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Drastic reduction in Xanax prescription
by danae, Feb 20, 2003 12:00AM
I am writing this email with great anxiety. Since 1994, I have been suffering from depression, agoraphobia, simple phobias, and anxiety disorder. I do not drink alcoholic beverages, nor do I take "leisure" drugs. I was taking 100mg/day Zoloft and 2mg/day Xanax (prescribed "take as needed"). My prescription for Xanax began as 1mg a day and is now at 2mg a day, which is all I need. My prescription for Zoloft began at 50mg/day and is now at 100mg. With the help of these drugs, I am often able to leave the house and attend college on a part-time basis even though I often miss classes because I am too anxious to leave the house. I continue to suffer panic attacks on occasion.
I just switched to a new psychiatrist (because the other one left the Center) who refuses to prescribe the 2mg/day that I have been taking for the last eight years. Instead, he wrote a prescription for only .25mg/3x day.
I understand that it may be in my best interest to be taken off this drug, but I thought that this was supposed to be done gradually.
I am more anxious now than ever worrying about withdrawal symptoms, of which I have suffered in the past when I was abruptly taken off Zyprexa. My doctor said that although it is mainly prescribed for schizophrenia, it would help my anxiety, which it did, but I gained 50 pounds in a little more than three months and didn't want to take it anymore.
Why are doctors allowed to do this drastic reduction in a drug well-known for dependency and withdrawals?
What can I, or what should I do?
danae
Florida
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The overwhelming symptom of Xanax WD, ironically, is anxiety and unfocused fear -- just what you started taking it for. I tried to stop Xananx in complete ignorance of the consequences and suffered three seizures as a result. Preceding the seizures were days and days of immobilizing terror. I thought I was going to go insane, then die. I wasn't far wrong.
If you've been taking Xanax daily for that many years, believe me, you're going to get WD symptoms that duplicate your original anxiety disorder, possibly worse.
However, there is a solution -- a surprizingly easy one, at that. Xanax is a fast-acting, short half-life benzo that leaves your body so rapidly you're brain can't adjust. You need to convince your doctor to switch you to one of the slow-acting, long half-life benzos: Valium is best, Klonopin is good enough. Between the two, Valium leaves the body much more slowly than Klonopin. Both are much easier to detox from than Xanax or Ativan. Klonopin has a reputation for causing less euphoria than Valium, so your doc might go for Klonopin over Valium. I'd try for the Valium, though. Cheap as dirt and, compared to Xanax, safe as houses.
The crucial point is that your doc put you on a dose of Valium or Klonopin equal (equimolar) to 2MG Xanax. After you've stabalized on the Valium or Klonopin, you can then start a very gradual taper down to the dosage he'll support. That taper should take a few months, BTW.
I can't believe that an MD would slash an Anxiety Disorder patient's Xanax like that. Believe me, if you reduce your Xanax that way, and then start having intense feelings of fear and anxiety combined with extreme muscle tension and rigidity, it's Xanax WD, nothing less. It's important that you know that now, because benzo WD symptoms are so often manifested as psychological states -- very hard to figure out what's happening to you when you're in the middle of one.
Also, don't go for tapering with Xanax. Many find that all but impossible. You need to swith to Valium or Klonopin, then taper to a dosage your doc will support. I don't care which medical school he went to.
It will help you to go into your doctor with some documentation backing up your request. Go to www.benzo.org.uk, find and print out Dr Heather Ashton's papers on safe benzo reduction and withdrawal. She is the preeminent authority in the world on the subject. It sometimes makes a difference when a doctor sees that his patient has proactively aquired this information and is not making an unreasonable or medically unsound request. Benzo.org.uk is also a great place to talk to other people going through your same ordeal.
On this forum we constantly read about how bad opiate wd is. After 30 years of opiate addiction, I certainly agree. But opiate wd is NOTHING compared to acute benzo withdrawal. The key is to understand that you cannot make sudden changes in dosing when it comes to benzos. The slower, the better. Write me if you have any questions or can't find the Ashton info (it's all over the web). I'm at ***@****
The risk of seizure from acute benzo withdrawal, especially from Xanax or Ativan, BTW is generally higher if one goes cold turkey off of a very high dosage. Your Xanax dosage is not that high and you're not going cold turkey. It's just that you've been on it for so long. Be careful.
Thomas
Meanwhile, I do have about a 10-day supply left of 2mg (=20 1mg). I will hold off on filling the .25 3x/day prescription.
I will get on the phone and try to find another psychiatrist - not an easy task since I am limited by my HMO and the location of any new doctors since I cannot drive far from home at all.
It's going to sound embarrassing on the phone, but I guess I'll have to ask the doctor how he/she feels towards maintaining my usual 2mg prescription of Xanax and s-lo-w-l-y reducing the dosage if that's what he/she decides to do...before he/she even meets me -- if I can get past the receptionist.
What upsets me the most, is to be at the age of 40 whereas nothing has helped me function without fear. Obviously, I haven't found the right psychiatric help yet, and I think I've been relying too much on professional treatment plans. I've done more on my own to get better, mostly by reading self-help books and changing my life-style (to surround myself with more peace is a priority), but have not found any set of tools that I can rely on to rid myself of anxiety. I don't plan on giving up, but it's times like these that cause me setbacks - a new set of anxious thoughts to dwell on. I've been attending college for three years and still suffer anticipatory anxiety on the days I have to get in my car and spend a few hours on campus...so much for repeated exposure.
Xanax should never have been manufactured if it was going to be used to treat, then create anxiety, by doctors that want to put an end to its usage. It has been the only drug that has helped stop my panic attacks and debilitating self-defeating thoughts or reactions to anxiety provoking stimuli. It helps me to walk out my front door. When doctors accept new patients, they owe it to the patient to reveal their personal beliefs upfront before the patient has to wait three or four weeks to find out the hard way - on the very first visit.
Again, thank you for answering my question. I deeply appreciate it.
danae
The site that you posted ( www.benzo.org.uk ) is very informative -- thanks from all of us. Do you (or anyone else) know where I could find a similar site for opiates? Thanks in advance. Peace to all.
pepsi4: You would think there'd be an opiate site like benzo.org. I haven't found anything quite like that. It may be because opiate dependence is well known, whereas the pharmaceutical giants have been fairly successful in suppressing the truth about benzos. Most opiate-related sites are like user sites such as med help or informational sites such as www.opioids.com or www.erowid.org. But check these two sites out. Both make for interesting reading.
Thomas