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Dr. Bob is Robert Hsiung, MD,
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Posted by Fred23 on March 7, 2004, at 22:59:57
In reply to Re: How to ask doctor for Xanax?, posted by theo on March 7, 2004, at 22:07:24
> Sounds to me like you are looking for a buzz rather than than something to take the edge off your anxiety. Subtle with less anxiety means the medication is working. I don't like to feel like I'm "on" something, I tried Klonopin and it made me very lethargic and a lot of folks agree that it makes you alot more sleepy than other benzos.
Well, I was looking for a "buzz" to be a substitute for alcohol's, but found that I wound up feeling simply normal, and more functional, since my nerves weren't like jangling keys anymore.
Then I saw that article, and realized why.
Posted by simus on March 7, 2004, at 23:50:20
In reply to How to ask doctor for Xanax?, posted by Fred23 on March 7, 2004, at 18:40:40
Have you tried taking GABA? I have heard good things about it. And it isn't addicting like Xanax. It might be worth a first consideration.
Posted by simus on March 7, 2004, at 23:50:20
In reply to How to ask doctor for Xanax?, posted by Fred23 on March 7, 2004, at 18:40:40
Have you tried taking GABA? I have heard good things about it. And it isn't addicting like Xanax. It might be worth a first consideration.
Posted by Fred23 on March 7, 2004, at 23:54:16
In reply to Re: How to ask doctor for Xanax? » Fred23, posted by simus on March 7, 2004, at 23:50:20
> Have you tried taking GABA? I have heard good things about it. And it isn't addicting like Xanax. It might be worth a first consideration.
I've read that it isn't really very effective.
(Not much makes it from the stomach, across the blood brain barrier and into the brain.)
Posted by Fred23 on March 7, 2004, at 23:54:16
In reply to Re: How to ask doctor for Xanax? » Fred23, posted by simus on March 7, 2004, at 23:50:20
> Have you tried taking GABA? I have heard good things about it. And it isn't addicting like Xanax. It might be worth a first consideration.
I've read that it isn't really very effective.
(Not much makes it from the stomach, across the blood brain barrier and into the brain.)
Posted by simus on March 8, 2004, at 0:08:47
In reply to Re: How to ask doctor for Xanax? » theo, posted by Fred23 on March 7, 2004, at 22:59:57
I am embarrassed for a post or two that you have received. We are supposed to be supportive, not accusitory. I understand about needing Xanax to feel "normal". I had to fall into such severe anxiety that I was having regular panic attacks before I was given Xanax and I suddenly felt normal - not drugged or high by any means. Just be aware that Xanax is addictive, and you need to take it under a physician's guidance.
Posted by rainyday on March 8, 2004, at 8:54:08
In reply to Re: How to ask doctor for Xanax? » Sebastian, posted by Fred23 on March 7, 2004, at 22:16:37
I am a recovering alcoholic and my psychiatrist has been as up front with me as I am with her. She put me on xanax after trying me on a non-benzo anti-anxiety drug called vistaril. It did not have the desired effect (made me sleepy and anxious). She sais that the dosage she has prescribed of the xanax is not high enough to be addictive, despite my fears. I had also been on beta blockers for both migraine and high blood pressure, and it induced depression in me after several months.
My opinion is that to be honest and up front with your doctor, including your suspicions about being an alcoholic. With careful monitoring and honesty (there's that word again) you should be able to bring the anxiety within control.
Posted by Laree on March 8, 2004, at 12:09:04
In reply to How to ask doctor for Xanax?, posted by Fred23 on March 7, 2004, at 16:00:13
Fred:
Have you only ever tried one type of benzodiazepine--Xanax? There are many types of benzos out there (that is the drug family that Xanax belongs to). Maybe there is one that would work better for you than Xanax. you may need one that works all day long as opposed to just a few hours. there are benzos that are better for "anxiety maintenance" (all day, every day) than ones designed for use when panic attacks occur (short-term; taken on more of an "as-needed" basis) that wear off within a few hours. I would definitely discuss possibilities with your doctor--and i think you may want to see someone who specializes in anxiety, such as a psychiatrist.
