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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by jealibeanz on December 27, 2006, at 23:36:27
Has anyone switch from brand name Xanax IR to brandname Xanax XR? Or generic alprzolam IR to generic alprozolam XR with any success? How does the dosing compare in real life? More or less than before? Do you do twice a day dosing?
I currently take Brand Xanax IR 1 mg t.i.d. I've been trying to take less, but end up take my full prescibed amount by the end of the night. Sometime I forget (there's that ADHD kickin in) or I tend to unknowingly let the axiety build until I need to take 2 or 3 within hours of each other. I'm going through a very stressful/emotional time. I think I'll hold off on my plan to cut back.
I notice I get really cranky when I don't take it. I'm not sure what to tell me doc exactly. I'm wondering if Xanax XR would be better, but there never seems to be wonderful reviews. I also fear that if he goes by the company's dosing conversion guidelines, I'll end up with much less of the drug than my body is used to. It seems like most people need more on XR than they did on IR. I doubt he'd very experienced with this med, since it doesn't seem to have been a big hit.
Still gotta work on the ADHD meds too. I've gone up to 54 mg Concerta. It has minimal effects and only lasts 4 hours. Don't know what's up with that. Hopefully he'll have new ideas!!!
Posted by med_empowered on December 28, 2006, at 0:47:03
In reply to REAL benefit from Xanax XR vs. Xanax IR, posted by jealibeanz on December 27, 2006, at 23:36:27
xanax xr is largely a patent maneuever, since xanax is now generic and very cheap, but I imagine some patients could derive benefit. Personally, I say stick with IR.
You'll notice that lots of benzos--even ones with long half lives, like tranxene--have xr or sr formulations that are only kinda sorta successful, if they took off at all.
Posted by yxibow on December 28, 2006, at 4:29:21
In reply to REAL benefit from Xanax XR vs. Xanax IR, posted by jealibeanz on December 27, 2006, at 23:36:27
> Has anyone switch from brand name Xanax IR to brandname Xanax XR? Or generic alprzolam IR to generic alprozolam XR with any success? How does the dosing compare in real life? More or less than before? Do you do twice a day dosing?
>
> I currently take Brand Xanax IR 1 mg t.i.d. I've been trying to take less, but end up take my full prescibed amount by the end of the night. Sometime I forget (there's that ADHD kickin in) or I tend to unknowingly let the axiety build until I need to take 2 or 3 within hours of each other. I'm going through a very stressful/emotional time. I think I'll hold off on my plan to cut back.
>
> I notice I get really cranky when I don't take it. I'm not sure what to tell me doc exactly. I'm wondering if Xanax XR would be better, but there never seems to be wonderful reviews. I also fear that if he goes by the company's dosing conversion guidelines, I'll end up with much less of the drug than my body is used to. It seems like most people need more on XR than they did on IR. I doubt he'd very experienced with this med, since it doesn't seem to have been a big hit.
>
> Still gotta work on the ADHD meds too. I've gone up to 54 mg Concerta. It has minimal effects and only lasts 4 hours. Don't know what's up with that. Hopefully he'll have new ideas!!!
If you and your doctor think that Xanax rx'd daily, XR or IR are a good thing, and you have best response to it compared to other benzodiazepines I suppose one can't stop a good thing. But the crankiness rings of interdosal problems.Benzodiazepines with short half lives generally have their best use as a PRN medication, and as such have a more powerful response when used occasionally. Valium or Klonopin still seem like better ideas for daily benzodiazepine regimes but some people I suppose may not respond as well.
Just a thought. And the XR is really just a patent extender, for the most part. Maybe a small market enjoys benefit because for them as I was noting above if that is your case, Xanax is the only thing for them that works better than the laundry list of benzodiazepines with longer half lives.
-- tidings
Posted by jealibeanz on December 28, 2006, at 5:11:52
In reply to Re: REAL benefit from Xanax XR vs. Xanax IR » jealibeanz, posted by yxibow on December 28, 2006, at 4:29:21
I know the responses I have received indicate that XR is just a marketing ploy, which is an idea I can accept, but does this means its use is of no benefit?
There are lotttssss of types of medicines that come in ER,XR,or SR versions. While consumers are bothered by the cost, these medications usually are beneficial, since patients only have to take medication once or twice a day, and the serum drug level is more constant.
Back Xanax XR... did you find that you were disappointed because it didn't last as long as the company claims? This happens frequently with any extended-release type drug.
Did it not provide anxiety relief? I've heard that many have to increase the dose above the companies recommended equivalent dosing.
Lastly, did you know that Xanax XR's patent ran out? There's now generic alprazolam XR manufatured by a few companies.
