Bacalla

[bacalla]

I used to take alprazolam 1 mg. 4 times a day,I was also taking prozac 20 mgs. once /day.This was for anxiety & depression.My Dr. increased my alprazolam to 2 mgs. 3 times a day & the prozac to 40 mgs. 2 in the am.I now find myself very nervous in thhe morning until I take my alprazolam.Then my nerves seem to calm down.This started when he increased the alprazolam.Have I become dependant & if so what is the best method to ween myself down.Any help will be appreciated.Thank you...........Bacalla

[my_mayberry]

well, the problems with your liver can cause you to metabolize it differently than a normal person. i can't offer any suggestions as to a taper...that can only be offered by your doctor.

my opinion of xanax XR is that there are a VERY small percentage of people who truly need to use it...but alprazolam simply isn't a drug thats meant to be used in that way unless the condition is chronic enough and won't respond to other maintenance meds. why do i feel this way? because if you're on it for any length of time, it simply stops working, period. then you have to keep going UP UP UP...and eventually you reach a max. once you're there, where do you go? well...you're stuck. anything you do will require a very SLOW transition to avoid seizures, and as far as daytime sedation goes, there's only the barbiturates that are really more effective than xanax. this is why most people who suffer anxiety see xanax as a bad drug to use every day.

many people in the anxiety forums will use a longer acting benzo like diazepam or klonopin for daily maintenance if they need it. in any event, the XR would keep a constant blood level and prevent the crash and burn, but you should do more research on it. by that, try to find people who have taken it and see how it has worked for them. i work in an EXTREMELY busy pharmacy and we have a problem with the XR going out of date, which gives some idea of how rarely it's used. My thoughts are that using the XR would cause the drug to become less effective even more quickly than the IR, just because your body adjusts so quickly to it being there.

in any event, if you were doing fine at your previous dose, perhaps ask your doctor about going back to it. the problems you're having could be a lot of things. when i took xanax regularly at a higher dose for SEVERE anxiety, i started to notice after a couple weeks that anxiety was being caused simply by the drug leaving my system and that it wasn't the same as what i'd experienced without the xanax. once i realized this, i quit taking it. you would need a taper if you do that...but if the previous dose was effective with no side effects, then perhaps staying where you were at would be best. messing around too much with your dose when you don't really need to can cause big problems.

if you don't know why your doc increased you, ask them. tell them you felt better at the previous dose. they may just switch you back. if they do, it would still take a few days for your body to adjust back to that.

[bacalla]

Thank you for your comments.They were plain & simple.My druggist gave my wife the alprazolam 1 mg. XR by mistake.I suppose that is the one you are speaking of.The "shakes" I mentioned are very similar to a low blood sugar attack.Did I mention to you that he`s been  giving me alprazolam for over 3 years.Since the dose was increased,it wasn`t long after that,that this nervousness started.It feels as though there is a spring inside my body & it is ready to burst.I`m also on testosterone i.v. twice/month.could you give me some advice on weening myself off of these alprazolam.I don`t even know why my "shrink" even increased me to the 2 mgs. from the 1 mgs.I have cirrhossis of the liver,also.Could this be playing any part of how my body is metabolizing all of these meds?My infectious disease Dr. said that I was not a candidate for interferon,I used to take shots of that in combinatioon w/ribivarin.That was stopped after my heart attack as he claimed it was too toxic.So,am I left to  worsen the condition of my liver because the medicine is too toxic & the virus is such a slowly progrssive one that I would most likely die with it.Some consulation,huh.Our house is like a walk in pharmacy.My wife suffers w/lupus,fibromyalgia,osteoporosis & the list goes on.Would it be better to be on the XR version of alprazolam or slowly start weeing off it all together.
Thank you for your advice & help.

[my_mayberry]

you probably are addicted. xanax has a short half-life and isn't always the best option for chronic treatment of anxiety. by 'addicted'....i mean even if you don't have a desire to abuse them, your body NEEDS them. this is common with people who are taking xanax. it has little coverage outside of 4 to 6 hours and the 'crash and burn' is quick if you don't get another dose. longer acting benzo's tend to be more preferred for daily chronic treatment because of the fact that they don't go up and down so radically.

if you are not experiencing an actual desire to ABUSE this medication, then you may consider using the anxiety/depression forums as well. many people there have a LOT of experience with treating disorders with this drug. i have experience with treating acute/chronic anxiety/ocd with it.....i found that for ACUTE anxiety it works wonders...however using it every day can turn into a nightmare.

you are on a high dose right now, plus you are on it three times daily instead of four, so even though the dose is higher, your body doesn't like not keeping your blood levels as consistant as they were  on four times a day.

you should really speak with your doc about a longer half-life drug for your treatment and see what they think. do research and learn all about benzo's and then consider whether this path really is the right one for you...because with a short acting benzo, if you continue to take it forever, you will ALWAYS have to increase the dose and eventually it becomes totally ineffective. NOT GOOD for treating chronic anxiety.

[medicos]

Hi, you will find definitely some help here .since when you are taking them.