Best of luck,
L.
Posted by Joy on March 8, 2004, at 13:01:23
In reply to Re: How to ask doctor for Xanax? » Fred23, posted by Laree on March 8, 2004, at 12:09:04
Hi Fred,
I have a suggestion. I take Xanax [about .5 a day] mainly at night and rarely do I need it in the daytime, but I have it here in case I do. I get it from a psychiatrist who may be more likely to give it to you for anxiety than a GP. I have never raised my dose in 3 years, and in fact, stopped it for 2 or 2.5 months last year. the generic is very inexpensive, and mine comes from Greenstone labs. With my medical plan I get 90 tablets [I get 1 mg and break it in half] for $10. I asked my family doc if he would prescribe it for me, and he said he would though I know he's not thrilled about it, so I will just get it my the psychiatrist that I do not need. I initially tried it from a friend also, and it helped me a lot. I was always careful not to overuse it. I have lung problems also. If your GP won't prescribe it, get a referral or ask your friend whose doc prescribed it. I find Xanax extremely helpful and very inexpensive. Good luck to you. I apologize for some of the curt replies your received. Most folks on the Board are very helpful.
Joy
Posted by Fred23 on March 8, 2004, at 21:49:14
In reply to Re: How to ask doctor for Xanax? » Fred23, posted by rainyday on March 8, 2004, at 8:54:08
> I am a recovering alcoholic and my psychiatrist has been as up front with me as I am with her. She put me on xanax after trying me on a non-benzo anti-anxiety drug called vistaril. It did not have the desired effect (made me sleepy and anxious). She sais that the dosage she has prescribed of the xanax is not high enough to be addictive, despite my fears. I had also been on beta blockers for both migraine and high blood pressure, and it induced depression in me after several months.
>
> My opinion is that to be honest and up front with your doctor, including your suspicions about being an alcoholic. With careful monitoring and honesty (there's that word again) you should be able to bring the anxiety within control.The dosage I am thinking that would be effective enough would be 0.5 mg/day of Xanax, and obviously the doctor could monitor that as he'd have to up the prescription himself.
The first beta-blocker he put me on *caused* depression, along with diminished mental capacity.
I flatly refused to take it, and the next one he gave me worked out much better.The how to explain the alcoholic potential without having that be interpreted as being a potential drug abuser is what concerns me. Some literature suggests that doctors don't like to give benzos to alcoholic types.
(I'm aware that has been a discussion here.)
Posted by Fred23 on March 8, 2004, at 21:56:47
In reply to Re: How to ask doctor for Xanax? » Fred23, posted by simus on March 8, 2004, at 0:08:47
> I am embarrassed for a post or two that you have received. We are supposed to be supportive, not accusitory. I understand about needing Xanax to feel "normal". I had to fall into such severe anxiety that I was having regular panic attacks before I was given Xanax and I suddenly felt normal - not drugged or high by any means. Just be aware that Xanax is addictive, and you need to take it under a physician's guidance.
The whole issue of benzo use vs abuse is controversial, I know, so I can understand why many have stong opinions one way or the other.
That is why I'd like to let my doctor know that I know from personal experience that it does not make me feel high, or drugged, or cause any of the many side effects that are possible.
I am aware that it alters the brain structure, and might take years to get "back" to where it was, but I'm convinced that where its at now is not worth getting "back" to.
Posted by Fred23 on March 8, 2004, at 22:04:37
In reply to Re: How to ask doctor for Xanax? » Fred23, posted by Laree on March 8, 2004, at 12:09:04
> Fred:
> Have you only ever tried one type of benzodiazepine--Xanax? There are many types of benzos out there (that is the drug family that Xanax belongs to). Maybe there is one that would work better for you than Xanax. you may need one that works all day long as opposed to just a few hours. there are benzos that are better for "anxiety maintenance" (all day, every day) than ones designed for use when panic attacks occur (short-term; taken on more of an "as-needed" basis) that wear off within a few hours. I would definitely discuss possibilities with your doctor--and i think you may want to see someone who specializes in anxiety, such as a psychiatrist.The only one my friend has is Xanax, so that's all I've tried. It seems to have a mystique the others don't, which may be due to its anti-depressant properties, which the others don't have.
