Question Regarding Xanax

I have suffered from severe anxiety and panic disorder for years, but over the past 6 months it has gotten worse and worse.  At the end of May it was to the point where I could not have the lights on in my office and I eventually took a week off work and just sat at home, unable to leave my house.  I was addicted to pain killers in the past so at that time I was only taking 1/2 of a .25 2-3 times a day.  I started having and still have very irrational fears of having a seizure.  I have constant muscle twitches all over my bosy and then I start freaking out that I am going to have a seizure.

I broke down at my Dr's office finally and he has me taking .25 xanax 4 times a day.  I know that xanax can be extremely difficult to come off of, and I am afraid that weaning off will cause a seizure. It has helped me a lot to function normally, but I am curious as to how you would taper off.  Is that a high dose?  I know I am only taking 1mg a day but will that be hard to come off of?  Because I have been using xanax every day for so long, even at really low doses I am afraid to even miss one dose becauseI am worried it could cause a seizure, so even when I feel fine I take it.  I never let more than 12 hours pass before I take a .25.  Can someone please give me some education on how to taper from the way I am taking it and if my fears are real?  Thank you!

[nursegirl6572]

Hi there.  I'm sorry you are going through such a rough time.  Please feel free to share with us here....we all have been in similar situations and can relate.

It sounds like you and your doctor have gotten down to the nitty gritty and put forth a solid plan, which is a great first step.  What is the taper plan your doctor gave you?  Are you going to gradually reduce how many times a day you take the Xanax?  Xanax generally only works for about 4 hours....so dosing a few times a day will cover most anxiety issues.

Has your doctor mentioned possibly switching to a more long-term benzo, like Klonopin, or Valium?  These benzos differ from Xanax in that they do not have the "tolerance" issues that the other benzos do....and you can safely take them for long periods of time without them losing their effectiveness.  That may be something to bring up to your doctor....maybe starting on something like that during your taper.  Because there is a history of substance abuse....I'm sure your doc will be ultra cautious...but that is okay...just be 100% honest with him and keep the lines of communication open.

As for your fear of seizure?  You've been on a fairly LOW dose for a while now...and even with the 1 mg total per day...unless you were to totally CEASE taking ANY Xanax, you pretty much don't have a risk with the tapering.  Follow the taper program your doctor has outlined, and again, maybe ask about being started on something you can take more long-term, as you still certainly should prolly be treating the anxiety.

I don't know how long it has been since you quit your opiate addiction...but of course, you need to keep in mind that ALL of that is definitely going to be playing into your symptoms if the addiction was substantial and fairly recent.  Your body is doing a complete 360 and trying to adjust to all the changes.

Keep us posted on how you're doing....we really care, and most of us can relate to the anxiety issues as well.  Hang in there...things WILL get better, it just may take some time.  Please try not to worry about the seizure risk.  While it is a very REAL risk...what you describe doesn't seem at all like a problem if you continue to be compliant with the taper.  Congrats, btw on your sobriety!!!!!  Way to go, good for you!

[Emmas Mom]

Thank you for your response!  Actually, my Dr. is not telling me to taper.  I was just moved up to the .25 4x a day recently.  For two years I have been prescribed .25 2x a day.  I never took it like I was supposed to.  I would only take it before when I was out of pain pills.  When I started getting panic attacks again, I started taking 1/2 a .25  when I would feel really anxious, never going over .5 a day total.  Well, I was to a non functioning point so my dr tried to put me on 2mg valium, which i HATED the way it made me feel.  When that didn't work, he prescribed me .5 xanax to take 3x a day, which was very recently.  .5 makes me fall asleep drooling at my desk, so I am taking .25 4x a day.  It keeps the worst of the anxiety at bay and God willing I have not had a panic attack since last Wednesday!!!!  That is HUGE for me.  The reason my anxiety was starting to get so out of control is I was worrying about having a seizure from muscle twitches.  I get them all over my body, sometimes they go on all day, but are much worse at night.  I guess I am worrying about all the damage I have done to my bosy while abusing pain medication.

He knows how I am taking the xanax and is fine with it.  I am 25 and I have taken xanax on and off since I was 16 and it has no addictive qualities for me.  I am just worried about taking .25 4x a day for a long time, because I know that it is short acting and I am afraid that if I go more than 12 hours without taking one I will have a seizure.  Can that happen at the dose I am taking?  Right now I take .25 at 7am, 11:30, 2:00 and my last dose at 6:30 or 7.  I guess I am just worried that I am going to have a hard time coming off of it, and I know I need something to help the anxiety.  I asked him at my last dr. appt if I could take .25 clonopin 2x a day and he said if we need to he will try that for me, but it is one or the other.  He will not prescribe xanax and clonopin and that makes me want to stay on the xanax, because I know if I do have a panic attack it will take it away quickly.

I hope this makes sense!  I appreciate your response more than you know!  I have been lurking this forum and I have posted a few times, but it is so nice that someone understands how I feel!

