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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by David 43 on January 30, 2004, at 9:49:32
Greetings,
As a long-time (20 years ) Alprazolam taker ( presently 2.5 mgs / day ) I had been abusing alcohol (beer) for years and years- I knew the two do not mix, but did it anyway ( I also take 100mgs imipramine and 100mgs metaprolol for depression and high B.P. / tachycardia ) OK- I detoxed from alcohol 8 days now- not a drop- feel OK.
Now- My original diagnosis was panic disorder in 1985- I was put on Xanax then. Actually- full blown panic attacks are very rare for me for several years now. But- anticipatory and generalized anxiety are a big problem. Over the years I have tried many times to taper off the Xanax but the withdrawals where horrible.
So- now the alcohol is out of the equation- While in the hospital ( detoxing from alcohol )- I was given Ativan ( which I never heard of ) and it worked like the Xanax sort of- ( I know it's a benzo ) my question is this....what to do? My parents want me in a detox center inpatient for Xanax- I think they are misinformed ( or am I ? ) I cannot "cold turkey" from such a high dose and I know I'd be climbing the walls.
Anyone know if they ( the detox program puts you on another benzo or something to take the place of the Xanax? ) Sounds like replacing one with another- but, perhaps something longer acting with some antidepressant characteristics might be a good thing. Anyone "been there, done that? "??Thanks!
Posted by Chairman_MAO on January 30, 2004, at 12:45:11
In reply to Alcohol detoxed.....Xanax next.help!, posted by David 43 on January 30, 2004, at 9:49:32
You cannot detox "cold turkey" from the "three B's": benzos, barbiturates, and booze. It is always adviseable--unless there is a clear reason not to--to use a drug from the same class that you've been taking. They gave you a benzo for alcohol detox simply because one cannot taper from alcohol!
You do not need to go to a detox center to get off the xanax; that is excessive. However, you should be switched to clonazepam 5mg/day (longest duration of action of any benzo in the US, I think. Contrary to popular belief, Valium and Librium are NOT longer acting and have funky pharmacokinetics) and, since you've been on xanax so long, and because you already are taking medication for high blood pressure/tachycardia, the dose should be tapered as SLOWLY AS POSSIBLE, ideally over the course of a year. The end of the taper is the hardest part, and if you've always failed before, a GABAnergic agent should be added to make total withdrawl possible. Good choices (in order of what I'd imagine would work best) are Gabitril, Depakote, or Neurontin.
I have "been there and done that". I cannot emphasize enough: DO NOT QUIT COLD TURKEY unless you want to end up in the E.R. or abusing alcohol again. Do not try to rush the tapering process; it will just increase the likelihood that you'll never get off benzos. I wish you the best of luck. As effective as benzos were for my anxiety, I'd rather HAVE some anxiety than indiscriminately dampening my limbic system. Some people require long-term prescription, but unfortunately benzos were irresponsibly prescribed (think making the patient dependent upon the physician is good medicine?) and, as usually happens in American medicine, the only thing that reigned in the public's consumption was classification as a controlled substance. Perhaps we as a society should have tried to figure out what about our CULTURE made people so eager to consume benzos and left the benzos where they belong: on the shelf at the pharmacy next to the Tylenol, which benzos are safer than. I believe in this rule of thumb: if you can deal with your anxiety well enough to get out of your house, you probably can do fine with other (albeit way more expensive) pharmacological/psychological treatments.
This is the end of the thread.
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