What Is the Big Deal About Xanax? What Is the Longest the Rx Can Be Used?
Question by Dear Jane…: What is the big deal about Xanax? What is the longest the Rx can be used?
I recently started a prescription for a low dose of Xanax, basically for anxiety and depression related symptoms. Man, this stuff really helps me out. I am able to function so much better on so many levels and really the only draw back is that it makes me sleepy.
Let me just say that I used to work in a pharmacy, and I understand the addictive properties of this drug and how people can and will abuse it. Even though my doctor understands that this is not going on, she told me today that they don’t like to continue Xanax for more than a couple of months and she also reffered me to a psychiatrist. I’m just wondering what the big fear of “more than a couple of months” is if it’s a) obviously working and working well and b) I’m exhibiting no signs of abuse etc. and keeping up with all my scheduled appointments? Now I know hydrocodone was a big deal because I learned in the pharmacy it’s basically like synthetic heroin or an opiate. I wasn’t of the understanding that Xanax was like that or had any properties like that and that people basically just abused it with alcohol or took like a whole bunch at a time. Am I missing something that I don’t know about this drug?
Here’s the thing: if it really works for me, why stop it? I don’t show any signs of addiction, I’m not asking the pharmacy over and over for them to fax the doctor for more refills than I was prescribed, and I’m not drinking or taking more than I should be. She only wrote it for one more month for once a day even though we talked about me needing it more. Before I had it three times a day and I was only taking it once a day because I didn’t want to abuse it. I simply just said that I thought some days I needed it twice, but not all days. When I forget to take it, a lot of anxiety I have over germs, and money is heightened and I start really freaking out. I can’t even use a public restroom on the days I forget and sometimes I get really angry or lash out. My husband will even be like, “Honey, take your medicine” because he notices how bad I get and I told my doctor and she was like “that is good that he sees that”.
I don’t want anyone to suggest that I start smoking weed. I’m sorry but that’s not even the same thing. Sometimes weed can make anxiety/depresssion worse and I have a job that is more important than getting high and I have a child that I don’t want to be high around. I don’t want to depend on something illegal anyway. So case closed on that and no one mention it, please.
So, I’m not trying to look like a pill head here, but I really need to know when I go to this psychiatrist what to say to make him continue the Rx. I also want to know, even though I’ve read up on side effects, compounds, and everything -what it is that makes doctors NOT want to let anyone continue this drug, even if it’s helping?
Best answer:
Answer by Liz
It sounds to me like you have a really good doctor. The doctor prescribed the xanax to treat anxiety and depression. The fact that it worked, means tha you have anxiety and depression and therefore, need the help of a psychiatrist. The psychiatrist will probably continue to prescribe the same medicine since it is working. Your doctor isn’t saying you shouldn’t take it, just that he shouldn’t be prescribing it for a long period of time. The prescription should come from a psychiatrist.
Answer by Aiden
Much like chronic pain, chronic anxiety is best managed by longer-acting drugs that reduce the incidence/severity of (a) rebound hypervigilance (which you’ve experienced when you missed a dose), and (b) physiological dependence.
Dependence follows habituation, and the severity of clinical habituation is inversely related to a drug’s half-life.
Even though both Xanax and Klonopin are benzodiazepines, for example, physicians are reluctant to use Xanax for long-term monotherapy for good reason.
Having had experince in working in a pharmacy, you’re probably aware of alternatives to Xanax and that some of these aren’t even benzos (e.g. BuSpar, Lyrica, Inderal, Paxil, and Elavil).
Anyway, your goal seems to be in finding a way to continue with Xanax because it works (for now); I can understand your logic but suggest a better goal would be to able to function well over the long term.
Xanax is often prescribed in the acute period following a diagnosis of some form of anxiety disorder, but its short half-life makes it a poor drug in the long-term. If I could sway you in any way, my advice would be to keep an open mind and talk to the psychiatrist about an option other than continuing with Xanax.
The goals of prescribing medications for chronic anxiety are to achieve quick symptom relief (e.g. with an initial course of rapid-acting anxiolytics) then symptom remission by switching to an anxiolytic with a more stable plasma profile to prevent rebound anxiety and habituation/dependence (i.e. by prescribing anxiolytics with longer half-lives which provide longer durations of action for maintenance therapy.
Seeing as Xanax works for you now, Klonopin (clonazepam) would likely work because both bind to the same (GABA-A) receptors in the brain. As an added benefit, a metabolite of Klonopin (7-aminoclonazepam) also works as a weak partial benzodiazepine receptor agonist to provide a smoother, longer-lasting anxiolytic drug profile than Xanax.
The provision of long-lasting relief is key to the success of any med. for chronic anxiety disorders … the psychiatrist you’re scheduled to see knows this and may have a better strategy. Why not talk over your options with him/her, ask questions, and decide what’s best for you in the long-term?
Heroin Addiction Warps Brain's Ability to Change
Healthcare costs due to opioid abuse total around $ 50 billion each year, according to Hurd, and opioid abuse in particular costs 2.5 times that of other medical disorders. She also noted that "many new heroin users were first prescription opioid users …
Read more on MedPage Today