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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by floatingbridge on October 2, 2011, at 17:52:41
I have felt the personal need to taper my Xanax XR. I had been taking 1mg twice daily.
After about ten days of mostly taking only 1mg daily, I told my pdoc. Five days ago I was scripted, at my request, for 0.5mg twice daily of the XR.
I have been doing much better lately, but stressful events this week have really crunched me. I seem to have little reserves for dealing with significant stressors, and this worries me. I got through them well enough, but this weekend I am feeling exhausted (as in bed) and finding faint icky thoughts circling.
I took an extra Xanax and noted it in my mood/med log.
Is this too fast a taper? I can realistically expect some more stress next week and the week after. Rather than knuckling through and falling back to very maladaptive behavior, I am wondering if I should take the pressure off and discuss going up one step, like 0.5mg 3x per day until I stabilize again.
I thought tenazepam and gabapentin at bedtime would cover the decrease.
(I have EMDR scheduled for the week after this. Cbt is coming up, too. Oh, arrrgh.)
I see both therapist and pdoc later this week.
Posted by Phillipa on October 2, 2011, at 18:42:45
In reply to Xanax XR taper, posted by floatingbridge on October 2, 2011, at 17:52:41
FB first did the extra .5 of xanax help? Seems to have as up and on computer. Since you are still experiencing a lot of anxiety and just stabalized on sleep. I definitely feel the taper is too fast. Oh my two types of theraphy and pdoc? Busy lady for sure. Love Phillipa
Posted by Laney on October 2, 2011, at 19:36:01
In reply to Re: Xanax XR taper » floatingbridge, posted by Phillipa on October 2, 2011, at 18:42:45
FB,
It seems if your going to just cut back on Zanax, it would be wise to go as slow as your able.
I took Zanax, my first psych pill ever, years ago but it was in and out of my system too fast and I switched to klonopin and have been on that ever since. I think I ended up needing less klonopin if I remember right.
If I was in your shoes, I would cut back very slowly, especially if there was no hurry.
Laney
Posted by floatingbridge on October 2, 2011, at 19:59:31
In reply to Re: Xanax XR taper, posted by Laney on October 2, 2011, at 19:36:01
Thanks Phillipa and Laney,
I did feel a little better after it hit my system. My mood lifted. So, I need to go slower. I'll call my pdoc tomorrow. 1.5mg is still less than 2mg. It's the right direction at least. I used to be able to cut back more quickly it seemed.
The only rush was my own.
fb
Posted by Laney on October 2, 2011, at 20:12:40
In reply to Re: Xanax XR taper, posted by floatingbridge on October 2, 2011, at 19:59:31
Glad your feeling better :)
Laney
Posted by Phillipa on October 2, 2011, at 20:51:19
In reply to Re: Xanax XR taper, posted by floatingbridge on October 2, 2011, at 19:59:31
FB oh how I wish it still worked like that for me the instaneous relief the ahhhh!!!! Phillipa
Posted by floatingbridge on October 2, 2011, at 22:08:51
In reply to Re: Xanax XR taper » floatingbridge, posted by Phillipa on October 2, 2011, at 20:51:19
But Phillipa, you take a tiny amount. I took an extra .5mg. Then, I notice in a little while I am feeling better and think back, oh yeah, I took that pill. Maybe because it's XR and not instant?
Posted by jono_in_adelaide on October 2, 2011, at 22:11:44
In reply to Xanax XR taper, posted by floatingbridge on October 2, 2011, at 17:52:41
My suggestion would be to taper in the following way:
Transfer from 1mg of Xanax XR twice a day to an intrinsicly long acting benzo in an equivalent dose, eq Diazepam 10mg twice a day.
After giving your self a week or two to stabalise, drop the dose down by 2mg per week until you arnt taking any.
Posted by floatingbridge on October 2, 2011, at 22:27:47
In reply to Re: Xanax XR taper, posted by jono_in_adelaide on October 2, 2011, at 22:11:44
Hi jono, I want to wait until my Xanax is low enough that the proper dosage of Valium isn't very high. Valium is a bit of a stoner med for me. It's like having a drink, but much more calming and not as sloppy. But I would be very slowed down on what would be right now 20+ mg of diazepam. I don't think I could drive :-)
Eventually, when Xanax is low enough, I imagine that's what my pdoc will do. I think he said it would be like 30mg to replace 1.5mg Xanax. (?)
Thanks.
Posted by Phillipa on October 3, 2011, at 0:06:12
In reply to Re: Xanax XR taper » jono_in_adelaide, posted by floatingbridge on October 2, 2011, at 22:27:47
FB how do you split the XR version without it all working at once? Remember I took higher doses during the time of menopause and later. Anxiety seems to peak then. Love Phillipa
Posted by floatingbridge on October 3, 2011, at 8:48:54
In reply to Re: Xanax XR taper » floatingbridge, posted by Phillipa on October 3, 2011, at 0:06:12
They are difficult to split--the pill is very hard and dense.
