Posted by chemist on June 11, 2004, at 1:34:59
In reply to benzos and xanax!, posted by harryp on June 9, 2004, at 16:26:38
chemist here, hello. comments delineated by **** below.
> > Harryp, I wanted to mention that along with the Lexapro I was prescribed Xanax on an as needed basis (.5mg) but I haven't taken it yet. I need time when I can just hang out for a few hours and see how it affects me - according to my doctor.
> >
> > Is Xanax in the same category as Lorazapam and Klonopin? I know Provigil is different from all of them.
> >
> > Thanks for any info - very much appreciated :-)
>
>
>
> That's right. The benzodiazapines are a family of antianxiety drugs that include Valium, Ativan (lorazapam), Xanax, and klonopin, along with several others (generic names usually end in "pam").
***incorrect. alprazolam is not a true 1,4-substituted benzo: it is a triazolo derivative. it hits a very specific area in the GABA_A receptor with a very small K_{i} and cannot be substituted for the 1,4 - or 1,5-benxos. ******
>
> These drugs got an undeserved bad reputation because they became something of a fad in the fifties and onward, and lots of docs prescribed them needlessly at excessive dosages and got their patients (especially women) hooked on them.
>
> Unfortunately, the pendulum has swung the other way, and it's now often hard to get them even if one really needs them. The truth is that they are the gold standard for anti-anxiety meds and are quite safe (as long as you DON'T mix them with alcohol). Regular use can cause dependence, which simply means you should taper off slowly when going off them. They are not "addictive" in the sense that they cause cravings and are very unlikely to cause any trouble to anyone who uses them to control anxiety, as opposed to getting stoned.
**** dependence is very much an issue with alprazolam. in 6 months, escalation of dose from 0.5 prn to 4 mg is not uncommon. *****
>
> I suggest trying .25 mg. (half a pill) of Xanax at first to see how you respond to it. That's roughly equivalent to .5 mg of lorazapam (lorazapam (Ativan) has a milder effect but lasts longer than Xanax--we're still only talking about a couple hours or so. Klonopin can last nearly all day.)****klonopin had a longer t_max} AUC, but your reference to 0.25 mg xanax == 0.5 mg lorazepam is way off. first off, the potency is roughly the same, but the K_{i} for xanax is much greater than lorazepam, and thus dependence will occur in a shorter time***
>
> My doc would have prefered to have me on an SSRI for my anxiety, but I couldn't stand the "zombie" effect, and eventually got him to accept the fact that my anxiety wasn't going away, and lorazapam worked great with essentially no side effects. Since I don't want to feel dull or sleepy, I only take the minimum necessary (about 1.5-2mg /day now) and I have not had a problem with tolerance in over four years.
>
> To be quite honest, the SE's of the benzos (when used properly) are zilch compared to Lexapro. I think you'll be impressed--they're one of those rare drugs that reliably do what they are supposed to.
>
> (Most important rule is AVOID alcohol while a benzo is in your system--Xanax should wear off in a couple hours or so)
poster:chemist
thread:354649
URL: http://www.dr-bob.org/babble/20040608/msgs/355621.html