to because, as I mentioned before, a prescription of 28 tablets tends to last me 6-8 months no problem.

but really does help when there is a death or you've had to deal with your dysfunctional family.

But yes ^^^ Things are really hard at the moment. So I am still taking them in the same way (when other things have failed and I need help to regulate) but there are many more spikes at the moment.

Anyway, I did a count and have taken 13 tablets in 6 weeks. So, if I carry on at this rate, I will be able to get one more prescription in the six month window, and that will be ok. Hopefully, I will not be continuing at this rate and will take fewer as things settle. Though I am mindful that I have two funerals and a medical procedure coming up…

I have used 1/2 a Lorazapam and found that combined with Aleve

Not sure what Aleve is. I’ll look it up.

Only way I found to reduce suffering was a substance, and it’s a mindset I recognise as being substance abuse. It’s the fact of feeling trapped that makes me choose a substance over other self-soothing activities such as walking and tea and so.

The thing is though, at night, I think there are fewer options. Some of my helpful things are going for a walk, colouring, watching cartoons… which is fine in the daytime, but not so practical at night. If I’m laying awake, completely wired, racing thoughts, feeling terrible at 3am, I’m not going to go for a walk or go downstairs and get my felt tip pens out. I can do a couple of mental counting exercises or whatever, which sometimes helps. But, if I’ve been laying awake and wired for hours and cannot feel calm, and am in a state, taking a tablet that will probably mean I’m asleep in 30-60 mins sounds like a good option to me! (Of course, not if I was doing it every night!)

Obviously doing this several days in a row reduces its effects so prompts you to take more. It’s important to shuffle them otherwise they won’t work well when you really really need them.

Yeah, I’m not taking them every day. So, I’ve never reached a point that they’re not effective. Is this what’s happened to you? It’s tough to lose another medication and have to juggle other things to compensate.

Now that my other drug finally came back after a festival of problems, I hope to reduce the lorazepam.

Glad you now have the other one and I hope that reducing the lorazepam goes smoothly.

Perhaps it would be worth considering the question with a psychiatrist and find a more adequate combination that works for you in the day to day and also knowing how to modulate when you overflow.

I’ve never seen a psychiatrist and don’t feel it’s what I need. I don’t generally need anything day to day…there’s just been a lot to deal with lately.

What I find as well is that doing group activities that don’t require a lot of computing power such as walking together and go for a picnic really are excellent antidepressants.

Ah, group stuff is the last thing I want to do when I’m not in a great place. A key sign for me when I’m not good is that I don’t want to be near people. My partner has the week off work this coming week, so that will be nice and we’re planning on getting out and about a bit. But the week also involves a (highly likely) stressful family visit!
Hold on you’ll get out of this. Take care.
Thank you!

Try to replace the reflex of taking it with something that helps you in another way.

It’s really not a reflex thing. I’ve taken 13 tablets in 6 weeks, during which time I’ve had an invasive medical procedure, the anniversary of my mum’s passing, two sudden and unexpected bereavements, and some challenging family stuff…and I’m on a break free m therapy as we’ve had a rupture and I can’t really afford it financially at the moment. So, in the circumstances, I don’t feel like I’m over-using them?
 
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