I've found that 0.5 mg of the ordinary product lasts all day, due to the way my body paces the half life, and maybe due to taking it in the morning along with my beta-blocker, which can prolong the Xanax's effect.
My hope is to quickly put this solution into place, as it seems to work, and not spend months experimenting.
Posted by Fred23 on March 8, 2004, at 22:13:31
In reply to Re: How to ask doctor for Xanax? Fred, posted by Joy on March 8, 2004, at 13:01:23
> Hi Fred,
> I have a suggestion. I take Xanax [about .5 a day] mainly at night and rarely do I need it in the daytime, but I have it here in case I do. I get it from a psychiatrist who may be more likely to give it to you for anxiety than a GP. I have never raised my dose in 3 years, and in fact, stopped it for 2 or 2.5 months last year. the generic is very inexpensive, and mine comes from Greenstone labs. With my medical plan I get 90 tablets [I get 1 mg and break it in half] for $10. I asked my family doc if he would prescribe it for me, and he said he would though I know he's not thrilled about it, so I will just get it my the psychiatrist that I do not need. I initially tried it from a friend also, and it helped me a lot. I was always careful not to overuse it. I have lung problems also. If your GP won't prescribe it, get a referral or ask your friend whose doc prescribed it. I find Xanax extremely helpful and very inexpensive. Good luck to you. I apologize for some of the curt replies your received. Most folks on the Board are very helpful.
> JoyMy usage need to be during the day, so I take it after breakfast, along with my beta-blocker, so I have their benefits while I'm awake. I like my sleep to be chemical-free.
I believe that 0.5 mg/day indefinitely would be enough, and I also have a similar insurance plan where the generic is cheap. What I'm hoping is that the GP wouldn't think a dose that low needs a fancier doctor. The clinic has a mental health wing, so it would only need to walk next door, if needed.
I'm not worried about "curt" responses here, as it is really hard to pin down what is "true" about benzo usage. There are so many "legitimate" medical opionions out there, and I'm sure they are all reflected here, too.
Until I personally experienced the effect, I didn't know what to believe.
Posted by Viridis on March 9, 2004, at 4:43:40
In reply to How to ask doctor for Xanax?, posted by Fred23 on March 7, 2004, at 16:00:13
Xanax is very helpful, but many doctors aren't at all comfortable prescribing it. I'd use the drug name (alprazolam) and just say you've found it helpful in past without it causing problems (you can be somewhat vague about the details) . Somehow saying "Xanax" can label you as a "drug seeker", and generally, telling a doctor that you've been using a friend's meds is not a good idea (plus it really could be dangerous!). I'm not suggesting that you lie, but you don't have to tell your doctor everything about something like this.
It's your call re: how much to get into brain chemistry etc., based on how good your rapport with your doctor is and how authoritarian they are. Some appreciate the fact that you've taken time to investigate potential meds, while many others are irritated or even threatened by this.
There is some justification in the caution, since Xanax has more of a reputation than other benzos for causing tolerance, and being abusable. Real problems seem to be limited to a small proportion of patients, but these rare dangers have been highly publicized, and this, coupled with the fact that it was probably over-prescribed at first and has a street value, has led to a backlash.
I use it occasionally, but developed tolerance quickly (not dependency or "addiction"; I just needed to take more to get the same anti-anxiety effect). So, I limit its use to situations of extreme anxiety, even though it was never a problem for me and I have plenty.
I find Klonopin (clonazepam) extremely effective, and doctors are more comfortable with it. If your doctor offers to prescribe this benzo but not Xanax, or if you can convince him/her to do so, I'd definitely give it a try for a couple of weeks (note: you may feel a bit sleepy at first, but this usually goes away quickly). I've done well on the same low, daily dose for almost three years and find it great for anxiety relief without causing any side effects (beyond the brief, initial sedation). It's definitely worth a try and (based on my experiences at least) would recommend it over Xanax for regular long-term use.
