Brief Answer:
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Detailed Answer:
Hi and Welcome to "Ask A Doctor" service.I have read your question and here is my advice.
I am reall sorry to hear of the trouble you have been through .I understand your situation very well and I know how difficult is to combat generalized anxiety disorder. However we need to manage the disease very cleverly and not to depend on drugs wholly solly.
Rivotril and all benzodiazipines are very effective in control of symptoms of anxiety and for temporary relief.However these drugs do not cure the disease and itself may cause problems by developing dependence and addiction.For the same reason we generally avoid use of benzodiazipines for long time. Then how to treat GAD?
The treatment is tricky and may be prolonged and is not an easy one. This includes phycotherpay, which is important part .Drugs include SSRI like fluxatine or ecitalopram are very effective in management of GAD and are prescribed for such patients .Many people are given these drugs .These may be used long term if needed.and yes few people may need it for years and possibly life long if needed.They are effective aaand may bring colors of life back.

Regarding your proplem first we need to get rid of rivotril .This is done by tapering it very slowly like reducing by tenth every two to four weeks .This may take few months. Stopping it abruptly is always disappointing. Secondly your anxiety may be managed with psychotherapy and SSRI.and would need reassessment periodically.This is not a difficult one and commonly managed by psychiatrist.
So you should not be disappointed and should be hopefull .However the task is a challenging one . this is not done without a psychiatrist to assess you .So I would advise you should see a psychiatrist ,discuss your problem with him should inform him of your concern rather then asking for Rivotril ,he may prescribe you the benzodiazipines but not for ever rather to tapper to get rid of it .He would also be managing your anxiety as well And I hope you would be feeling quite well in little time.i am very hopeful for you .



Hopes this answer help you understand your query. Let me know if you have any further questions about it. I would be glad to answer any further questions.
Regards, Dr Mahboob ur Rahman,

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Brief Answer:
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Detailed Answer:
Yes, you are right,
I am sorry could not go through your past medical history.

In fact here now we need to to go with some out of box idea. Generally, we don't advise to take benzodiazepines for long but you are right one size don't fit all. If other drugs don't work for you, and you are fine with clonazepam this may be an idea to continue with the same.

I personally would like to Continue with it with all cares needed. Medicines used to improve quality of life. We need to see the benefits and risk. If the benefit is more for you we may opt to take the risk of continuing it. So this may be an idea you can discuss with your doctor.

You may use the other drugs and try to minimize the dose needed of clonazepam. This is to very slowly reduce the dose like reducing it every two weeks. Reduce the dose to a level where you feel bad, you should stop there for a few weeks and then give another try to reduce it more slowly. Where ever you feel unwell go back to the dose that helps you keep reasonably good.

So the idea is to continue other things like SSRI and psychotherapy and Continue with a minimal possible dose of clonazepam.

Good luck
Please feel free to ask more questions.

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Brief Answer:
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Detailed Answer:
Hi.
I understand your worries and yes I know that you have not been given benzodiazipines, but what I understand that if it works this well for you, we may think of prescribing this to you. This is the point what I want you to openly discuss with your doctor. However this always be prescribe only if its Benefits over weigh its risk. What I understand is that you can raise this point with your doctor in details about your quality of life without being treated.
I am sorry to hear that you were not satisfied with your doctor, he might be thinking in your better interest, however if you are not happy with one you can always ask to take another's opinion and can show him your concern. I understand you must be frustrated with this disease (it can be frustrating many times) but giving up is not the best answer. We need to continue the fight.
Let me know if you have more questions about it.
Regards Dr XXXXXXX

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