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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 36. This is the beginning of the thread.
Posted by jealibeanz on May 4, 2007, at 4:29:42
I found this psychiatry blog. It's not like I didn't know that doctors didn't love prescribing Xanax, but I've never actually heard their opinions flat-out and unfiltered. It's very upsetting to read.
http://psychiatrist-blog.blogspot.com/2007/02/why-docs-dont-like-xanax-some-of-us.html
None of them said they'd ever written the first script for Xanax with a patient. They'd either never prescribed it, or only done so if they were continuing another doctor's care.
One poster mentions that benzo's are like finding a "shoe that fits". Every patient has their preference and some work better than others. I guess if Xanax is that perfect fit they all think the patient must settle for the 2nd or 3rd best medication for them in that case.
There's one person, an NP, who states that it's very difficult to transition a patient from a short-acting to a long-acting benzo. They struggle.
Posted by jealibeanz on May 4, 2007, at 4:33:37
In reply to Doctors = The-Anti Xanax, posted by jealibeanz on May 4, 2007, at 4:29:42
This all pretty much solidifies my suspicions that my doctor was purposely trying to switch me off of Xanax because of fear of addiction and he didn't want me "hooked", not for my own benefit of just taking a pill once a day. He must think he's really in the clear regarding me and Xanax. I certainly did not transition willingly or happily, but it's been done for 2 months now.
Yup, I no longer take 4 tablets a day... and I no longer get any anxiety relief because I'm on Xanax XR. I could probably taper down fairly easily and willingly because there's nothing for me to miss or argue about with XR (He already sneakily moved me from 4mg/day to 3 mg/day since that's the largest XR tablet made. Why don't I just try it?!). I don't like it!
I am the kind of person who would be proud of myself for having the strength and determination to accomplish something, even if it were uncomfortable and the immediate result was not fun. I tend to do things which I know will be good for me in the long run. My innate behavior is driven toward delayed gratification and I pride myseslf on my self-control.
However, I don't sit around and think, "It would be a great accomplishment if I could get myself off Xanax or Xanax XR."
I don't think it would be. I wouldn't be proud of myself. Even if in years to come I find a different drug that relieves my anxiety, I won't look back and be proud of getting off Xanax.
Why?! Because I see no point! It's like doing something just for the sake of doing something. I've actually been proud of myself for getting my doctor to prescribe Xanax for the past year at appropriate levels. It's the only thing that's ever helped and I was proud of myself for allowing myself to get what I needed.
This all really bothers me.
Posted by Klavot on May 4, 2007, at 10:41:41
In reply to Doctors = The-Anti Xanax, posted by jealibeanz on May 4, 2007, at 4:29:42
I often wonder how many doctors themselves take benzodiazepines, and what mechanisms are in place to prevent them from becoming addicts themselves, since they can just prescribe themselves the drug, or live off samples given to them by pharmaceutical representatives, etc.
Klavot
Posted by Honore on May 4, 2007, at 11:06:03
In reply to Re: Doctors = The-Anti Xanax, posted by Klavot on May 4, 2007, at 10:41:41
I've heard that some doctors do become addicted to xanax and that it's an extremely nasty addiction, and very hard to work away from. My pdoc has often been consulted in difficult cases like that, and he still prescribes xanax, but strongly recommends not taking more than 2 mg a day, because as you move up, the addictive potential becomes much stronger.
Honore
Posted by jealibeanz on May 4, 2007, at 11:10:11
In reply to Re: Doctors = The-Anti Xanax, posted by Klavot on May 4, 2007, at 10:41:41
> I often wonder how many doctors themselves take benzodiazepines, and what mechanisms are in place to prevent them from becoming addicts themselves, since they can just prescribe themselves the drug, or live off samples given to them by pharmaceutical representatives, etc.
>
> Klavot
MD's and DO's can write for themselves in the US. There are a few restrictions, but benzodiazepines aren't one of them. (They can't prescribe marijuana for themselves.)Depending on the state, NP's and PA's can write some scripts for themselves, but there are definitely restrictions. They have restrictions on certain controlled drugs in many states as it is, and I'm not sure that any state would allow them to self-prescribe benzodiazepines.
I think the only way a doctor would get in trouble is if a colleague brought it to the attention of a medical boards, HR, etc. Doctors do have a sort of anonymous reporting system when they suspect another has a susbstance abuse problem or any other condition that it dangerous to themselves and their patients.
