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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Jennifer on August 1, 2000, at 21:04:45
Dear Cam,
I was at the dentist today getting a root canal, and I took my handful of xanax beforehand, to make sure that I didn't get a panic attack. My attaks are less fequent, and I really take xanax only a couple times a month when I feel trapped. (such as in the dentist chair, or carpooling with someone). I know that I take more than I need, becuase I'm not in the position to have a break though attack. 1.5mg would have probably covered me today, but I took 3mg (1.5 then 1.5 half hour later) I mentioned to the dentist that I wish it worked sublingually to avoid overusage. He gives his patients Halcion sublingual prior to procedures to downplay the panic. I know Halcion is no fun as a long term drug, especially in the elderely, but at age 37, with infrgeuentt use, do you think it would be ok ?? Would it mix with Nardil?? Jennifer
Posted by Cam W. on August 2, 2000, at 6:39:49
In reply to CAM! Halcion for panic?!!!, posted by Jennifer on August 1, 2000, at 21:04:45
Jennifer - I have noticed that the dental office across the alley has been ordering generic Halcion (triazolam) from me. They had a new "Doogie" start there a few months ago. I thought he was ordering the Halcion for "personal use", but have subsequently found that they are using it for sedation in anxious patients. Even the older (our age) dentist is now using it. Up until now, they had been using diazepam (Valium) injectible for anxiety, but they use that much less now.
Occasional Halcion use should be no problem. It is when you take it everyday and build tolerance to the effects, that problems start (or when you throw up in the lap of a Japanese Prime Minister - half a tablet, my a**). Also, there can be some problems with amnesia while under the influence of the drug. This can make driving home treacherous. The short half-life of an hour or two is a bonus, though (the effects don't last anywhere near as long as Valium). Sublingual use of Halcion may work faster and better for the panic, but I don't think that it would have anything to do with stopping overusage. The best way to stop overusage is to not have a supply of the drug handy, which your dentist will probably not give you, anyway.
One potential problem is that Halcion is metabolized by the cytochrome system (primarily CYP-3A3/4). This means that inhibitors of this system (eg Serzone, Luvox, Prozac, diltiazem, grapefruit juice, etc.) could increase Halcion's effects (and side effects). If you were taking any of these CYP-3A3/4 inhibitors, you would probably require a smaller dose of Halcion for the same anti-panic effect. I haven't heard of any problem using Halcion with MAOIs.
Yes, occasional Halcion use should cause few, if any problems. Hope this helps - Cam.
Posted by danf on August 2, 2000, at 8:19:08
In reply to CAM! Halcion for panic?!!!, posted by Jennifer on August 1, 2000, at 21:04:45
would like to reinforce a bit of what Cam said.
halcions effect on short term memory makes it not a good drug for general anxiety use. Some folks may have a big memory gap, others less or none. if you are by yourself you will not even know that you do not remember. It does not put you out, just kind of erases a brief period.
taken for sleep this gap is during sleep & so is not missed.
this effect is liked by dentists because people have less fear later if something was uncomfortable. they don't remember the unpleasant episode.
most of the benzos can be speeded in onset if you let them melt under your tongue. part is absorbed thru the mucosa in the mouth. Xanax works this way too. It gets the med into the blood stream quicker.
Posted by SLS on August 2, 2000, at 21:10:01
In reply to Re: CAM! Halcion for panic?!!!, posted by Cam W. on August 2, 2000, at 6:39:49
> Jennifer - I have noticed that the dental office across the alley has been ordering generic Halcion (triazolam) from me. They had a new "Doogie" start there a few months ago. I thought he was ordering the Halcion for "personal use", but have subsequently found that they are using it for sedation in anxious patients. Even the older (our age) dentist is now using it. Up until now, they had been using diazepam (Valium) injectible for anxiety, but they use that much less now.
I am curious to know if there is a tendency for someone with an anxiety disorder to experience acute rebound anxiety after taking a single dose of Halcion. I would think this possible.
> I haven't heard of any problem using Halcion with MAOIs.
I have taken Halcion with Parnate and Nardil without any problems.
- Scott
Posted by danf on August 2, 2000, at 21:35:10
In reply to Re: CAM! Halcion for panic?!!!, posted by SLS on August 2, 2000, at 21:10:01
scott, did you take it for sleep or for anxiety control during the day ?
