Benzos seem to have stopped working for me...

[Routine]

... at least as far as dental procedures go (since the psychiatrist said it's ok to take them for other highly stressful situations and I have problems with anxiety overall).

When I was prescribed it a few years ago, it worked quite well, I didn't feel the all-encompassing panic that I usually do. But now, I take the pills, 20mg as always, when they kick in I get that nice, relaxed and drowsy feeling, but when I sit down in the dentist's chair and she's about to inject the anesthetic, all that goes away and I start feeling fully-blown panic again.

Why does this happen? If the pills only make me relaxed when I'm not feeling scared it kinda defeats their purpose. Should I just start taking a higher dose? Technically the prescription says it's okay to take up to 80mg (though I wouldn't try that much) and the most I ever took was 40mg, but I don't remember how much of a difference it made, since it was a while ago.

I wasn't expecting to build much of a tolerance, since even between the dentist and my anxiety problem I take benzos at most once a week. Just for information's sake, I also tried clorazepam, but it had almost no effect compared to temazepam.

I'm worried, because I'll have to see the dentist soon for the first time in months. It's only for a filling, because one fell out, the tooth doesn't even hurt, but I'm still scared. My phobia has been at its worst since a pretty bad extraction last year, sadly.

 

[comfortdentist]

The right dentist is more important than the right pill

 

[vicki]

From reading the many stories on this forum over the years and also my own experiences with taking Diazepam this year, it would seem that benzos work differently for different people in different situations, so it's not an exact science. A dose that works perfectly for one person, might not have any effect on another and that's before you consider the level of anxiety that you're experiencing before and during your appointment.

Earlier this year, my dentist referred me to an endodontist to have a previous root canal re-treated plus a new root canal on another tooth. Normally, I just take beta blockers for dental appointments; they don't affect how you feel, but they do control the physical symptoms of anxiety such as shaking and a fast heart rate. But knowing what root canal treatment involves and because of past experiences, I decided to visit my doctor to see if he would prescribe some benzos so that I didn't get into so much of a panic. My doctor prescribed Diazepam and gave me some 2mg tablets, with instructions to take 1 or 2 tablets and that if I needed a higher dose, I had to go back and see him. I had about 5 or 6 weeks until the first root canal appointment was booked, so I did a 'test run' with a single 2mg tablet and it had no effect whatsoever. Unfortunately I started having severe pain in one of my other teeth during this time, so my dentist decided the best course of action was to place a dressing in preparation for another root canal (so a total of 3 root canals for the endodontist to do !).

I booked an appointment with my dentist for the following day and about an hour before my appointment time, I took 4mg Diazepam. By the time I was sat in the waiting room, I felt no different, so I decided to take another 2mg tablet (6mg in total). About 20 minutes later, I started to experience a warm, fuzzy feeling and was actually not all that bothered about the treatment that was to come. So far so good. The appointment went like a dream... Life was wonderful, my dentist was wonderful , everything was wonderful. Sorted. All I had to do was take 6mg for the root canal appointments and all would be well (or so I thought).

About an hour before my first root canal appointment with the endodontist, I took 6mg in one dose and set off for my appointment (my mum took me to the appointments since I didn't think I would be in any fit state to drive). As we were sat in the waiting room, I was waiting for the fuzzy, nice, warm feeling to start... and it didn't. The nerves really started to kick in and when the dentist came to meet me in the waiting room (and even though I'd already met him for an initial consultation a few weeks' before, so I knew that he was really nice), the panic set in. After the injections, I started shaking really badly and my skin went blotchy because I was having such an adrenaline rush and was in a real panic. I was that bad, that the dentist thought I was having some sort of allergic reaction and was getting ready to administer the emergency drugs until I managed to convince him that it was all symptoms of panic. So much for 6mg Diazepam .

Before my next appointment, I decided to look up Diazepam on the internet and see what dose is given to people to make them relaxed before surgery and the information on the internet (and also on the leaflet that came with my tablets), said between 10 and 20mg. So after going back to the doctors and getting some 5mg tablets, I took 10mg about an hour before my next appointment and as we were sat in the waiting room, I still didn't feel any different. So I took another 5mg and about 10 minutes later, went into my appointment. I still had exactly the same panic and adrenaline rush that I had at the previous appointment, even though I'd taken a decent dose of Diazepam. It was like I hadn't taken anything and yet it wasn't anything that the dentist had done because he was so nice and probably the nicest dentist I've met.

I realised that the adrenaline rush was probably preventing the Diazepam from working and so I wondered whether taking the beta blockers as well might help. I decided to ask a friend of my mum's as she is a doctor and see whether it would be OK to take the 2 drugs together. She told me that they could be taken together, what dose to take and that I should take some Diazepam and beta blockers the night before and then some more about 90 minutes before my appointment the following morning.

The new drug regime worked a treat; I slept like a baby the night before and the fuzzy "whatever" feeling started to kick in whilst I was on the way there in the car . The only downside was that it made me really dizzy, so I had to have help to get out of the car and also help to walk from the waiting room into the surgery, but it was a small price to pay. Over the next few months, I had 6 root canals over about 18 appointments and pretty much every single one was easy... Life was wonderful... the dentist was wonderful (and very patient!)... root canal treatment was wonderful (can't believe I've said that !). The result is that I've now got a pain free mouth.

So it could be that you maybe need a different dose, a different drug and/or different timing.

However, what comfortdentist said is also true. Even if I had taken an entire packet of Diazepam, it wouldn't have made the slightest bit of difference if the dentist I saw hadn't been as kind, patient and laid back about everything as he was (and he was unbelievably patient and still had a sense of humour even though I got into a real state sometimes !).