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Anxiety Community
This patient support community is for discussions relating to generalized anxiety, anxiety and eating, anxiety and sleeping, mood swings, and phobias.
Xanax XR
by JeepJessy79, May 29, 2007 12:00AM
Is anyone out there on Xanax XR or know of anyone on it? I'm thinking about asking my Doctor to put me on it. Let me know please.
Ideally, Xanax (in any form), should be used only temporarily. The XR version was designed to prevent "interdose anxiety" due to the short half-life of Alprazolam (about 4 hours).
The original Xanax should only be used on a PRN basis, and the XR version for the temporary treatment of short-term anxiety disorders (one or two weeks).
If used long term, the drug is extremely difficult to taper from directly, namely due to the short half-life. Alprazolam does not accumulate in the body, therefore, the withdrawal phenomenon is abrupt (occurs shortly after the drug is discontinued). Even with the XR version, the drug never reaches steady-state.
Ativan is similar, but less potent.
Better choices for the long-term are Klonopin 1/2 mg BID or TID, Valium 10 mg TID or QID, or Librium 25 mg QID. The more popular choice is Klonopin. These Benzodiazepines have an intermediate to long half-life, and reach steady-state over a period of three days to two weeks. Steady-state plasma levels eliminate interdose anxiety. They are also easier to discontinue, as the plasma levels fall gradually when the drug is tapered slowly.
The nice thing about the long-acting Benzodiazepines is that they rarely lose their anxiolytic effect (that is, their anti-anxiety properties). Tolerance to this effect is extremely rare.
-Ryan
I don't know much about benzos other than the one I'm taking, but Xanax has a notorious reputation for the reasons Ryan talked about. Seems like it would only be used short-term in a controlled environment (in-patient).
I took Xanax recreationally as a kid, and certainly wouldn't want to use it to treat anxiety. No doubt it works, but there are too many drawbacks.
--end quote--
1/2 mg of Ativan every *other* day isn't bad, provided you're only taking ONE 1/2 mg tablet every other day. 1/2 mg is a small dose, equal to 0.25 mg of Xanax or 0.125 mg of Klonopin (or 2.5 mg of Valium). I really don't see a problem here, as the dose is extremely small.
Ativan has a half-life of 8 hours, which means by the second day, almost all of the drug is eliminated from your system before your next dose. It never has a chance to reach "steady-state", and your risk of dependency is small.
If taking the Ativan in this manner is helping you to cope, continue on.
-Ryan
i only take it when needed and here and now i need it to get passed my stress anxiety. its .05 took one this am but i counterd it i almost waited to late to take it , it took 4 hours before i calmed down on it . . so this does not build up in system thats good than why do drs have such a hard time giving them. its not like you get hooked on .05 if you take it now and than they act like its a bad drug and you will need more and more . ive bben taking them for 23 years . i get a bottle of 30 they last me a year or more so they have to see i dont abuse them. am glad to see they last 8 hours i was thinking you said 4 hours for ativan, so that makes me a little happier. i did see a dr who wanted me to go on lexapro 10mg a day but i dont want to do it if i can take ativan and get over the stress it will go away sooner or later . ok thanks your a great help ryan
Xanax is a short acting Benzodiazepine indicated for the short term treatment of anxiety disorders, or for use on a PRN (as-needed) basis. Xanax is not indicated for the long term management of anxiety disorders, and should not be used for more than a few weeks consistently. Ideally, it is best reserved for use on an as-needed basis, for aborting sporadic panic attacks.
Xanax has a rapid onset of action (15-20 minutes), and a half-life of 4-6 hours. The effects are short lived, and the drug does not accumulate. If it is used over a prolonged period of time on a daily basis, tolerance to the effects develops rapidly, as the plasma level never reaches steady-state. Therefore, Xanax is not indicated for long term use, or for the management of GAD or Panic Disorder, as the risk of tolerance is high.
Xanax-XR is merely an extended-release version of the original Xanax. It is designed to release a specific dose roughly every six hours. The 0.5 mg version releases 0.5 mg every six hours, and so on. However, the drug is still indicated for short-term use only, and the same risk of tolerance applies. Xanax-XR is NOT indicated for long term use.
While Xanax may provide you with relief now, over the long run, it will cause nothing but grief. The effectiveness will continue to decrease, and the dose will need to be increased to maintain the same therapeutic effect. Xanax is also very difficult to discontinue, and it cannot be tapered from directly without producing severe withdrawal phenomena and rebound symptoms.
Therefore, rather than requesting Xanax-XR (which is not indicated for the management of anxiety disorders), you may want to request Klonopin instead. Klonopin is a long acting Benzodiazepine, and is indicated for the long term management of anxiety disorders. Tolerance to Klonopin is rare, as the drug carries a long 50-hour half-life. Klonopin works on the principal of steady-state and accumulation, unlike Xanax (which works immediately). Plasma levels of Xanax peak and trough, while plasma levels of Klonopin are maintained (providing 24 hr coverage of symptoms).
Making the transition from Xanax to Klonopin is straight-foward (they are dose equivalent), however, the full benefits of Klonopin are not instantaneous. Klonopin requires roughly two weeks to reach steady-state. During the transition from Xanax to Klonopin, there is a window of vulnerability where you may experience rebound and withdrawal phenomenon. This will pass within two weeks.
In short, neither of you should be using Xanax long-term. If you continue to use it, you are going to suffer in the future. Ask the doctor to switch you from Xanax to Klonopin.
-Ryan
Basically, take what you read on these forums with a grain of salt. Xanax XR works great in the long-term for many people as placebo trials have proven. While people may become tolerant to its hypnotic effects after two weeks or so, the anxiolytic effects remain the same.
Don't give up on the Xanax XR just because of some of the horror stories. They seem to be the only stories that get posted on the internet anyway. There are plenty of long-term users like myself out there who find Xanax XR to completely viable in the long-term. I am not sure if this forum allows links to be posted so I won't post any but again, use google to your advantage. Read the drug guidelines set forth by the makers of Xanax XR in detail. It is not a demon drug when it comes to long-term use.
-Adam