Posted by Elizabeth on June 15, 2001, at 22:10:17
In reply to Re: more about Xanax and depression » Elizabeth, posted by paulk on June 15, 2001, at 18:53:43
> I hadn’t heard that there was a XR version anywhere. Who is making it?
Pharmacia & Upjohn, the same company that makes regular Xanax. Xanax SR isn't marketed in the USA, though.
> I talked to a University Psydoc about this very issue - he said because the patent was out, no one would pay for the studies - etc. etc. (and several other cures are gone wanting for the same reason)
That's true, although there is something called a "use patent" (which is why you still can't get generic Prozac in the US).
> I’m taking a very low dose (.25mg/day) of Clonazepam, which is also suspected of having some antidepressant effect (some study mentioned some seritonin activity), but in my mind Xanax (Alprazolam) was even better that way.
Most people find it to be, and there's evidence that Xanax is an antidepressant when used in high doses.
> Unfortunately, it was quite a bear to manage frequent dosing at a low level, so I stopped it many years ago. Xanax quits so fast and nasty that I can see why it would be addictive. Sure wish there was an XR version to try.
Addiction results from using large doses of a drug to get high. Anybody who's been taking Xanax for a long time will get withdrawal symptoms; that's not drug addiction, it's a normal reaction.
> I’m now also taking Nardil. Figured out why it is started the way it is – (starts off at 15mg – ramps quite rapidly and then back to 15 – 30mg/day) – the drug only has a 1-2 hour half-life – so it seems strange – until you figure that the enzyme it is deactivating has a much longer half-life of being replaced (no mention of this in the PDR BTW).
Nardil is an irreversible enzyme inhibitor; its elimination half-life isn't relevant. There's no reason to take it in divided doses, even, except perhaps to even out any side effects that you might get.
I know a guy who was able to decrease his need for Xanax dramatically when he started taking Nardil. Nardil is a great drug for anxiety.
> You need to have about 90% of MO enzyme deactivated before it can start to work – and then it might take a few weeks.
That's because antidepressant effects aren't due to the direct effects of the drugs, they're due to longer-term adaptations to the direct effects. (MAOIs seem to work faster than other ADs sometimes, though, and the anxiolytic effects of Nardil in particular may kick in sooner.)
> Do you know if the low BP side effect is a ‘primary’ effect of the drug or a result of the lowering of the MO enzyme level?
I'm not sure I understand the question. Orthostatic hypotension (slowed cardiovascular adaptation to changes in posture) is probably due to central activation of alpha-adrenergic receptors (which results from increased norepinephrine, which results from destruction of MAO).
> I understand why one shouldn’t take SSRIs and the like but I don’t understand why there would be a need to discontinue other MOAIs when switching between types? After all, the Nardil would wash out in a day or so? Are they acting on different enzymes?
That one is a mystery. It may only be a problem when switching between Nardil or Marplan (the hydrazide MAOIs) to Parnate (an amphetamine-like MAOI).
> I’m also wondering if I should get a med-alert bracelet - I understand that Demerol (meperidine) can be fatal – I would hate to be in a car accident and get Demerol in the ER that could kill me.
Demerol's pretty crappy anyway. They should use morphine. :-) Yeah, it probably is a good idea to have a medical emergency bracelet or necklace. (I prefer the latter; the bracelets seem to get in the way a lot.)
-elizabeth
poster:Elizabeth
thread:65795
URL: http://www.dr-bob.org/babble/20010612/msgs/66625.html