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Low Dose Xanax
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Low Dose Xanax

Is it possible to be come addicted to a low dose of Xanax? I take half of a 0.25 mg. pill in the morning and the other half in the evening, It is most helpful but I worry that I will need increasing doses as time goes by, or that I will suffer withdrawal if I quit. Does anyone have information on this subject?
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1696489_tn?1370825574
Xanax is a benzodiazepine, and all benzos cause dependence in people who don't even abuse them.  NOTE: addiction is possible and would be defined as taking more than the amount prescribed.  Sometimes an increased dosage is medically warranted, sometimes not... I have been on the same dosage of a benzo for four years.  And I know that if I ever want to come off it, I will needto be tapered off under a doctor's care, because of dependence, not addiction.  I hope this is helpful.  Blessings - Blu
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5347058_tn?1381192026
Hi and welcome! Using any amount of Xanax on a daily basis, no matter how small , will create a dependence. You will need more and more to achieve the same effect. Xanax and other Benzos are notorious for having horrible, and sometimes dangerous withdrawl (withdrawal) symptoms. I think that you should talk with your dr about all of this. It will be a matter of weighing risk vs. benefit. You are currently taking a very low dose, and I think that if it's helping you, and you need it, you probably should continue taking it. Take care. Good luck to you!
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480448_tn?1403547723
Hey there!  Haven't seen you around lately!  How have you been?

Like ariley said, even at low doses, if you're taking it every day regularly, then eventually dependence and tolerance will become an issue, yes.  Also, Xanax is short acting, which makes it a better med to be taken on an "as needed" basis.  When taken regularly, you will experience a lot more ups and downs, because it kicks in, then peters out fast.  As your tolerance builds, you will notice an increase in anxiety, and a decarese in the efficacy of the Xanax..

I personally think that if someone NEEDS an anti-anxiety med every day, then a long acting med, like Klonopin is the way to go.  There are still the same concerns with dependency and tolerance, but not nearly as bad as with the shorter acting benzos.  There are definitely options.

My opinion is the BEST way to utilize a benzo in anxiety treatment is an "as needed" med, to be taken here and there when anxiety is very high.  When taken like that, dependency and tolerance are never an issue.  I've been on a PRN dose of Ativan for 23 years, with really no issues, because I only take it when I need it.

How long have you been taking the Xanax regularly?  I would recommend discussing these concerns with your prescribing doctor.  You may be wise to switch to a PRN ("as needed") regimen, before you're faced with the tolerance and dependency issues.

I'm assuming you're not abusing your script or anything right?  If not, maybe we should see about getting this moved to the Anxiety forum?  That just may be a slightly better place for your thread.

Glad to see you posting!  :0)
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1696489_tn?1370825574
Xanax is a benzodiazepine, and all benzos cause dependence in people who don't even abuse them.  NOTE: addiction is possible and would be defined as taking more than the amount prescribed.  Sometimes an increased dosage is medically warranted, sometimes not... I have been on the same dosage of a benzo for four years.  And I know that if I ever want to come off it, I will needto be tapered off under a doctor's care, because of dependence, not addiction.  I hope this is helpful.  Blessings - Blu
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757137_tn?1347200053
For the record, I am under a doctor's care and do not have an addictive personality. Quite the reverse actually as I don't like having to take any of this stuff. I had been taking Xanax on as an as needed basis for about two years to abort panic attacks caused by high cortisol (resulting from the use of prednisone and inhaled steroids for COPD). I was prescribed 0.25 mg and was told to take a second one if the first was inadequate. The low dosage worked so I tried taking only half a pill. Usually that worked just as well. I had no side effects from using the drug.

Then I had a serious accident which put me in hospital and rehab for almost two months. During that period I was doped up with all sorts of drugs of which I have little memory. Coming out of rehab I continued to use Xanax but my need for it increased because of an increase in episodes. Now as well as the panic attacks I seem to be plagued by a more or less constant anxiety. For this reason my doctor put me on this low maintenance dose a couple of weeks ago. He is aware of my fear of addiction and says that at the first hint he will switch me to Ativan. Wouldn't there be a cross dependence since both drugs are closely related?
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480448_tn?1403547723
Yes, there would absolutely be a cross tolerance/dependency issue.  You may not have issues right away, but it wouldn't take long after being switched.

The thing is, there ARE times in our lives, if we're prone to anxiety, when we need more of our anti-anxiety med.  It sounds like you're dealing with the stress of coming out of the rehab and having been all kinds of other meds (which ones, btw...they may be causing the anxiety).  If you NEED the Xanax and it's helping you, and you're not yet dealing with tolerance issues, where you feel the same dose isn't as effective, then just be prepared to taper back down to a lower or prn dose after a period of time, and for now, take it as you need it, as prescribed.  

In the meantime, it would be helpful to determine what's causing the increase in anxiety if you can.  I think it may be these other meds you're talking about.  Were you on any strong pain killers?  Sleep meds?  Those kinds of meds can cause their own issues when coming off, even if you haven't yet become dependent on them.

It sounds like it's only been a few weeks, so I wouldn't get too overly concerned right now.  Maybe try skipping the second dose, just to see how you do, and monitor your anxiety.

