please help

[Driller560]

I was prescribed xanex around 16 months ago to make me sleep. 1 mg before bed. It really works good. After the first 4 months I started having this feeling of pressure or a full feeling in my neck. It really started to worry me being a smoker so as of now I've been to 3 ENT specialist. I've had MRI, CT scan, etc. Everything has came back normal. The only time my neck does not bother me is soon after I take a xanex at night and first thing in the morning. Then like clock work it will start bothering me by mid morning. So after about 2 weeks of this misery I tried 1/4 mg of xanex during the day and it calmed my neck down. So for the past year I've been taking 1/4 mg twice a day and 1mg at night to cope with this bad feeling in my neck. Also it gets worse when I'm doing physical labor or when I am stressed which is quite often. It is really bothersome, makes me feel bad and I am so frustrated with it. Could this be a side effect of xanex and does anyone have these same feelings in there neck? PLEASE HELP

[RCA7591]

The Xanax is rebounding. Speak with the doctor about implementing Valium in place of the Xanax.

10 milligrams, three times daily.

Xanax is not indicated for long-term use. The duration of action is 4-6 hours, and tolerance occurs rapidly. Valium provides full, 24-hr coverage when dosed three times daily.

Ryan

[OneScaredBuckeye]

I agree that Valium would be far better than Xanax, but 10 mg. three times a day sounds like a pretty high dose to me.  I would try to get by on 5 mg. twice a day and if that doesn't work, have your doctor increase it.  Good luck.

[RCA7591]

Bear in mind that 1 mg of Xanax is equal in potency to 20 mg of Valium.

He also states to have taken an additional 1/4 mg twice daily in conjunction with the 1 mg of Xanax at night. 0.5 mg of Xanax is equal in potency to 10 mg of Valium. Hence, 10 mg, t.i.d. would be the correct dosage in his case.

Ideally, Valium is dosed three times daily. Valium's major active metabolite is Oxazepam, which has a therapeutic benefit of eight hours in duration. Thus Valium is dosed every eight hours if being utilized as a maintanence drug. This provides round-the-clock coverage.


Ryan

[OneScaredBuckeye]

But the half-life of Valium is so very, very long.  I've never met anyone who takes 30 mg. a day.  Even if he needs that much, I think he should try to bring the dose down a bit.  That's a lot of Valium, though true, Xanax is a stronger drug.  It is, however, eliminated from the body faster.

Benzodiazepines also differ markedly in the speed at which they are metabolised (in the liver) and eliminated from the body (in the urine). For example, the "half-life" (time taken for the blood concentration to fall to half its initial value after a single dose) for triazolam (Halcion) is only 2-5 hours, while the half-life of diazepam is 20-100 hours, and that of an active metabolite of diazepam (desmethyldiazepam) is 36-200 hours. This means that half the active products of diazepam are still in the bloodstream up to 200 hours after a single dose. Clearly, with repeated daily dosing accumulation occurs and high concentrations can build up in the body (mainly in fatty tissues). There is a considerable variation between individuals in the rate at which they metabolise benzodiazepines.

[OneScaredBuckeye]

.5 mg of Xanax is out of the body in six to twelve hours, while 10 mg. of Valium take twenty to two hundred hours to clear.

http://web4health.info/en/answers/bio-benzo-overview.htm

[OneScaredBuckeye]

I do agree that 1 mg. of Xanax is equal to 20 mg. of Valium, but don't you think he should try to reduce the Valium dosage from 30 mg. day to maybe 20 mg. day or even 15 mg. day, over time?  Especially in light of the long half-life?

[RCA7591]

Here is all of the information from the *original* 1964 document for Valium, the most honest description of this drug. You'd be hard pressed to find this information anywhere. Unfortunately, we can't upload images on this forum, so I have to type it!

Valium Roche (Diazepam):

DESCRIPTION: Valium (Diazepam) is useful in the control of anxiety and tension states and aids in relief of the muscle spasm of cerebral palsy and athetosis. Chemically, diazepam is 7-chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4 benzodiazepin-2-one.

ACTIONS AND USES: Valium (Diazepam) is of use in dealing with anxiety reactions stemming from stressful circumstances or whenever somatic complaints are concomitants of emotional factors. It is useful in psychoneurotic states manifested by anxiety, tension, fear, and fatigue. Valium may also be useful in acute agitation due to alcohol withdrawal. Valium may be of use to alleviate muscle spasm associated with cerebral palsy and athetosis.

DOSAGE AND ADMINISTRATION:

-Mild to moderate psychoneurotic reactions: Manifested by anxiety-tension alone or with depressive symptomatology, agitation, restlessness, psychophysiological disturances - 2-5 mg, three times daily

-Severe psychoneurotic reactions: Where severe anxiety, fear, agitation, agression, or hostility exist alone or with depressive symptoms - 5-10 mg, three to four times daily

-Muscle spasm - 2-10 mg, three to four times daily

CONTRAINDICATIONS: Valium (Diazepam) is contraindicated in infants, patients with a history of convulsive disorders, or patients with a history of glaucoma.

WARNING: Valium (Diazepam) is not of value in the treatment of psychotic patients, and for this reason should not be employed in lieu of appropriate treatment.

PRECAUTIONS: In the elderly or debilitated patient, it is important to limit the dosage to the smallest effective amount to preclude the development of ataxia or oversedation (not more than 1 mg twice daily initially, to be increased gradually as needed and tolerated). As is true of all CNS-acting drugs, until the correct maintenance dosage is established, patients receiving Valium should be advised against possibly hazardous procedures requiring complete mental alertness or physical coordination. Driving an automobile during the period of Valium therapy is not recommended. In general, the concurrent administration of Valium and other psychotropic agents is not recommended. Since Valium has a central nervous system depressant effect, patients should be advised against the simultaneous ingestion of alcohol and other CNS depressants during Valium therapy. The safe use of Valium during pregnancy has not been established.

SIDE EFFECTS: In clinical use, fatigue, drowsiness, and ataxia have been reported; in most instances they are dose related and may be avoided by proper dosage adjustment. Mild nausea and dizziness may occur on occasion. As with any new agent, when it is administered for a protracted period of time, periodic blood counts and liver function tests are advisable. Abrupt cessation after prolonged use, may, in some patients, produce withdrawal symptoms (eg: convulsions, tremor, abdominal and muscle cramps, vomiting, and sweating). Changes in EEG patterns have been observed in patients during and after Valium treatment. Paradoxical reactions such as excitement, depression, stimulation, sleep disturbances, acute hyperexcited states, and hallucinations have been reported. Other side effects noted have been blurred vision, diplopia, headache, incontinence, slurred speech, tremor, and skin rash.

HOW SUPPLIED: For oral administration: Valium scored tablets, 2 mg (white), bottles of 50 and 500, and 5 mg (yellow), bottles of 50 and 500.

Product information issued Sept, 9, 1964

More on Xanax/Valium later today. But 10 mg, three times daily is a standard dose (even back in 1964). Valium is 43 years old, and yet nothing has surpassed it to this day.

Ryan

[OneScaredBuckeye]

Thanks for typing all that, Ryan.  I think a lot of people are afraid of Valium today, but I used it for years and had not one bad reaction and I never became physical dependent on it, however, when I was feeling my worst, I do think I was psychologically dependent on the drug.  That passed of its own accord, however, when I started feeling better.  I credit Valium with saving my life and my sanity.  I had simple anxiety-muscular tension, which I believe was initially caused by a hormonal imbalance, but really, who knows?  As a former patient, I agree, nothing has surpassed Valium, in effectiveness or safety, for anxiety.  Again, thanks for typing all of that.