Maybe the DEA would question it. I don't know. That would look awfully suspicious if a doctor were self-prescribing benzo's. (I'm not saying they shouldn't take them, but shouldn't be monitoring themselves.) Some doctors get their license revoked when it's been found out that they were prescribing controlled drugs to friends (who's give them back to the doc), under false or dead patient names, etc. There must be a reason why they'd go to such lengths, so maybe they do fear the DEA.
I don't think many doctors have benzo samples. If they do have them in the office, they'd be locked. It would be hard for a doctor in a hospital or group practice to do any of these things.
Here's my gripe:
When push comes to shove you KNOW doctors would take Xanax if they needed it. If they suddenly had major anxiety and couldn't function well enough without drugs, they probably would start an SSRI and a benzo. If the SSRI didn't work or wasn't tolerable, they'd probably just go with the benzo, because they know it works and works well.
I just look at some of the burnt out doctors I know and think, they're definitely going to get themselves some proper meds, if they haven't already done so. I know a few who had to leave practice or significantly cut back because of stress/anxiety/depression. Why would they go med-free when they are aware of the options?
Posted by jealibeanz on May 4, 2007, at 11:18:03
In reply to Re: Doctors = The-Anti Xanax » Klavot, posted by Honore on May 4, 2007, at 11:06:03
> I've heard that some doctors do become addicted to xanax and that it's an extremely nasty addiction, and very hard to work away from. My pdoc has often been consulted in difficult cases like that, and he still prescribes xanax, but strongly recommends not taking more than 2 mg a day, because as you move up, the addictive potential becomes much stronger.
>
> HonoreI thought the "magic number" was 4 mg, but maybe that just what the manufacturers publish, not what occurs in real life.
Is it possible for someone to just not become addicted? I really don't feel like I am. I don't crave it. I don't hoard it. I'm not out looking for another doctor because I'm currently not being prescribed regular Xanax, which I prefer over others.
I'd think that if I were seriously addicted I would have gone out of my way to either beg my doctor to switch me back or contact every doctor in the area and see if they'd be willing to rx daily Xanax. But I haven't done these things. I'm just quietly dissatisfied.
Posted by Klavot on May 4, 2007, at 11:26:01
In reply to Re: Doctors = The-Anti Xanax, posted by jealibeanz on May 4, 2007, at 11:10:11
Hi jealibeanz
Pardon my ignorance, but what do NP, DO and PA stand for?
Klavot
> MD's and DO's can write for themselves in the US.
> Depending on the state, NP's and PA's can write some scripts for themselves, but there are definitely restrictions.
Posted by Phillipa on May 4, 2007, at 12:11:47
In reply to Re: Doctors = The-Anti Xanax » jealibeanz, posted by Klavot on May 4, 2007, at 11:26:01
I can answer that Do is Doctor of Osteopath who can prescribe, NP is Nurse Practicitoner they also prescribe meds and PA is physicians's Assistance also can prescribe meds. My own take on this is in the 35 years of my own benzo use which by the way was always prescribed by a pdoc and his idea I've never taken nor wanted more than 2mg of xanax. And I've switched from short to longacting without a problem. The only problem I've had is that klonopin immediately made me feel suicidal. And just recently I dropped a pdoc as he prescribed too high of a dose of benzos for me specifically xanax so back on the longer acting valium and cutting down. Contrary to what you read I cut 5mg at a time without any side effects. No withdrawal. So the less I take when life is going well the better I feel. It's the ad's that kick my butt. I've never done well or felt well on them. As most of the serotonin is in our gut how can they help our brain? At least Gaba is in the brain? And xanax has mild antidepressives properties. I stopped it as it was making me tired. Never ever has a benzo made me feel high. Just sleepy or relaxed. Love Phillipa
Posted by Klavot on May 4, 2007, at 13:05:47
In reply to Re: Doctors = The-Anti Xanax » Klavot, posted by Phillipa on May 4, 2007, at 12:11:47
Posted by Shortstop on May 4, 2007, at 13:29:15
In reply to Re: Thanx P! (nm) » Phillipa, posted by Klavot on May 4, 2007, at 13:05:47
I don't know about doctors, but I've been using Xanax as needed for, oh, I think it's around three years now. If I haven't started using it habitually -- that is, taking the pills when I don't really need them -- by now, I doubt addiction will become a problem for me at any point. One of the things that keeps the impulse to reach for a benzo, for me anyway, is that they make me sleepy. I hate being sleepy! My pdoc's advice when he first wrote the scrip was: Always wait to see if your panic or acute anxiety passes within an hour. If it doesn't, go ahead and take a Xanax. That's what I've been doing and so far, so good.
