Small success/Why didn't the Triazolam work?

[Shoe Lover]

So the good news...I visited an awesome dentist who is a phobic specialist. He has a beautiful office, and his staff seems well quipped for people who have trouble even setting foot in the door. I met with the dentist briefly on Saturday; since I was an anxious wreck over just talking, he prescribed a benzodiazepine called Triazolam (AKA Halcion) for today, when we did X rays and an oral exam. (ew)

So...took said miracle pill...and NOTHING HAPPENED. I still had nasty panic attack while my fiance drove me there, struggled to get out of the car, assorted hysterics etc. I made it through the X rays and a quick exam but felt like I was on the verge of jumping out of my skin. On one hand, I was proud of myself for sticking it out, despite hysterics, but I want to know why the tablet didn't work.

I am a 25 year old female, I weigh 130 pounds, I have never had a drug/smoking/alcohol addiction; actually, I'm more of a 2-drinks-and I'm tipsy kind of a girl. I don't take any regular meds at all, and normally, even something like cough syrup knocks me out.

Does anyone know why I felt absolutely no effect from .25 mg of this?? I have an appointment for a cleaning in a month...I'm already terrified...what can I do?

 

[swansong]

Hi Shoe Lover, I don't think I can actually help you since I seem to be in exactly the same place you are - halcion not being very effective, panic attacks in the car, hysterics etc etc - I just wanted you to know that what I did to try and increase the effects of the halcion (I had 3 x .25mg before the appt) did not work. Please read my long post to see what not to do. I was at my wits' end and honestly I know exactly how you feel. I only managed to get halfway through my check-up/cleaning and still have a lot to be done (apparently I made them stop) so I'm now looking for an alternative to halcion. I just wanted you to know that you're not on your own with this. I have to say I'm different from you in that I can drink a lot of people under the table and I smoke (a lot more when I'm scared) and I also wish I was 130lbs but I'm not, however my thoughts are with you and I hope you can find an answer to this question from someone more knowledgeable than me. Keep posting, it honestly does help to have somewhere to let out how you feel, whatever time of day or night it may be. There are a lot of people here who do understand how we feel and have been through what we're going through and have somehow come out the other side feeling better, which I know seems impossible but appears to be true.
Good luck!

 

[Dr. Shirley]

Hello Shoe Lover ... betcha got tons of pretty shoes too. fun fun.

as far as the Halcion "not working". the saying.... "mind over matter" Well, it's because the subconscious mind is running the show. and the subconscious mind wants to keep you in the same place (in this case: away from the dentist office ) it will do EVERYTHING in its power to keep you away from there. ie... the crying, the kicking and screaming, the panic, the hysterics. the subconscious mind remembers bad past experience whether it was from a day ago or 20 years ago... the subconscious mind remembers. no matter how many times people tell you that going to the dental office is now TONS better, which it is... the bottom line is that when you are aware that you are going to the dental office and the subconscious mind feels threatened, it kicks your adult conscious intellectual mind out the door and takes over, and sends you into hysterics and is so strong that it can make a dose of medication seem like nothing.

I've found that when the appt is over with some patients, that is when the subconscious mind now realized 'it is safe now' it settles down... and then you are sleeping like a baby.... because NOW the medication can actually work on a body that is not in high panic mode.

a higher dosage of medications will help to suppress the symptoms the subconscious mind wants to kick up. but in essence, I believe that being able to slowly take baby steps in peeling the onion to the core causes of dental phobia will be the best way to feel at peace when going to the dental office as well as a feeling of confidence for being able to walk through the fears and reach the 'other side'. That is where the feeling of "wow, I DID it!!!!" comes in. it's euphoria... to KNOW in your core that you took the steps to do it. And you've already taken the biggest step, making and getting to the first appointment. YAY! to that.

We are here by your side. Please keep us updated as to your progress. We'd like to help you along the way as much as we can.

Best wishes,
Dr. Shirley

 

[Sweet Sue]

I don't agree with this "mind over matter" at all. I have taken triazolam a few times over the past 20 years and it worked great. Then recently I took it for 2 different dental visits, and it did not work the same. I was much less anxious, but I was aware of everything and remembered it later. I am looking for answers on why it quit working for me.

 

[Neurospicy]

I haven't tried triazolam, but as someone who's had paradoxical responses to a few drugs, some people do get this. It seems common with ADHD and EDS, both of which I have. I was warned amitriptylene would make me sleepy and hungry, it gave me insomnia and suppressed my appetite. I was put on clonazepam for a parasomnia, and after a week I became agitated with suicidal ideation. Bizarrely, I'm fine with diazepam and temazepam, so I'm really hoping I'll be OK with midazolam.

There's research on paradoxical responses, I remember one case study about a patient in ICU who kept getting more agitated, because they didn't realise it was the midazolam so they kept giving him more of it.

With ADHD, the well known one is that stimulants calm us down, and many people self-medicate with caffeine. I've also encountered people who find that if they're kept up late at night with Restless Leg Syndrome, which like ADHD is about dopamine, then a good strong pot of coffee will get them back to sleep!

I'm not saying the mind over matter thing can't happen, but there are definitely patients who get paradoxical reactions. Some of us are patients who consistently get odd reactions to medications, and are very sick of being disbelieved. People with EDS typically find that local anaesthetic doesn't work, or takes multiple shots to work, and if a dentist disbelieves this, the results can be traumatic.