Tranquilisers and flushing

[lisa]

Hi Dr Nase,

When I'm very stressed (i.e. this generally means an appointment with a doctor!!), or I really can't sleep - I take a quartre lexitan (Tranquiliser). I find then that I don't flush. Does this tell you anything about the cause of my flushing? Obviously I can't live on tranquilisers so I take them v. seldom. But maybe it also gives you some ideal about how to prevent flushing.

Any assistance appreciated.

thanks, Lisa

[drnase]

Lisa,

Excellent observation.

I dont give this advice out lightly as this is a very important subject regarding medications that must be taken very seriously and monitored by a physician.

Tranquilizers or benzodiazepams (clonazepam) used for special occasions are the single best anti-flushing medication that is known to date. But, only used sparingly -- some just use one tab or two tabs on the weekends to give them back a semblance of a life for 48 to 72 hours. People can do amazing things (that normal non rosaceans take for granted) while on clonazepam because of its specific actions on the dilator nerves in the hypothalamus and its reduction in dilator hormone output and cortisol production. This is the reason why it works, but it should not be used everyday or tolerance will build up and you may experience a rebound affect.

If someone is at the end of their ropes it is worth discussing with your doctor the risk/benefit ratio of clonazepam and just tell the doctor that you want your weekends back (e.g. a script for 8 tablets per month so you cant overdo it). With the long half life of clonazepam many get amazing relief from rosacea, flushing and burning sensations on Saturday, Sunday and half of Monday with just two 0.5 mg pills (or for males 1.0 mgs on Saturday and 1.0 mgs on Sunday)..

Once again this is a serious subject that should only be addressed by your physician. I did quote one expert in my book who recommended this approach if it helps sway the mind of your physician. But, it is physically impossible to become addicted or experience withdrawals by taking clonazepam two days in a row and then five days offf. Best of luck.

[lisa]

Thanks, Dr Nase. What about SSRIs then with anxiolytic properties? Would they have the same effect?

[drnase]

Lisa,

They have some effect but only about one-tenth the effect because they work on different parts of the brain. It is definitely worth trying because these are made for daily use. What brand were you refering to?

[lisa]

Not sure. Don't really know the different brands. But a mild one. As I'm also currently quite depressed - it should help with that as well.

[drnase]

Lisa,

You are in great company here. I really dont know anyone who is not depressed by chronic life altering disorders. IN FACT, IF YOU WERE NOT, THEN YOUR AMYGDALA (PART OF THE BRAIN THAT MIMIICKS YOUR ANATOMICAL 'SOUL') WOULD NOT BE WORKING CORRECTLY.

[drnase]

Lisa,

Try to find out the brand name.

[drnase]

Lisa again,

The newer dual serotonin and Norepinephrine antidepressants are generally better for rosacea sufferers.

[lisa]

Thank-you. I'm going to ask the doctor about them.

[Bob Bear]

Dr Nase

Could you please give me some advice on getting a prescription for Clonazepam?

It seems that every GP in the UK closes up the second i mention benzo's. The ones who are actually prepared to hear me out still wont prescribe me because of the addictive side effects.

I can see their point to an extent:

Since my IPL I look pretty normal most of the time. Im young and fairly 'fresh faced' most of the time. So when I walk into the surgery I think they get this impression Im 'just some kind with a blushing problem'. The one Dr i saw who was up for working with me said he couldnt justify prescribing anything more than a beta blocker.

Im really at a loss. I would love to try this drug cuz I feel I need that, as you say, magic bullet of safety. I may appear young and naive, but I know Im responsible enough to use such a med safely and effectively. I cant help but feel that Im gonna have to wait until Im 40 with a tomato for a head before anyone is going to take me seriously! I feel like screaming "Dude Iv had half my face scorched with lasers, the other half pickled with botox... Im seriously about this!".

btw, I took your book in and a few quotes. The Dr congratulated me on bringing a good case to the table... but still no script.