Having said that, I will readily admit to taking a Xanax if I'm wide awake at bedtime and need to sleep in order to be well rested for work the next day. Those are the only times I take Xanax when acute anxiety or panic isn't bowling me over. I'd say this happens around 6 to 8 times a month. (I'm a bit of a night owl.) If a lot of people are addicted to Xanax, surely that's because people are reaching for it when they don't really need it.
I know that this is anecdotal evidence, the weakest form of evidence, but I offer it for what it's worth.
Posted by jealibeanz on May 4, 2007, at 13:35:04
In reply to Re: Doctors = The-Anti Xanax » Klavot, posted by Phillipa on May 4, 2007, at 12:11:47
> I can answer that Do is Doctor of Osteopath who can prescribe, NP is Nurse Practicitoner they also prescribe meds and PA is physicians's Assistance also can prescribe meds. My own take on this is in the 35 years of my own benzo use which by the way was always prescribed by a pdoc and his idea I've never taken nor wanted more than 2mg of xanax. And I've switched from short to longacting without a problem. The only problem I've had is that klonopin immediately made me feel suicidal. And just recently I dropped a pdoc as he prescribed too high of a dose of benzos for me specifically xanax so back on the longer acting valium and cutting down. Contrary to what you read I cut 5mg at a time without any side effects. No withdrawal. So the less I take when life is going well the better I feel. It's the ad's that kick my butt. I've never done well or felt well on them. As most of the serotonin is in our gut how can they help our brain? At least Gaba is in the brain? And xanax has mild antidepressives properties. I stopped it as it was making me tired. Never ever has a benzo made me feel high. Just sleepy or relaxed. Love Phillipa
Klonopin (+ Adderall) made me very depressed too. Not suicidal, but was crying out of nowhere.
Klonopin made me very tired. Xanax does not. Xanax XR does.
I agree that Xanax has antidepressant qualities. I don't care that doctors are instructed not to prescribe it for depression with anxiety, without an anti-depressant. I think it can help with those who don't do well with AD's.
For me, Xanax XR is somewhere in the middle of the two. It certainly doesn't have anti-depressant qualities. It hasn't caused me to quickly become depressed like Klonopin, but I do think it is depressing.
I know this makes no sense to doctors, pharmacists, and pharmaceutical manufacturers. Xanax XR and Xanax are the same chemically, they shouldn't be totally different, but in reality, I think they are.
Posted by jealibeanz on May 4, 2007, at 13:45:16
In reply to Re: Thanx P!, posted by Shortstop on May 4, 2007, at 13:29:15
> I don't know about doctors, but I've been using Xanax as needed for, oh, I think it's around three years now. If I haven't started using it habitually -- that is, taking the pills when I don't really need them -- by now, I doubt addiction will become a problem for me at any point. One of the things that keeps the impulse to reach for a benzo, for me anyway, is that they make me sleepy. I hate being sleepy! My pdoc's advice when he first wrote the scrip was: Always wait to see if your panic or acute anxiety passes within an hour. If it doesn't, go ahead and take a Xanax. That's what I've been doing and so far, so good.
>
> Having said that, I will readily admit to taking a Xanax if I'm wide awake at bedtime and need to sleep in order to be well rested for work the next day. Those are the only times I take Xanax when acute anxiety or panic isn't bowling me over. I'd say this happens around 6 to 8 times a month. (I'm a bit of a night owl.) If a lot of people are addicted to Xanax, surely that's because people are reaching for it when they don't really need it.
>
> I know that this is anecdotal evidence, the weakest form of evidence, but I offer it for what it's worth.The sleepiness always helped me patrol myself too. I said before that Xanax doesn't make me tired. It can, just not knocked out like Klonopin.
I always tried to live on the edge of having too much anxiety because I needed to be awake and alert more than I needed to be relaxed. I had far too many classes to complete and couldn't be sleeping through them.
I actually remember telling my doctor that once. That I was very very careful about deciding whether or not I needed Xanax and whether I was too tired to take a given amount.
I think some thought needs to go into who Xanax is being prescribed for and what their daily activities consist of. In my opinion, a person who is very active and working full-time, going to school, or parenting will not want to over use Xanax because they can't afford to be unproductive.
