Posted by Rathrbfishn on May 10, 2002, at 22:08:11
In reply to Re: Just starting to take paxil, posted by keilia on May 10, 2002, at 6:45:02
keilia...if your current doc is not a psychiatrist, find one. You have PAD, a psychiatric condition, your taking xanax, a psychiatric drug. You need to have this aspect of your health handled by a pdoc. If your current doc is a pdoc, fire him/her and find another one.
Any average pdoc would not rx paxil to help with the side effects when starting to withdraw from xanax. I posed this question on a web site I have frequented for the last 4 years that is dedicated to anxiety disorders almost exclusively, and know many of the posters who take a benzo or an ssri that are very very knowledgable, and no one has ever heard of starting paxil to alleviate the symptoms when withdrawing from xanax. All paxil will do is add more suffering due to it's start up side affects to the withdrawal of the xanax. Paxil can take weeks before you see any AD effects, if at all.
No legit pdoc would have you withdraw from xanax without explaining what to expect. Besides, you have already tried to withdraw and found it difficult. PCP's and family doctors will conclude that if you have difficulty withdrawing from xanax you are probably addicted. They are not specialists in psychiatric disorders. I had a very good PCP for a while. One day we were talking about my xanax use and he said he didn't even know they made a 1mg tab of xanax.
If you are really only taking 2mgs of xanax a day and not having any problems in your life, not abusing any illegal drugs, drinking, functioning well, no cognitive problems, etc., and find it works well for your PAD, there is no good reason I can think of that you should be taken off it. 2mgs of xanax/day is not a very large dose for PAD sufferers. Another reason to stick with xanax is that benzo's have been used for over 40 years with good results if used with the appropriate diagnosis, especially chronic PAD. And the side effect profile for xanax is much milder than almost any other drug used for treating PAD, including paxil. Also, the more recent term for long term benzo use is medical dependency, not addiction. Addiction implies something completely different than medical dependency, but this is where your condition gets a little gray. I'll get back to you on that later.
If, for some reason, you can't find a pdoc that will allow you to stay on 2mgs of xanax and insists on having you withdraw from it, ask about the pdocs withdrawal procedure. Withdrawing from xanax is much easier if you do it very slowly, I mean something like taking 1.75mgs for a couple of weeks or longer, until your body adjusts to the reduced dosage. Then drop another .25mgs for a few weeks, and so forth.
You may be uncomfortable reducing at this rate and dosage, but it shouldn't be unbearable. Remember, you've been taking xanax quite a while.A good pdoc will be able to tell the difference from rebound anxiety and re-emergence of the PAD during the withdrawal.
Also, the ssri's, which paxil is, do help many people who suffer from PAD. I don't understand why the doc you have now doesn't just add the paxil and leave you on the xanax. Once the ssri's start to work, 2-3-4 weeks usually, sometimes longer, and they really do help many people, then the pdoc will taper you off the xanax. It is very common for a pdoc to rx an ssri and a small dose of a benzo at first.
Now lets discuss the gray area I mentioned. You don't have to answer these questions of course.
Why were you letting a doctor prescribe xanax at 12mgs/day when you were only taking 2mgs? What you were doing was stocking up on xanax instead of having your doctor follow up at appropriate intervals to see how things were going and if all was well, you would receive another script for 2mgs/day until the next follow up visit or refill.Stocking up on a potentially addictive drug is a sign all good docs look for when watching for an addictive personality.
Another sign of an addictive personality is doctor shopping. That is going from one doctor to another until you find one that will prescribe the drug you want. Again, good doctors will recognize this as a symptom of addiction and will not enable you to continue your use of your drug by giving you a script. How many docs turned you down, 4, or was it five?
Please don't get upset, but most GP's reading your post above will assume that you are addicted and refuse your request for a script to xanax. They don't have the specialized training and experience psychiatrists do with PAD and the use of xanax.
Another aspect to all this is that if you do not live in a large city, most doctors in your town will find out about another doctor who has had their liscense revoked. The pharmacies get involved and patients the ex doc was treating inappropriately will eventually get around to all the other doctors and pharmacies and you will find it next to impossible to get a doctor to give you a script. I've had a pharmacist refuse to fill 4mgs/day of xanax before. I had been going to this pharmacy for years, but she was new and felt like 4mgs of xanax was too high. She even called my pdoc and chewed him out. He told me he just laughed and said fine. He then called another phamacy and they filled the script.
Bottom line is this. You need to have a pdoc evaluate you for PAD. Then, if you have it, you need to let him/her control your meds, with appropriate follow ups and at appropriate dosages. No doctor in their right mind is going to prescribe 12mgs of xanax when your PAD is controlled by 2mgs. If they do, they'll lose their liscense to practice also. This may be difficult for you now if you don't live in a very large city.
Find a pdoc, be honest, and you'll begin to gain the pdocs trust. If 2mgs is all you need, and the pdoc feels you have PAD, that's what will be scripted. If your taking more than 2 a day, you will run out before your next refil or follow up, and the doctor will be very skeptical about your story.
Sorry about the long post. Your story had lots of elements to it. Get back to me by email if you like, >rspringer@prodigy.net< I'll be happy to tell you about my experience with taking xanax at 13mgs/day in the mid 80's, prescribed by a pdoc. At that time I knew nothing about xanax, PAD, or any of the other issues I've discussed. I just blindly followed the pdocs instructions and it was one wild ride for a couple of years.
poster:Rathrbfishn
thread:105759
URL: http://www.dr-bob.org/babble/20020510/msgs/105943.html