[drnase]

Bob,

I dont kow the practices in the UK, but in the US if you go into most doctors and say you have a neurovascular disorder that is kept under control by intermittent use of clonazepam and just tell him you need a script for 8 one mg pills per month to use as needed or every weekend, there is rarely a problem because it is impossible to get addicted with this few pills and the drug holidays during the week. 8 pill is nothing and you have to emphasize that number. What they are scared of is 30 pills per month with refills because it is human nature to use something more if it works.

[drnase]

Bob,

I do know of a half dozen UK rosacea sufferers on this board who have successfully received scripts for this. I obviously wont give out their names, but hopefully they will contact you and tell them their approach.

[Bob Bear]

Thanks Dr Nase,

I must admit I feel like this is getting to be an up hill struggle. I assumed that Dr's would be the ones trying to help me, not the ones standing in the way!

Crazy thing is, I dont even plan on taking 8 pill a month. I just want this there for one off occassions. I may only use 8 pill a year!

Anyway, I will stay positive and try again. I got reffered to derm last year, so maybe if i go armed to the teath he might let me try this stuff out.

Thanks again

BB

[Max]

Could you please give me some advice on getting a prescription for Clonazepam?

you could get a prescription for Clonazepam even from a GP. i've had good experiences with them. in general they do a much better job in listening and taking care then most derms.

so if you know one you can trust i'd take the chance to ask him.

good luck...

[Bob Bear]

Yeh I got refused by my GP. He seemed to be completely closed to anything i mentioned, even with quotes to backup my claims.

Not to worry though, my IPL Dr may be able to help. I learnt that he had prescribed this drug to former patients, so i shall ask at my next session.

Thanks!

[tobanonymous]

Can Klonopin cause hair loss?

[arcticlobo]

Would this type of drug help reduce all flushing triggers, or only certain ones? It would be great if I could take this once a week or so, just to give me a day where I can have some sort of my regular life back.

Has anybody had any experience with these types of drugs, and what have the results been?

[Steve95301]

Would this type of drug help reduce all flushing triggers, or only certain ones? It would be great if I could take this once a week or so, just to give me a day where I can have some sort of my regular life back.

Has anybody had any experience with these types of drugs, and what have the results been?

Benzos are great for anxiety and stopping the blushing/flushing positive-feedback loop. Physical triggers (heat, foods, harsh cleansers, etc.) will probably still make you red though. But at least you won't care! :D

The hypnotic effects of the drug (sleepiness) usually disappear after a week of using the drug. However, occasional users never use it for that long and therefore don't build up that tolerance. In other words, you may feel very sleepy, or loosy-goosey like you took a muscle relaxant. With the correct dose, though, you should be able to avoid this.

You may experience "emotional blunting", where you have neither highs nor lows. Benzos also interfere with memory formation.

(Though not as thoroughly as scopolamine, (http://www.rense.com/general38/frug.htm) which completely prevents memory formation; interesting article :)).

See this site for more info: http://www.benzo.org.uk/

[drnase]

Yeh I got refused by my GP. He seemed to be completely closed to anything i mentioned, even with quotes to backup my claims.

Not to worry though, my IPL Dr may be able to help. I learnt that he had prescribed this drug to former patients, so i shall ask at my next session.

Thanks!



Bob,

If its the doc Im thinking of he will listen to you very attentively. I think he still has my email address, but if not, tell him to email me if he wants to update me on his protocols and talk about you -- you'd have to sign over your rights though so he could discuss certain parts of your treatment such as what you are seeking now. drnase1000@hotmail.com

It always feels good to know you have a magic bullet in your pocket for a special day or weekends off, and this my friend is one of the best.

[arcticlobo]

Would a muscle relaxer such as cyclobenzaprine have the same or similar effect an Clonazepam? My ENT told me to take 5 mg at night for TMJ. Perhaps that could explain my clear face in the morning? Or my IPL treatments are working...

[Bob Bear]

Cheers Geoffrey, appreciate it.

I actually posted that quite a while ago, but I still intend to see my rosacea doc about this. My regular GP's wont have any of it, but I hear Dr P uses this now and again.

You are so right on the benefits of the 'magic bullet'. To get that short break means the world. I'll give the good doc an email soon to discuss this (and will pass on your message at the same time).

Thanks

BB

PS. You should have a chat about preflushing. I think he is still using niacin or alcohol.