I have .5mg pills right now.
Have used a pill cutter, but does not make near accurate cuts.
Posted by Phillipa on October 3, 2011, at 19:59:55
In reply to Re: Xanax XR taper » Phillipa, posted by floatingbridge on October 3, 2011, at 8:48:54
Aren't they time realease no cutting?
Posted by jono_in_adelaide on October 3, 2011, at 20:07:02
In reply to Re: Xanax XR taper » Phillipa, posted by floatingbridge on October 3, 2011, at 8:48:54
If you find diazepam makes you feel too groggy, it might be worth trying chlorazepate (Tranxene, some peple find this less sedating/druggy, and it is also very long acting.
You can take it as a single dose at bedtime and it works through all of the next day
Posted by floatingbridge on October 3, 2011, at 22:35:46
In reply to Re: Xanax XR taper » floatingbridge, posted by Phillipa on October 3, 2011, at 19:59:55
Phillipa, have you seen the XR? They are just tabs that are very dense w/o any coating. I think they retain their time release feature even if cut because they are bound in a time release matrix of some sort.
I think cutting in half compromises the time release only a little by making a smaller pill.
Don't qoute me. But the cut tabs do not feel like the instant or regular that simply dissolve when wet.
Make sense?
Posted by floatingbridge on October 3, 2011, at 22:46:42
In reply to Re: Xanax XR taper, posted by jono_in_adelaide on October 3, 2011, at 20:07:02
Thanks Jono, I haven't heard of that benzo. Seems there are infinite benzodiazepine forms.
I feel lucky right now that I have a pdoc I trust who I think knows what he is doing. So, I'll get his instructions. I think I was self-tapering too fast. This new pdoc has told me a number of times that Xanax is not like other benzos and can be for some lucky folks more difficult to discontinue. He went into an entire explanation which included the blood brain barrier and then ended with that the addictiveness of Xanax is still not completely understood but accepted as fact.
As I taper, I'll update if you are interested in how.
Posted by Phillipa on October 3, 2011, at 23:32:33
In reply to Re: Xanax XR taper » Phillipa, posted by floatingbridge on October 3, 2011, at 22:35:46
I took them for one week when that doc took away luvox and didn't sleep for two weeks. I don't remember what they looked like. Probably have some in the basket under the sink. Love Phillipa
Posted by Chairman_MAO on October 6, 2011, at 14:11:08
In reply to Xanax XR taper, posted by floatingbridge on October 2, 2011, at 17:52:41
This is what you do IMHO:
http://www.benzo.org.uk/manual/bzcha01.htm#24
Whatever your daily dose of alprazolam is, find the equivalent dose of clorazepate (Tranxene). In this case that's 60mg, right? Ashton recommends using diazepam, but I think why not just cut to the chase and use nordazepam itself (?)
Trying to come off these high-potency benzos is much harder than low potency ones.
Discuss this with your doctor, I'm just "some guy on the internet". (standard disclaimer)
Posted by Phillipa on October 6, 2011, at 19:53:36
In reply to Re: Xanax XR taper » floatingbridge, posted by Chairman_MAO on October 6, 2011, at 14:11:08
A wise one also in a good way knowledgeable. Phillipa
Posted by floatingbridge on October 6, 2011, at 21:34:21
In reply to Re: Xanax XR taper » floatingbridge, posted by Chairman_MAO on October 6, 2011, at 14:11:08
> This is what you do IMHO:
>
> http://www.benzo.org.uk/manual/bzcha01.htm#24
>
> Whatever your daily dose of alprazolam is, find the equivalent dose of clorazepate (Tranxene). In this case that's 60mg, right? Ashton recommends using diazepam, but I think why not just cut to the chase and use nordazepam itself (?)
>
> Trying to come off these high-potency benzos is much harder than low potency ones.
>
> Discuss this with your doctor, I'm just "some guy on the internet". (standard disclaimer)Jeez, I've been hanging around here for over three years,
and I have not heard of some of these. So, two votes for
Tranxene. But nordazepam has the word 'daze' in it....Well, when the time comes (whenever that may be) to move off Xanax for good, I will have more info to discuss with my
doc. I could bring up Tranxene and see if he
makes a face. He sometimes does when discussing medication. It's subtle but readable.'Some guy on the Internet' made me smile.
Is Tranxene available in the US?
Posted by Chairman_MAO on October 7, 2011, at 0:21:20
In reply to Re: Xanax XR taper » Chairman_MAO, posted by floatingbridge on October 6, 2011, at 21:34:21
Yes, it is. Not only that, but it even has a sustained release formulation! ;-)
This is the end of the thread.
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