Posted by Phillipa on December 28, 2006, at 11:29:27
In reply to Re: REAL benefit from Xanax XR vs. Xanax IR, posted by jealibeanz on December 28, 2006, at 5:11:52
Not only did I not know that but I didn't know there was an IR version whats the difference between xr and IR. Thanks, Phillipa
Posted by yxibow on December 28, 2006, at 12:09:08
In reply to Re: REAL benefit from Xanax XR vs. Xanax IR » jealibeanz, posted by Phillipa on December 28, 2006, at 11:29:27
> Not only did I not know that but I didn't know there was an IR version whats the difference between xr and IR. Thanks, Phillipa
IR is just a codeword for instant release, the original Xanax, as far as I surmise in this conversation. XR is the mostly patent-extended version of Xanax which allows an enteric pill to be distributed in the gut over around 24 hours instead of taking about 4 original Xanax a day.
Posted by yxibow on December 28, 2006, at 12:26:43
In reply to Re: REAL benefit from Xanax XR vs. Xanax IR, posted by jealibeanz on December 28, 2006, at 5:11:52
> I know the responses I have received indicate that XR is just a marketing ploy, which is an idea I can accept, but does this means its use is of no benefit?
I mentioned the only benefit above if Xanax is the only thing that happens to work for you, it eliminates some of the interdosal issues by taking it once a day. At the same time I still don't believe a drug that has such an immediate release as Xanax should be, for lack of a better way of saying it, wasted on a 24 hour cycle when it has better use as a PRN medication for breakthrough serious anxiety situations rather than a less subtle agent like clonazepam. But as I said, if it is the only agent that "works", then thats about the use of it.
> There are lotttssss of types of medicines that come in ER,XR,or SR versions. While consumers are bothered by the cost, these medications usually are beneficial, since patients only have to take medication once or twice a day, and the serum drug level is more constant.This is true for some agents -- but they are deliberately timed when either a patent runs out or the original agent fails its marketing.
The one that I can think of that has had medically valid uses in any recent time is Wellbutrin SR, but not necessarily XR. Wellbutrin by itself runs a higher risk of seizure disorders in even non-epileptic patents but SR tends to smooth out that. XR is probably not necessary for that and was a patent extender because there was already SR generic formulations anyhow, but it might have decreased that risk slightly more. SR with a small dose of any AED though would probably be about the same.
> Back Xanax XR... did you find that you were disappointed because it didn't last as long as the company claims? This happens frequently with any extended-release type drug.
>
> Did it not provide anxiety relief? I've heard that many have to increase the dose above the companies recommended equivalent dosing.
>
> Lastly, did you know that Xanax XR's patent ran out? There's now generic alprazolam XR manufatured by a few companies.
Most all, if not as you say all, benzodiazepines have long ran out their patents. There hasn't been much new benzodiazepine research on the market because there are a gamut of agents that have worked successfully for as long as nearly 50 years.I think there should be more original research on agents other than the (mostly) 1,4 benzodiazepines that exist, further understanding their attachments to GABA-BZ and creating less habituating compounds.
Still, there are those who are purists or who think that the "original" is best, and some for example spend extra money for the "original" Klonopin, first approved nearly 32 years ago, still manufactured in some smaller runs I guess, even though it is available generic from about a dozen companies.
In the irony of the FDA's growing resentment and restrictions on importation, if one takes a look at their bottles of OTC medication like generic loratadine (Claritin), they're likely to see "manufactured in India" (which has several generic firms including Mr. Reddys) or generic Zantac (which is made in Canada sometimes).-- tidings
Posted by jealibeanz on December 28, 2006, at 13:18:09
In reply to Re: REAL benefit from Xanax XR vs. Xanax IR » jealibeanz, posted by yxibow on December 28, 2006, at 12:26:43
> I mentioned the only benefit above if Xanax is the only thing that happens to work for you, it eliminates some of the interdosal issues by taking it once a day. At the same time I still don't believe a drug that has such an immediate release as Xanax should be, for lack of a better way of saying it, wasted on a 24 hour cycle when it has better use as a PRN medication for breakthrough serious anxiety situations rather than a less subtle agent like clonazepam. But as I said, if it is the only agent that "works", then thats about the use of it.
>Right, I found Xanax to be the best benzodiazepine for ME. Many people like Klonopin, or generic clonazepam, but I found it depressing, sedating, clouded my thinking, and made me clumsy, even at tiny doses (1/8 to 1/4 mg). I like Xanax (especially brand-name, the generics vary quite a bit in my opinion. My copay is only $2 more, I just have to be using a pharmacy that carries, or is willing to order, which all are.