Good luck!
Posted by KathrynLex on March 9, 2004, at 12:20:16
In reply to How to ask doctor for Xanax?, posted by Fred23 on March 7, 2004, at 16:00:13
Hi Fred,
I would suggest telling your doc that you're interested in trying Xanax for long-term use because of some anxiety and see how he/she reacts. Do this without the long explanation of why you want it, just get an idea of how your doc feels about prescribing it.
In my experience, most doctors either like Xanax or they don't. There isn't a whole lot of middle ground. The ones who have a favorable impression of it don't seem to mind prescribing it and don't ask a lot of questions. (Example: My new psychiatrist - who I see for meds only - gave me a Xanax prescription of 30 pills with 2 refills knowing that I only take it 3 or 4 times a year. My GP feels that Xanax is a little dangerous and gave me a prescription for only 10 pills when I asked her about it last year.)
If your doc isn't in favor of giving you Xanax, get an appointment with your friends doctor...you know they don't have a problem prescribing it.
One last thought, it's always a good idea to take meds with a good psychiatrist monitoring your dose. This way if anything goes wrong or you start experiencing unusual side effects you have someone available to help you.
Good luck!
K.
Posted by Fred23 on March 9, 2004, at 18:04:41
In reply to How to ask doctor for Xanax?, posted by Fred23 on March 7, 2004, at 16:00:13
> ### footnote listing that article's name:
Dick DM, Edenberg HJ, Xuei X, Goate A, Kuperman S, Schuckit M, Crowe R, Smith TL, Porjexa B, Begleiter H, Foroud T. Association of GABRG3 with alcohol dependence. Alcoholism: Clinical & Experimental Research, vol. 28:1, pp. 2042-2047, January 2004.
A link that a synopsis of that article is:
http://www.nattc.org/asme/details.asp?ID=0402dHas it been discussed anywhere yet on these forums?
Posted by Fred23 on March 9, 2004, at 19:18:18
In reply to Re: How to ask doctor for Xanax? » Fred23, posted by KathrynLex on March 9, 2004, at 12:20:16
> If your doc isn't in favor of giving you Xanax, get an appointment with your friends doctor...
That was for reasons unrelated to anxiety, and whatever other doctor I would go to should be done by referral from my primary doctor, to avoid the appearance of "doctor shopping".
Posted by Fred23 on March 9, 2004, at 19:19:17
In reply to Re: How to ask doctor for Xanax? » Fred23, posted by Viridis on March 9, 2004, at 4:43:40
> I'd use the drug name (alprazolam)
I was thinking of saying "generic Xanax" to avoid the look of trying to impersonate a doctor.
> say you've found it helpful in past without it causing problems
Since he's my primary physician I'm sure he'd be wanting to know who the "other" doctor was, for many reasons.
One of which would be, why aren't I going to that doctor instead?
(Isn't that what is referred to as "doctor shopping"?)> telling a doctor that you've been using a friend's meds is not a good idea (plus it really could be dangerous!).
As it means there are at least two people in violation of federal laws.
> I find Klonopin (clonazepam) extremely effective [...] and would recommend it over Xanax for regular long-term use
After hearing what it did to Stevie Nicks, I am somewhat put off by it, and also think that the minor anti-depressant properties of Xanax are needed.
Posted by Viridis on March 10, 2004, at 1:29:16
In reply to Re: How to ask doctor for Xanax? » Viridis, posted by Fred23 on March 9, 2004, at 19:19:17
I was just suggesting that you say alprazolam because that's what's prominent on the label (mine say "Alprazolam" in large letters and "substituted for Xanax" in much smaller letters below). So, I doubt you'd be thought of as impersonating a doctor; it just seems that "Xanax" carries a negative connotation for many.
I'm not sure how to handle the issue of past use, am not suggesting dishonesty, and yes, if he's been your doctor for a long time this is difficult. I simply told my pdoc (truthfully) that I'd benefited from Xanax years before and he prescribed it, cautiously (it was legally prescribed by another doctor previously, but he didn't ask about the circumstances, just wanted to verify that I was familiar with its effects and risks, which he then reiterated). Your case could be quite different.