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757137_tn?1347200053
The odd thing is that my anxiety increased last night, whereas it shouldn't have since I am taking Xanax twice a day (only .0125 mg each time) as directed. And right now I can feel the onset of anxiety (some hours before my next dose is due). It was suggested to me (not by a doctor) that I was having  rebound effects. I am getting very upset. My last panic attack was the worst I have ever had and tremendously overwhelming.
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480448_tn?1403547723
I agree with the rebound theory.  Let me try to explain it.  It's actually a simple concept, but hard to explain.

The rebound effect can be attributed to the onset of action, and duration of the med.  Its onset of action is very fast, but it doesn't stay in the system long, it peters out quick.  So, when a person doses more than once a day regularly, it's not unusual to start experiencing an increase in anxiety, due to the ups and downs.  It's just not "built" to be the kind of med taken regularly for this reason.  

By the time you get to the 2nd daily dose, your anxiety is higher than normal, because you've gone for that period of time during the day after the first dose wore off, with no benefit of the med.  As tolerance also builds, the med will pack less and less of a "punch", making it even harder to get to that 2nd dose because each dose is far less effective.  That's when some people decide to add a dose in the middle (BAD idea), which of course helps temporarily, only to be worse off yet again in a few days.  A fast acting "rescue" med just isn't optimal for daily use.  Not when it has such a short duration.

Now, Klonopin is a longer acting benzo that builds in the system, to avoid that rollercoaster effect.  If you feel you're going to need an anti-anxiety med on a more regular basis and not just as needed, then Klonopin is the way to go, IMO.  It has less of a tolerance issue as well, where dosage increases are needed much less frequently compared to the shorter acting benzos.  It's something you may want to talk to your doc about.  

The fact that you're on such a low dose IS a good thing...it will give you more options on where to go from here.

Sorry you're going through this....I know it stinks.  :0(  Keep in touch, let us know how you're doing.  When do you see your doc again hon?  You may want to make an appt, get this figured out.
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757137_tn?1347200053
I have decided to try to wean myself off Xanax. Then I will go back to using it on an as needed basis. This dependence thing is too confusing and confining. Hope anxiety doesn't intervene to make getting off the stuff impossible. But I am employing a Chinese treatment (related to acupressure) to relieve the anxiety.  My fingers are crossed. Drugs can be wonderful, but I hate them.
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480448_tn?1403547723
Please just be careful.  You're on a VERY low dose, which should hopefully make the process a bit easier for you, but still make sure the taper is slow and gradual.  Turn to your doc for guidance, okay?  And, if the anxiety becomes too much, talk to your doctor as well, you may have to look at some other options.


Drugs can be wonderful, but I hate them. .

I think a lot of people feel that way.  It's a shame the meds that seem to help the most come with the most issues.  Sure seems like it!

Hope it goes very smoothly for you, post updates when you can, okay?  I'm thinking of you!
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757137_tn?1347200053
Thanks for your concern. Actually i don't need a doctor's help to taper off this stuff. My father was a compounding pharmacist and I grew up understanding addiction. Oddly enough, although I am sensitive to Xanax, I was not vulnerable to the pain killers I was taking. For instance, after many weeks of using Percoset. I got off it almost cold turkey. No withdrawal at all. My anxiety problems appear not to be related to drugs, but to irresponsible hospital care following the accident.
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757137_tn?1347200053
Thank you for clarifying the use of the word "dependence" as related to drugs. I was out of the country for a great many years and, before I left, both dependence and addiction were called "addiction" The use of the world "dependence" has therefore confused me.
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757137_tn?1347200053
You asked me to keep in touch. Good idea. I am trying a new way to start a taper. For starters, instead of lowering the dose, every few days I am increasing the number of hours between doses by one.There may not be any special virtue in the system, but it keeps me from getting bored.
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Is a Dr. helping you with this taper?  How many are you taking now?
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480448_tn?1403547723
I'm glad you're keeping us in the loop.

To be honest, I'm not real sure if your approach is adviseable, as I've only ever known a taper to include a gradual drop down of dose (maybe along with a decrease in frequency after the taper is well underway), so just be careful.  I personally would recommend a typical dosage reduction taper, as it seems there would be better control.  I could be wrong.

I would feel better if I knew you at least had some guidance...from a doc or pharmacist.  If your method is okay...I would imagine the biggest consideration would be to take your time adding the hours, give yourself a break in between adjustments, don't decrease every day, allow your body to readjust a little.

Hang in there.
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757137_tn?1347200053
Thank you for your concern. At present, every 13 hours I take 0.125 mg. That is getting close to nothing. In a couple of weeks I will be off Xanax altogether as a maintenance drug and, after a short delay, can go back to "as needed."
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757137_tn?1347200053
By lengthening the interval and reducing the dosage I got off Xanax about a week ago. I am now where I want to be - on an as needed basis again. You were concerned that I was doing this on my own, but I probably had not mentioned that my father was a compounding pharmacist and I have understood addiction since childhood - just from conversations in the household. In any case the dosage I was on was very very small. I just don't like to be on a pill regimen.
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480448_tn?1403547723
Sounds wonderful!  So happy you got yourself back to a PRN regimen.  Thanks for the update!
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