My comment about the benefit of XR, SR, and ER drugs was mostly coming from my knowledge of antidepressants. It's must better to have your patient take it once a day... then they less likely to miss a dose! But still they are many many other drugs. They keep serum levels even and are easier to remember to take daily. I'm just not one who completely dismissed all of the new formulation as a money-makers for big pharma. Sure, they are, but they also help patients.I also think that it's easier to get the IR versions FDA approved, so they start with that, then when the company's patent is coming out, they submit an extended-release version to the FDA. I may be wrong, but I think this is true at least in some situations.
> > Back Xanax XR... did you find that you were disappointed because it didn't last as long as the company claims? This happens frequently with any extended-release type drug.
> >>
I'm not sure of the approval date, but Xanax XR hasn't been around that long, which is why the patent just ran out in January 2006.
Of course there are other long-acting benzodiazepines available, but they all have different chemical structures and therefore work on different receptors. That's why we all have our invididual preferences. I personally think Xanax XR is a good idea, since many people like it for short-duration use, why not see if that group of people can have a version of an effective drug that only requires once or twice a day dosing?
>
> I think there should be more original research on agents other than the (mostly) 1,4 benzodiazepines that exist, further understanding their attachments to GABA-BZ and creating less habituating compounds.
>There is research being done into different forms of benzodiazepines, especially those that are being modified to not cause sedation (there may be one available in Europe?). I can't recall specific nomenclature off the top of my head, but I know there are some in the "pipeline."
>
> Still, there are those who are purists or who think that the "original" is best, and some for example spend extra money for the "original" Klonopin, first approved nearly 32 years ago, still manufactured in some smaller runs I guess, even though it is available generic from about a dozen companies.
>
>
By this I assume you mean brand name vs. generic. I've have widely varying responses to generic and brand name versions of many types of medications. So, I believe if you find a particular brand, or generic company, that works best, stick with it. The FDA allows a +/- 10% "error" for all generics, in regard to the active ingredient. The inactive ingredients aren't required to be exactly the same. Some companies use different "fillers and dyes". This could cause a variation in response. Also, if you speak to many doctors or pharmacists, they'll admit that the FDA doesn't always do a great job regulating certain generic company's drugs. They've got patients who can attest to widely differing responses when switching between companies. I know there are standards, but those only hold up in an ideal world!Good discussion!!!
Posted by blueberry1 on December 28, 2006, at 17:13:56
In reply to REAL benefit from Xanax XR vs. Xanax IR, posted by jealibeanz on December 27, 2006, at 23:36:27
It is purely personal opinion, but I favor immediate release xanax better than extended release. I don't take xanax regularly, but whenever I have taken it I get a pronounced rapid antidepressant effect. I don't get that from the extended release. Makes me wonder why I don't take it more often. Even as much as I think benzo phobia is ridiculous, I think I have benzo phobia. Go figure. Anyway, I like IR better than XR.
Posted by yxibow on December 28, 2006, at 18:11:35
In reply to Re: REAL benefit from Xanax XR vs. Xanax IR, posted by blueberry1 on December 28, 2006, at 17:13:56
> It is purely personal opinion, but I favor immediate release xanax better than extended release. I don't take xanax regularly, but whenever I have taken it I get a pronounced rapid antidepressant effect. I don't get that from the extended release. Makes me wonder why I don't take it more often. Even as much as I think benzo phobia is ridiculous, I think I have benzo phobia. Go figure. Anyway, I like IR better than XR.
>
>If you have pronounced euphoria, its probably good that you do take it more often. That is what I was referring to the PRN nature of Xanax. If one gets used to the "immediacy" of Xanax and Ativan it becomes less valuable for that crushing day when its needed. But that's up to the individual.
-- Jay
Posted by Phillipa on December 28, 2006, at 19:29:01
In reply to Re: REAL benefit from Xanax XR vs. Xanax IR » Phillipa, posted by yxibow on December 28, 2006, at 12:09:08
Thanks Jay so a code word. Love Phillipa
Posted by Phillipa on December 28, 2006, at 19:35:39
In reply to Re: REAL benefit from Xanax XR vs. Xanax IR » blueberry1, posted by yxibow on December 28, 2006, at 18:11:35
When I took xanax and ativan at differant times I found them to just keep me smooth. No breakthrough anxiety. I've heard from realatives that their pdoc had to add back in the regular xanax as the long acting didn't release as it should so there were gaps. Love Phillipa
Posted by yxibow on December 28, 2006, at 20:06:11
In reply to Re: REAL benefit from Xanax XR vs. Xanax IR » blueberry1, posted by yxibow on December 28, 2006, at 18:11:35
> > It is purely personal opinion, but I favor immediate release xanax better than extended release. I don't take xanax regularly, but whenever I have taken it I get a pronounced rapid antidepressant effect. I don't get that from the extended release. Makes me wonder why I don't take it more often. Even as much as I think benzo phobia is ridiculous, I think I have benzo phobia. Go figure. Anyway, I like IR better than XR.