Posted by Cynthia_Greene on May 4, 2007, at 18:24:35
In reply to Re: Doctors = The-Anti Xanax, posted by jealibeanz on May 4, 2007, at 11:18:03
Most doctors in my area love prescribing Xanax. I know several people who take it and I had no problem getting a practically bottomless prescription for it whenever I wanted to. In my opinion, Valium is the hardest medication to get a prescription for.
Doesn't make much sense, considering that Xanax is the most addictive benzo out there.
Posted by Phillipa on May 4, 2007, at 19:43:01
In reply to Re: Doctors = The-Anti Xanax, posted by Cynthia_Greene on May 4, 2007, at 18:24:35
I really think it's the person and not the med seriously if you have an addictive personality you will probably become addicted to any med or alchohol or whatever. Back to Jelly I wonder if it's the different binders in the long acting xanax that makes it not work for you. Oh and also a little piece of a regular xanax would solve the problem of productivity do you think? Love Phillipa
Posted by jealibeanz on May 4, 2007, at 19:43:04
In reply to Re: Doctors = The-Anti Xanax, posted by Cynthia_Greene on May 4, 2007, at 18:24:35
> Most doctors in my area love prescribing Xanax. I know several people who take it and I had no problem getting a practically bottomless prescription for it whenever I wanted to. In my opinion, Valium is the hardest medication to get a prescription for.
> Doesn't make much sense, considering that Xanax is the most addictive benzo out there.My god! What state/area do you live in?!
Posted by Quintal on May 4, 2007, at 20:32:33
In reply to Re: Doctors = The-Anti Xanax, posted by jealibeanz on May 4, 2007, at 4:33:37
>Why?! Because I see no point! It's like doing something just for the sake of doing something. I've actually been proud of myself for getting my doctor to prescribe Xanax for the past year at appropriate levels. It's the only thing that's ever helped and I was proud of myself for allowing myself to get what I needed.
Maybe you would feel better about yourself, your treatment protocol and your relationship with the pdoc if you were to come off Xanax XR? Wouldn't that be an accomplishment? I'm just wondering because you've posted quite a lot recently about your struggles with this med and as you say, it no longer seems to be having any therapeutic effect. The next logical step would be to make an appointment with your pdoc and explain in person about your experiences and dissatisfaction with Xanax XR and ask to go back to Xanax IR, only then can you truly know what he thinks about the situation you're in. If he refuses to reinstate Xanax IR then coming off Xanax XR or switching to another benzo is probably the best thing to do.
Q
Posted by Quintal on May 4, 2007, at 20:37:27
In reply to Re: Doctors = The-Anti Xanax » Klavot, posted by Phillipa on May 4, 2007, at 12:11:47
>I've never taken nor wanted more than 2mg of xanax.
I remember you taking 6mg Xanax XR a short while ago Phillipa.
>Contrary to what you read I cut 5mg at a time without any side effects. No withdrawal.
I don't know what to say.
>As most of the serotonin is in our gut how can they help our brain? At least Gaba is in the brain?
There are definitely serotonin receptors in your brain and they influence your mood, and SSRIs can have antidepressant effects because of this.
Q
Posted by Phillipa on May 4, 2007, at 20:58:28
In reply to Re: Doctors = The-Anti Xanax » Phillipa, posted by Quintal on May 4, 2007, at 20:37:27
Q yup for one week when I went back to my old pdoc who lowered the dose as I didn't want that amount of xanax. So is there a problem?
Whatever I seem to do better withoug any serotonin except what my body produces on my own. When you add a serotonin agent in soaks in the receptors and the brain figures out it doesn't need to manufacturer as many. Why would I want to do that? I am getting further with the therapist and exposure therapy. Thanks for caring. As far as Jelly is concerned not to speak for him but I think it's the generic he doesn't like and would rather have regular xanax back instead. Which I feel is reasonable. Love Phillipa yes still loving everyone remember I am and was a flower child. Peace to all.
Posted by jealibeanz on May 4, 2007, at 21:06:12
In reply to Re: Doctors = The-Anti Xanax » jealibeanz, posted by Quintal on May 4, 2007, at 20:32:33
> Maybe you would feel better about yourself, your treatment protocol and your relationship with the pdoc if you were to come off Xanax XR? Wouldn't that be an accomplishment? I'm just wondering because you've posted quite a lot recently about your struggles with this med and as you say, it no longer seems to be having any therapeutic effect. The next logical step would be to make an appointment with your pdoc and explain in person about your experiences and dissatisfaction with Xanax XR and ask to go back to Xanax IR, only then can you truly know what he thinks about the situation you're in. If he refuses to reinstate Xanax IR then coming off Xanax XR or switching to another benzo is probably the best thing to do.