Posted by Jennifer on August 3, 2000, at 4:02:17
In reply to did you take it for sleep ? » SLS, posted by danf on August 2, 2000, at 21:35:10
Thanks guys! I questioned the dentist about the "forgetfulness" thing since I remembered having to check on any elderly patients around midnight to see if they were "out to lunch" after their h.s. dose of Halcion, but I infrequently worked the med unit, so I never had the opportunity to see anyone with "occassional" use. He said the anti-anxiety effect would wear off in 3-4 hours which is plenty long enough for me, but I'm forgetful enough as it is. My main thing is that when I need xanax, I need it NOW. Even sublingually it isn't fast enough. I'd pay good money for a hep-lock and an IV push! I can go weeks without needing it any, but occassionally I may need it a couple times in the same week. Unfortunately, I don't now how much I need. Sometimes 1mg covers the immediate situation and I'm ready to sleep in an hour. At the other end of the spectrum: Once I was subpeoned by the District Attorney in a murder case (No, I had NOTHING to do with it, I was just the nurse that turned the family in to APS). I talked with her beforehand that I would feel MAJORLY TRAPPED, so she promised me I would be up first, and only on the stand about 20 minutes. I took 2mg of xanax at 8am, then another.5mg at 8:30, then .5mg more every half hour so that it would "peak" while I was on the stand. The defense attorney decided I needed to go LAST, after lunch, and after FOUR hours of testimony, I had taken a total of 10mgs (between 8-5pm) and I was WIDE AWAKE. Boy did I sleep that night though! I didn't remember making my family dinner, but they said I did. That's probably what the Halcion feeling is like. I have a pdoc appt coming up, so I think I'll run it by him. I doubt he'll go for it though. I'm going on vacation the 12th...I'd sure hate to forget that I got to go! Thanks for the advice! Jennifer
Posted by SLS on August 3, 2000, at 10:24:40
In reply to did you take it for sleep ? » SLS, posted by danf on August 2, 2000, at 21:35:10
> scott, did you take it for sleep or for anxiety control during the day ?
Hi Dan.I took Halcion with and without Ativan while I was on both Parnate and Nardil. I don't recall the dosage. It may have been 1.0mg total (two 0.5mg tablets).
I believe I experienced a sort of mild benzodiazepine withdrawal syndrome early the next day. My guess is that this represented a rebound effect as the level of Halcion drops precipitously. I am wondering whether rebound anxiety can occur in individuals with an anxiety disorder when it is used to treat it acutely and temporarily. Halcion (triazolam) is perhaps the most potent of the benzodiazepines. It is also the one with the shortest half-life. The half-life is about 3 hours. It is metabolized primarily by CYP3A4.
- Scott
Posted by danf on August 3, 2000, at 11:21:16
In reply to Re: did you take it for sleep? - Rebound anxiety ?, posted by SLS on August 3, 2000, at 10:24:40
I know several people that took halcion as a sleep aid, not for anxiety.
some had episodes where they got out of bed & did things & had no memory of it the next day.
This has made me somewhat leery of it for daytime use, but then I do not know of anyone who has taken it during an acute panic attack.
I have also seen some folks who got it ( one time dose) for minor local surgical procedures & they had the memory loss of about 1/2 hr.
one lady swore she had never seen her Doctor & did not know who did her surgery. She was awake the whole time & talked to him for 30 min. The next day she did not remember the doctor being there at all.
I don't know about the rebound of anxiety. It does happen with xanax, so probably does with halcion as well.
Posted by Jennifer on August 4, 2000, at 4:56:45
In reply to Re: did you take it for sleep? - Rebound anxiety ?, posted by danf on August 3, 2000, at 11:21:16
Ongoing Halcion use is infamous for nighttime amnesia. It gets worse the longer you're one it. Especially in the elderly that might already be suffering from "sundowner syndrome" and metabolism changes. I've never personally had rebound anxiety from prn use of Xanax. One funny addition to your note...when I worked in O.R., people SWORE we didn't do surgery and refused to pay! Now how DID that cataract come out and that new lens get in your eye? Magic? Jen
> I know several people that took halcion as a sleep aid, not for anxiety.
>
> some had episodes where they got out of bed & did things & had no memory of it the next day.
>
> This has made me somewhat leery of it for daytime use, but then I do not know of anyone who has taken it during an acute panic attack.
>
> I have also seen some folks who got it ( one time dose) for minor local surgical procedures & they had the memory loss of about 1/2 hr.
>
> one lady swore she had never seen her Doctor & did not know who did her surgery. She was awake the whole time & talked to him for 30 min. The next day she did not remember the doctor being there at all.
>
> I don't know about the rebound of anxiety. It does happen with xanax, so probably does with halcion as well.
This is the end of the thread.
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