> >
> >
>
> If you have pronounced euphoria, its probably good that you do take it more often. That is what I was referring to the PRN nature of Xanax. If one gets used to the "immediacy" of Xanax and Ativan it becomes less valuable for that crushing day when its needed. But that's up to the individual.
>
> -- Jay
>Ack, how do I miswrite these mis-double unnegatives... I mean't dont take it more often... I proofed my writing oh well... anyhow... I meant do not take it more often
Posted by Phillipa on December 28, 2006, at 21:28:49
In reply to Re: REAL benefit from Xanax XR vs. Xanax IR » yxibow, posted by yxibow on December 28, 2006, at 20:06:11
Jay that's funny you made me laugh a great accomplishment. Love Phillipa and don't be hard on yourself for a simple typo
Posted by valene on December 29, 2006, at 8:56:10
In reply to REAL benefit from Xanax XR vs. Xanax IR, posted by jealibeanz on December 27, 2006, at 23:36:27
I find that xanax ir works just fine for me and have taken it since it came on the market. Seems my metabolism is such that I can go many hours between doses (up to 10-11) but I try to space it evenly taking less now than I did 25 years ago. Never tried Klonopin and don't want to since if you do a search here on babble you will find K is depressing to many people. I take 1.75 mg. xanax per day, down from 3mg. which I took for many years. It works for me but wish I never took the first pill :(. Withdrawals are real and not fun so when I do reduce it's miniscule. Yes a benzo is a benzo and all have w/d but xanax has such a short half life and no metabolites so I reduced by using valium instead and found I hated valium due to it's depressant properties. I actually find that xanax does have a bit of an a/d effect on me.
Val
Posted by jealibeanz on December 29, 2006, at 10:14:56
In reply to Re: REAL benefit from Xanax XR vs. Xanax IR, posted by valene on December 29, 2006, at 8:56:10
I agree that Klonopin has depressing properties. That, in conjuction with Adderall, sent me spiraling into crying spells and the oddest feeling of depression and dissociation. We had to remedy the with a short period of Effexor (yuck, hate all SSRIs/SNRI/Wellbutrin), but it brought me to a more stable point.
Sad, because previously it had been the happiest and most productive time in my life. Yes, I was suffering from anxiety, which I always have, and struggled a bit from fatigue and ADHD. However, I was working very hard and was at a very successful and lifechanging time at my life due to my efforts. I asked to return to a trial of the medications because I was getting very anxious from my own predispositions, coupled with my lifestyle. It turned into a disaster.
I am able to take Xanax with no problems at all. If I take a large dose due to extreme stress and near panic, I am very tired, but other than that, no complaints. I also find it to have antidepressant effects.
I must metabolism meds quickly. Xanax IR (and yes, I use only brand name now), works for about 3 hours.
My Concerta only seems to last about 4! It's supposed to have 12 hour coverage, but from what I've read, most patients to not get quite 12 hours, but maybe 8-10. Some even do twice a day dosing or supplement with Ritalin IR.
The Concerta dose is probably far too low for me, at 54 mg, so I will discuss this at my next appointment a few days from now. He may even want to try a different med, other than Adderall! I am getting little effect from Concerta, but thankfully no adverse effects, so increasing may be an option, as well as supplement Ritalin IR. But who knows, only time and trial and error will tell.
I don't think I'll bring up the anxiety right now. I'm just going through a short patch where my life turned upside down and trying to fix many things! I'll be OK in no time, if not, it'll be addressed at the next follow-up appointment in a month or two.
Posted by Phillipa on December 29, 2006, at 19:37:02
In reply to Re: REAL benefit from Xanax XR vs. Xanax IR » valene, posted by jealibeanz on December 29, 2006, at 10:14:56
So since it was my big idea to switch to valium. Do you all think I should try and switch back to the xanax as I took it too for years and then it just started to make me tired. But it did have ad properties. But how would you go from a long acting benzo to a short acting one? Love Phillipa
Posted by elanor roosevelt on December 29, 2006, at 20:12:23
In reply to Re: REAL benefit from Xanax XR vs. Xanax IR » jealibeanz, posted by yxibow on December 28, 2006, at 12:26:43
for me the major benefit of xanax is how quickly it kicks in so that you can take very low doses as needed
my anxieties are not consistent across time
This is the end of the thread.
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