My PCP won't refill Xanex- Psychiatrist wants me on Effexor. I need advice!!!!!

[tashanbrad]

Four months ago I started having panic attacks.  My PCP prescribed Xanax for me (.25mg twice daily) and recommended counseling. I have been in therapy since and it is going well.  My panic attacks have minimized and I'm sleeping great and feeling great.  My Psychologist recommended me to see the Psychiatrist on duty at the facility since I was being prescribed Xanax and my insurance might cut my 20 maximum visits per year if I didn't see him.   I made an appt and saw the Psychiatrist.  My appointment lasted 13 minutes and he told me that he wouldn't refill my Xanax prescription since he believed it to be very addictive and wrote me a script for Effexor XR.  In researching this anti-depressant, I've discovered HORRIBLE withdraw symptoms and addiction, not to mention the side effects including insomnia.  I went back to my PCP and told him that I wasn't convinced that I needed an anti-depressant rather an anti-anxiety med and that the Psychiatrist wouldn't refill it.  My PCP told me to go back and see the Psychiatrist since I was now under his care, and my PCP wouldn't refill my script.  I'm terrified at what might happen to me when I begin withdrawing from the Xanex and what might happen if I begin to take Effexor.   I don't understand why I couldn't continue taking what worked for me.  I never took more than recommended and never asked for the script milligrams to be increased.  I feel abandoned by the PCP who has cared for me for 15 years.  I KNOW you aren't supposed to quit Xanex cold turkey.  I have 2 days left of Xanex pills and I'm so frustrated I could cry.  Does anyone have suggestions on what I should do?  Should I follow the Psychiatrists orders and take a med that isn't really what I need?  I don't suffer from depression.  I felt that I was making real progress and now I've just taken three steps back.  Needless to say, a panic attack followed the PCP visit this morning.  Suggestions anyone?

[Brenndy]

Just read an article that for long-term treatment of anxiety, diazepam (Valium) should be the physician's drug of choice when prescribing.  Do you want me to locate the article and send you the URL?  

[leaves14]

I have encountered the same problems.  I have taken effexor and xanax, as well as many other antidepressants.  

It is true that it is not good to be on xanax for extented periods of time as it is addictive.  Drugs such as effexor, cymbalta, prozac, wellbutrin, etc..... are less addictive.

In my case, my doctor prescribed xanax, but only until another less addictive antidepressant/antianxiety had time to build up in my system.  Then at that point, I was given a prescription for a very small amount of xanax, but it was only for "emergencies". Like if I felt an anxiety or panic attack coming on.

Now, I can not find a doctor that will prescribe xanax at all.  However, ask about similiar drugs in the "xanax family" that are slightly less addictive. (I can not think of the names right now).  Even these are usually only taken "as necessary" and are usually prescribed in conjunction with another less addictive medicine.  Xanax works great and quickly, but it is not the best answer for long term, extended relief.

As to your fear about taking an antidepressant.....  I understand that you do not want to take these meds, and I understand that some of the side effects are not pleasant, but in my case I felt as if I did not have much of a choice.  The meds probably saved my life. I hope to not need the meds someday, but in the meantime they keep me functional.  If you do take them, you can always have a doctor help to wean you off off them when you and your doctor agree that it is a good time to try to stop the meds.  If you are slowly weaned off antidepressants, the "withdrawals" are not so bad.

Well, I wish you luck and I send my best wishes and support to you!!!!!

[jewellsj]

I feel your frustration with the medical community.  They put you on these addictive drugs and then want to play "GOD" with you and your body turning their backs on you when you need them the most.  My dr. wouldn't treat me and sent me to the ER in full Xanex withdrawal after she was the one who prescribed the drug for me.  They are afraid of a malpractice suit.  

I have gone through Xanex full withdrawal and ended up in the ER 3 times in 3 days.  IT was torture.  Do what you need to do even if it means going to the ER because you can expect to suffer from withdrawal.  You are NEVER to stop taking Xanex cold turkey!!!  I recommend a hospital with a Phsyciatric Unit.  You have more options if you need to be admitted that way.  This my seem extreme but it is what I ended up having to do.  From there I was treated and got immediate attention.  You can wait months going through the normal channels waiting for an opening as a "new" patient with a new doctor.

I am now on Clonazepham and doing pretty well.  It lasts twice as long as Xanex and is not as addictive since you take it twice daily.  I too suffer from anxiety and took Xanex for 7 years never knowing how addicitve it really was.

Also, did you know that Effexor can increase your cravings for alcohol.  So, as most anxiety sufferers if you self-medicate with alcohol - you need to think about taking it long and hard.  

I have been through 3 drs and am still searching for one who clearly understands anxiety and all it encompasses.  My physciatrist won't treat me now because my I have Hypothyroidism and my levels are not under control.  I mean that could take years and in the mean time I suffer daily with anxiety.

Keep strong and keep fighting for yourself!!!

[Brenndy]

Thanks for your input.  Practicing "mindfulness" can be very therapeutic, but not when an anxiety-ridden person's mind is racing, as many are.  I think it best initially be utilized as an adjunct to anxiolytic/s.

[mskandy]

I know this is probably not what you want to here but it has worked for me and allowed me to come of meds without having my old panic attacks and relying on Xanaz.  I have suffered for over 13 years, been on ADD meds, Zoloft and Xanax.

