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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by bassman on April 15, 2006, at 10:18:26
I have panic disorder and depression. I'm taking 0.75 mg Klonopin and 150 mg Wellbutrin, and 5 mg (that's right) of Prozac. 300 mg of Wellbutrin gave me intensely fearful periods during the day. Frankly, my meds aren't doing much good at all-I'm still depressed and anxious. But here's the question: if I take 1 mg of Xanax at about 6 PM, the next day I feel vastely better-almost happy. My doc is fine with me taking the Xanax, so that's not a problem. I just wonder if it's worth the dependence to feel much better and if I have reason to believe it would continue to work. 1.75 mg of benzos a day seems a lot to me. 0.5 mg doesn't work the same way at all. Any thoughts on this question or alternative ideas? Thanks.
bassman
Posted by Glydin on April 15, 2006, at 10:55:40
In reply to Advice on Xanax solicited, posted by bassman on April 15, 2006, at 10:18:26
> I just wonder if it's worth the dependence to feel much better and if I have reason to believe it would continue to work.
~~~ I certainly thought it was for me. I was accepting of my use of Klonopin and the medical dependence that came with it. Klonopin was a true and trustworthy friend to me. During my time of use, I did not experience tolerance and while I titrated, my range remained consistent for three years. While I don't have alot of experience with Xanax, I see the category of benzo's in general terms.
I think there is good evidence to support that alot of folks who are using benzo's for anxiety control do find a maintance dose that works for them, they remain with that dosing, and can find that effect consistent for years and years. As a class of meds, benzo's have been around quite a while and we know alot about them. When one searches, the horror stories abound BUT that is not always the case for everyone. I think they are good meds with a proven track record.
Posted by SLS on April 15, 2006, at 11:42:40
In reply to Advice on Xanax solicited, posted by bassman on April 15, 2006, at 10:18:26
Hi.
I agree with Glydin.
> I just wonder if it's worth the dependence to feel much better
Don't look now, but you are on two drugs that produce a physiological dependence. Dependence means only that there will be a withdrawal syndrome upon discontinuation or rapid dosage reduction. Prozac and other SRI antidepressants produce dependence.
Actually, I guess the term "dependence" can be generalized further. If you find a treatment that works; the cessation of which allows for a relapse; you become dependent on that treatment to maintain your health.
It is a matter of perspective.
If it were me, I would accept the fact that I will develop a dependence on Xanax, and that I will need to take it indefinitely. Dependence only would become an issue if a time should come when it is in my best interests to discontinue the drug, in which case a managed discontinuation strategy will mitigate withdrawal symptoms.
There is the option of discontinuing both antidepressants, continuing with BZD therapy, and trying Nardil.
Be well.
- Scott
Posted by blueberry on April 15, 2006, at 11:48:12
In reply to Advice on Xanax solicited, posted by bassman on April 15, 2006, at 10:18:26
I can relate to your story. I have had similar experience and doubts with xanax.
While on prozac and zypexa, I was basically ok but had anxiety and a lack of pleasure. Going to an annual convention my doc gave me xanax. I was stunned to find that on the first day with at .5mg X 3 I felt perfectly normal and fine for the first time in years. After the convention, I weaned off the xanax fearing dependence, tolerance, or the loss of the good effect. Would it have kept working? I do not know.
The same thing happened a year later, this time on just zyprexa and 1mg (yeah, just 1mg) of cymbalta. I was a nervous wreck and depressed. Xanax once again proved to be wonderful. I felt perfectly normal. Again, I weaned off.
I am not on meds now. When I take xanax by itself, it is lousy. It relaxes my body, but that's about it. No mood enhancement, no removal of fear. For some strange reason, it only worked wonderful when in combination with zyprexa and prozac or cymbalta. Would it have kept working is a good question. I should have just gone with it and not worried so much.
Posted by bassman on April 15, 2006, at 12:43:49
In reply to Re: Advice on Xanax solicited, posted by blueberry on April 15, 2006, at 11:48:12
Thanks, that's really interesting-when I was on 3 mg of Xanax (only) a few years ago, it did very little to help either panic or depression. In combination with Paxil, I felt the best I ever have, for about three years. Then I decided to taper off the Xanax-then the Paxil didn't work. I wonder if it was really the combination that worked, as was your experience...so maybe the Paxil didn't poop out, it just did't work the same without the Xanax. I've had a really easy time of withdrawing from Paxil, Klonopin, and Ativan-as in, no symptoms. With Wellbutrin withdrawal, I was passingly dizzy for a couple days. And of course, I did withdraw from Xanax, but I did feel that, for sure, slow as the taper was. Thanks...hummmm...