>
> QHaha... ohhh I wouldn't even consider coming off Xanax XR an accomplishment because I feel like it is not a pleasurable or beneficial drug... however, I haven't asked to go off yet because it probably gives me some relief and I'm slightly scared since I've heard the withdrawal horror stories.
But... I wonder what would happen if I just stopped without a taper. I think I could do it. Maybe I'll get my refills next week, just so I have a back up. Then, I could see how long I could go without the XR.
I have to have a physical some time this summer, so I will be seeing my foctor for real in person. I guess that would be a good time to tell him again, about my thoughts/feelings about his plan and ask what he has in mind for my future.
Posted by Quintal on May 4, 2007, at 21:10:21
In reply to Re: Doctors = The-Anti Xanax » Quintal, posted by Phillipa on May 4, 2007, at 20:58:28
>Q yup for one week when I went back to my old pdoc who lowered the dose as I didn't want that amount of xanax. So is there a problem?
No problem, just thought maybe I had it wrong.
>Whatever I seem to do better withoug any serotonin except what my body produces on my own. When you add a serotonin agent in soaks in the receptors and the brain figures out it doesn't need to manufacturer as many. Why would I want to do that?
I don't really understand what you're saying here Phillipa? I thought you were still taking Luvox?
>I am getting further with the therapist and exposure therapy. Thanks for caring.
Well that's good to hear, and probably more likely to lead to lasting changes than meds. Good luck with the therapy.
Q
Posted by jealibeanz on May 4, 2007, at 21:17:26
In reply to Re: Doctors = The-Anti Xanax » Quintal, posted by Phillipa on May 4, 2007, at 20:58:28
> Q yup for one week when I went back to my old pdoc who lowered the dose as I didn't want that amount of xanax. So is there a problem?
>
> Whatever I seem to do better withoug any serotonin except what my body produces on my own. When you add a serotonin agent in soaks in the receptors and the brain figures out it doesn't need to manufacturer as many. Why would I want to do that? I am getting further with the therapist and exposure therapy. Thanks for caring. As far as Jelly is concerned not to speak for him but I think it's the generic he doesn't like and would rather have regular xanax back instead. Which I feel is reasonable. Love Phillipa yes still loving everyone remember I am and was a flower child. Peace to all.
Wait... Phillipa, are you speaking of me or my doctor's concerns and preferences?It is true that I prefer brand name over generic. I also prefer immediate release over extended-release.
So, in other words I like brand Xanax IR... my doctor... hmm... recently doesn't seem to care for it, but never had a problem in the past.
I'm uncertain of his intentions, but it is possible that he's not totally against my going back IR and has been forcing me to give the XR an adequate trial. Either that or he intends to never rx IR again and want me off all formulations of the drug.
Posted by Phillipa on May 4, 2007, at 21:19:55
In reply to Re: Doctors = The-Anti Xanax » Phillipa, posted by Quintal on May 4, 2007, at 21:10:21
Q taking low dose luvox as my brain has adjusted to that so I will stick with what works for me. I still would like to try EMSAM as it is a patch not as much interraction with my liver although I Know there is still liver envolvement. I will keep soaking up knowledge who knows one day I may write a book about med? You never know where the Road Less Traveled will take you. Love Phillipa ps Scott Peck I know no double quotes
Posted by Phillipa on May 4, 2007, at 21:22:12
In reply to Re: Doctors = The-Anti Xanax, posted by jealibeanz on May 4, 2007, at 21:17:26
Jelly misunderstood my apologies. I certainly hope he doesn't plan on taking you off what works for you. Love Phillipa
Posted by jealibeanz on May 4, 2007, at 21:39:21
In reply to Re: Doctors = The-Anti Xanax » jealibeanz, posted by Phillipa on May 4, 2007, at 21:22:12
> Jelly misunderstood my apologies. I certainly hope he doesn't plan on taking you off what works for you. Love Phillipa
He already did. :)
That's my problem!
Posted by Phillipa on May 4, 2007, at 21:44:42
In reply to Re: Doctors = The-Anti Xanax, posted by jealibeanz on May 4, 2007, at 21:39:21
Jelly I still think you should call him and tell him you don't want sedation during the day only at night. Maybe then? love Phillipa
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