My therapist has taught me something called mindfulness. She gave me a CD with a little guided exercise. You lie down (goes for 15 mins) and you just focus you attention on the body part she mentions.  She didn't give it to me to relax or meditate on (I know when you feel anxious, there is NO way you can lie down and relax or switch off).  She gave it to me so I could understand how easily my mind can wonder, even when trying to do the most trivial of things(ie. thinking about my fingers without interupting thoughts or worrying thoughts)

It has taught me that with a little bit of effort to focus on what is going on around me NOW, instead of worrying about future or past, that I can be in control the levels of anxiety and not let the thoughts spiral out of control.  It's an ongoing practice, but i've learnt to apply it to things like showering, driving, walking etc, where I just focus on what i'm doing there an then, and feel, look and listen to what's going on around me.  Now after years of alleged ADD, I can study because of applying what I have learnt.

Now, i'm not saying that it's all in the mind, because I know it's a chemical thing, but chemistry can be changed, not with postive thinking but with repetition.  If you focus on being mindful, you will find that you can only think of one thing at a time (not dart from thought to thought but remain focused) and that there becomes no room for other thoughts.  Over time, if practiced, this becomes a habit so it becomes automatic and this is when the chemical change occurs and old neural (anxiety) pathways in the brain die off and new pathways are formed.

I hope i'm not imposing my view too much and I apologise but i'm making an assumption that eventually you'd like to get off medication completely and have control again.

Not to mention, I'd much prefer to be part of life fully than feel numb from the medication

Feel free to criticize as it just something i'm sharing that has worked for me and this is all i've had experience with.  I'm in no way saying that it is the answer for anyone else. We are all individual and have our unique lives, bodies and minds so we all need our own unique approach an understanding.

I hope everyone finds peace soon

xoxoxox

[remar]

i went throught a similar thing. my dr. wanted me to stop xanax cold turkey when i wanted to go off effexor. he said if i did'nt take the effexor then he would'nt refill my xanax. effexor has such horrible side effects and i was desperate to get off it. how stupid can some drs. be? i did find another dr. that i still have and love. i hope you find a good dr. that listens to you. take care. remar

[Brenndy]

One of many, and probably most serious, effects of quick withdrawal from Xanax is seizures.
See another Doctor, and/or make a telephone call to a friend.  Don't stop abruptly, if at all possible.

Please keep us posted.

[nursegirl6572]

I agree that if the p-doc was not budging, you need to find a new one asap.  If you think you could make another appt and express your concerns...give it a shot.

Explain that you need to be TAPERED off the Xanax safely for one thing, b/c yes, stopping it abruptly could lead to pretty nasty w/d's.  I don't know whether his train of thought was that you were on a low dose for a short time?  But, either way, it should still be tapered.

Whether Effexor would help you or not, you would have to try it.  Please do not discount all anti-depressants as an appropriate kind of medication to treat panic/anxiety.  I totally understand that people are reluctant to try an AD b/c they aren't "depressed", they are "anxious", but speaking from experience...AD's have helped tons of people with anxiety disorders.  My own personal opinion.....I wouldn't think that Effexor would be the first one to try...but that is just me.

You also have other options.  Another benzo, Klonopin can be used long term without the "tolerance" issue (where one requires a higher and higher dose to maintain its effectiveness).  Klonopin alone has been very successful for a lot of people with anxiety disorders.

Stick with the therapy as well.  I absolutely concur though that if this doc isn't willing to hear you out...demand a second opinion from a completely different psychiatrist.  Go with an open mind....indeed trying an antidepressant may seem strange,but everyone is different, and it may work wonders for you.  At least consider all of your options.

When I was in the midst of my panic disorder...having almost constant panic attacks....etc....Ativan helped me tremendously.  Then, I was started on Zoloft (this was my 1st go around with meds)...and within 2 months...I was taking an Ativan only VERY seldomly and felt almost myself...almost anxiety free.  Same with my experiences with Prozac and Lexapro (other SSRI antidepressants).

Just keep in mind that pretty much ALL of these meds require you to be tapered off and carry the risk of pretty significant withdrawals.

Let us know how it turns out!

[MrGreen]

For starters if you don't suffer from depression it is one whacky tablet to put you on. I was given the same tablet once. I suffer from anxiety. Not depression. Nightmare it was. Sent me through the roof. Such a tablet is designed to bring a person up because they are down. But with anxiety you need medication to bring you down. Not up. Hence it can have nasty effects and did on me. Yes xanax is highly addictive. Horrible tablet and I was hooked on that for years. Maybe try strike up an arrangement for a different type of medication. Zispin is an anti-depressant that works well for anxiety. Easy to take and no side effects other than sleep. But if you go back naming tablets he will know you have been researching up on things. Just from an anxiety point of view I think what he is offering you is the wrong choice of tablet. It is hard to get on. Harder to get off too. I know this won't make you feel any better. There is little I can do as I am not your doc. That's all going to boil down to what he wants to give you. How it reacts on you will be important. Might take you back off it if the reaction is bad. Wink Wink.

[snoozies43]

I would ask for a different psychiatrist ASAP. If it was working for you they should never stop it. It is a very difficult medicine to come off of.

If you cannot do this. Please post your question in the depression community as well.

Many doctors are getting people off of these medicines..ie: Xanax and clorazepam as they have addictive qualities.

With that in mind..the new anti-depressants also contain something for anxiety and are not as addictive. I think him stopping it completely right away is not a good thing to do.

Call for another psychiatrist and also post in the depression community.

Stay in the moment, and let others help Good luck!.