Posted by SLS on April 15, 2006, at 13:45:53
In reply to Re: Advice on Xanax solicited, posted by bassman on April 15, 2006, at 12:43:49
There is a rationale as to why benzodiazepines should work so much better when combined with certain antidepressants.
Stephen Stahl, MD is a big proponent of combining a SRI antidepressant with a benzodiazepine. They seem to complement one another (serotonin + GABA). It is disappointing that so many doctors don't realize this. I would think that Paxil or Effexor + Xanax or Klonopin would be at the top of the list to treat anxiety disorders with and without depression. I guess Valium should not be forgotton. Adding some CBT wouldn't hurt.
- Scott
Posted by valene on April 15, 2006, at 14:55:46
In reply to Advice on Xanax solicited, posted by bassman on April 15, 2006, at 10:18:26
I take 1.5 - 1.75 xanax daily and was on 3mg. a year ago. I feel that I need it for my quality of life. I have been on xanax for over 20 years and am not about to just stop it at this time.
Val> I have panic disorder and depression. I'm taking 0.75 mg Klonopin and 150 mg Wellbutrin, and 5 mg (that's right) of Prozac. 300 mg of Wellbutrin gave me intensely fearful periods during the day. Frankly, my meds aren't doing much good at all-I'm still depressed and anxious. But here's the question: if I take 1 mg of Xanax at about 6 PM, the next day I feel vastely better-almost happy. My doc is fine with me taking the Xanax, so that's not a problem. I just wonder if it's worth the dependence to feel much better and if I have reason to believe it would continue to work. 1.75 mg of benzos a day seems a lot to me. 0.5 mg doesn't work the same way at all. Any thoughts on this question or alternative ideas? Thanks.
> bassman
Posted by Phillipa on April 15, 2006, at 22:27:58
In reply to Re: Advice on Xanax solicited, posted by blueberry on April 15, 2006, at 11:48:12
Blueberry you found something that worked for you why suffer and not take what works for you. I think you are fortunate to find a combo that works for you. Fondly, Phillipa
Posted by greywolf on April 16, 2006, at 0:34:40
In reply to Re: Advice on Xanax solicited » blueberry, posted by Phillipa on April 15, 2006, at 22:27:58
I take up to 4mg/day Xanax. Seems to do fine by me, although there is some fatigue involved at that dosage.
Posted by blueberry on April 16, 2006, at 14:38:54
In reply to Re: Advice on Xanax solicited » blueberry, posted by Phillipa on April 15, 2006, at 22:27:58
Phillipa, you're right, I did find something that worked. But it was for such a short time and I was maybe overly fearful of a benzo in the mix, even though it was the benzo that made everything else work. I was so afraid of it pooping out and leaving me screwed and facing withdrawals at the same time.
If I could turn back the clock, I probably would stay with it. The problem is, I have deteriorated so badly in the last 2 months being off of all meds, that I am now in a very fragile state. I bet even just a miniscule amount of any of the meds I used to take would either feel really bad or feel like rocket fuel or something. I am so terrified to take another med, and yet terrified to stay where I am.
Posted by Phillipa on April 16, 2006, at 14:56:34
In reply to Re: Advice on Xanax solicited » Phillipa, posted by blueberry on April 16, 2006, at 14:38:54
Blueberry you sound like my twin. Why don't you switch on your Babblemail light or use my babblemail since mine is on and send me your E-mail address. And I'm send you mine. Seems we have a lot in common meds wise. Love Phillipa
Posted by rvanson on April 16, 2006, at 21:37:49
In reply to Advice on Xanax solicited, posted by bassman on April 15, 2006, at 10:18:26
> I have panic disorder and depression. I'm taking 0.75 mg Klonopin and 150 mg Wellbutrin, and 5 mg (that's right) of Prozac. 300 mg of Wellbutrin gave me intensely fearful periods during the day. Frankly, my meds aren't doing much good at all-I'm still depressed and anxious. But here's the question: if I take 1 mg of Xanax at about 6 PM, the next day I feel vastely better-almost happy. My doc is fine with me taking the Xanax, so that's not a problem. I just wonder if it's worth the dependence to feel much better and if I have reason to believe it would continue to work. 1.75 mg of benzos a day seems a lot to me. 0.5 mg doesn't work the same way at all. Any thoughts on this question or alternative ideas? Thanks.
> bassmanI have been on Xanax, more often then not, ever since it his the market in the early 1980's.
It has saved my life, as it allows me to sleep, but it doesn't help with depression in my case.
My .02 cents
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