[Emmas Mom]

I have a small phobia of pills now and not feeling normal, which is why I am trying to stay low in the anxiety meds, but I want to be able to function.  I don't want to get to that point where I can't leave my house!  I am half tempted just to tell my Dr. to put me on the klonopin and have him stop prescribing the xanax because I have xanax stock piled from when I was only taking 1/2 of what I was prescribed a month!

[nursegirl6572]

Hi again...sorry I misunderstood you.  You are worried about having a seizure if you are late in taking your med, or something like that?  Nothing to worry about there.  Hopefully you can rest easy about that.

As far as the Xanax vs. Klonopin...the Xanax is very helpful as a "rescue" med....in halting panic attacks in their tracks.  Klonopin, on the other hand...taken twice a day, builds up in your system as a way to PREVENT the attacks all together.

It sounds like you're pretty sensitive to the Xanax, so trying the Klonopin may actually work better for you.  You're still going to have some initial drowsiness, but as your system adjusts, it should resolve.

Maybe discuss with your doc......the pros and cons of each type of treatment for you, comparitively.

Good luck.

[Emmas Mom]

I am worried about a few things.  I am worried that if I go longer than 12 hours without taking .25 that I will have a seizure.  I am also worried about staying long term on xanax, which I know is a short acting medication.  Does it matter what medication you take long term for anxiety?

My Dr. says that he will keep working to adjust my meds, but it is either xanax or another med.  He will not prescribe xanax and say clonopin at the same time.  And I think I would benefit from taking a longer acting med, but I worry about not having a rescue medication if I were to have a panic attack.

Do you by any chance know if the muscle twitches I am getting are anxiety related?  I am sure they are and my Dr is not worried about it, but I do!  I get them all over and it really freaks me out.

Sorry if I am bugging!

Beth

[barfer]

I just started reading this post and of course, I've got to add my two cents!  I see where your doctor is coming from because of your history of addiction to pain killers.  I was really worried myself, about not having my back up of ativan when I started on klonopin.  In actual fact, I did have a back up of them but was afraid to use them.  As it turned out, once I got to a steady state on the klonopin, I really didn't need the ativan.  Although, I still carry it in my purse at all times.  Once you are at a steady state with the klonopin, your doctor might let you have the xanax to take only on an as needed basis.  When I say as needed, I mean once in a very blue moon.  Xanax should only be used as a band-aide solution.  If you have breakthrough panic while on klonopin, that is when it could be used.  Mind you, if you do have frequent breakthrough panic attacks while on klonopin, it might mean that the dose should be raised.  This is a medication that you won't need to be messing around with once the correct dosage is established.  There are lots of people who have been on it for years and never have to go up on dose once they find the right one for them.  This is a medication you should seriously consider but because of the xanax use, you will have to expect some sort of transition issues so make sure you don't blame them on the new meds (klonopin) because it more than likely will be from withdrawal of the xanax.

[Emmas Mom]

If I were to switch to .25 of klonopin 2x a day, would i withdrawal from the xanax?  I have a lot of xanax stockpiled from when I was not taking very much of it, and even now I am prescribed to take a total of 1.5 mg a day and I am only taking 1mg.  I am just trying to figure out what to do, what will be best for me.  I do not want my life to be ruled by fear any longer.  

Does anyone know anything about the muscle twitches?  I feel like I am driving myself crazy sometimes.  I am trying to realize that nothing is wrong with me, it is just anxiety but it is so hard.

[nursegirl6572]

It IS hard to deal with all of the symptoms of the anxiety.  It drives you nuts.

Usually, how the transitition is done...is to do a gradual taper of the Xanax while starting you on the Klonopin.  If done that way....it shouldn't be much of an issue for you...especially at a fairly low dose like you're on.

Talk with your doc about the Klonopin...it may be more effective for you than the Xanax...and like Barfer said...usually an *occasional* dose of Xanax during the beginning of your Klonopin therapy for breakthrough panic is ok.  Again....ask the doc about that.  Once you taper off the Xanax and get on the Klonopin, you prolly won't need the Xanax at all.  You MAY end up needing a higher dose of Klonopin....if you start on the 0.25 and are still having a significant amt of anxiety after a week or two.  It just takes some time and some adjusting.  Just keep in mind that sometimes a little adjusting is necessary to get you where you need to be.  That's totally normal.

I think it is definitely something to discuss with your doc....get all of your questions ready and make an appt.

Best of luck!

[remar]

i agree with all the other posts. your on a low dose of xanax and you won't have a seizure if you quit taking it. i've been on and off it for many years and have done the tapering. if you quit cold turkey you may have some nausea and anxiety but not a seizure. i quit the first time i took it after a few months, i was on .25mgs 3 times a day, and i did'nt have a seizure, just nausea and anxiety. it sounds like klonopin might work for you. your dr. will help with the transition. the muscle twitches are probably from the anxiety, did you ask your dr. about this? i really think that when you get the anxiety under control the muscle twitching will go away. anxiety causes many physical problems. take care. remar