Aside from the legal issues, what I really meant was that it could genuinely be dangerous (healthwise) to take prescription meds without a doctor's supervision. In any case, I wouldn't advertise this, in part because it suggests that you may be somewhat cavalier about use of medications and in part because it raises the issue of whether you might share your meds with others. I'm not saying that you are or would, but this is how some doctors seem to think.
Re: Klonopin: maybe it would be good for you, maybe not. Some people (e.g., Stevie Nicks) can get into trouble with it, but a large body of evidence indicates that overall it tends to be less problematic than Xanax, plus its effects are much longer-lasting. Both are excellent meds for some people, and I find Klonopin an antidepressant too (probably because most of my depression seems to stem from anxiety). Who knows how you'd react, but it might be worth a try, especially if your doctor refuses to prescribe Xanax.
Again, good luck!
Posted by Fred23 on March 10, 2004, at 21:57:42
In reply to Re: How to ask doctor for Xanax? » Fred23, posted by Viridis on March 10, 2004, at 1:29:16
>it just seems that "Xanax" carries a negative connotation for many.
As you suggest, it likely is better to say "alprazolam" instead
of "Xanax" as it may suggest that I've done my homework, rather
than tapping into a fad. How to present my homework without
appearing to usurp the doctor's role is the balance to keep.>I'm not sure how to handle the issue of past use
The *only* way I'm going to be able to say with certainty that I
*know* alprazolam is effective is to cite personal use.>just wanted to verify that I was familiar with its effects and
>risks, which he then reiterated).Every time I see him I explain that my AMA Encyclopedia of
Medicine (a physical book) says that a doctor should be seen in
the situation I'm coming for.>could genuinely be dangerous (healthwise) to take
>prescription meds without a doctor's supervision.A lot of which goes on these days, with highly publicized bad
outcomes.>Re: Klonopin: maybe it would be good for you, maybe not.
Clonazepam (Klonopin) is in the "nitro" class of benzodiazepines,
while alprazolam (Xanax) is in the "triazolo" so they have
different characteristics. Klonopin seems to be more of an
anticonvulsant, with sedative properties, while alprazolam seems
to be better for anxiety.What I realize is that what I want to ask my doctor is contrary
to the conventional view of treating anxiety with BDZs on a
short-term basis. So I can see how a GP would be less
enthusiastic about the idea than a specialist. But if my anxiety
stems from faulty GABA processing due to genetics, I doubt that I
can talk therapy my brain chemistry into cooperating.
Ironically, the dollar amount of a prescription for alprazolam
would be less than what I'm presently spending on nutritional
supplements to help my mind out already.But, the *control* of the dosage would lie with him, so he could
prevent or allow any escalation. If it just stays at the low
dosage of 0.5 mg per day, I would think that would be below the
"danger zone".
Posted by Fred23 on March 11, 2004, at 18:20:21
In reply to Re: How to ask doctor for Xanax? » Viridis, posted by Fred23 on March 10, 2004, at 21:57:42
Putting it more succinctly:
1. Problem = that "alcoholic gene" causes GABA mis-regulation.
2. Solution = benzodiazepines were created to regulate GABA.
3. A genetic problem is a long-term problem, so a long-term solution is needed.
4. Now that I've felt "normal" as a reference, I have a basis to explain the difference to whatever doctor I have to, to attain that goal.
Posted by Fred23 on March 11, 2004, at 22:01:06
In reply to Re: How to ask doctor for Xanax? » Fred23, posted by Viridis on March 10, 2004, at 1:29:16
>Re: Klonopin: maybe it would be good for you, maybe not.
In reading other messages here, over on the Re: "Buspar and Klonopin for depression w/ anxiety?" thread, micro on March 9, 2004, at 22:49:20 says:
"Klonopin causes depressive symtoms in those who are not depressed, hence the need for adjunctive antidepressive meds."
That's the reason I want something like alprazolam, which has purported anti-depressant properties, to offset the potential depression that can be caused by the beta-blocker I am taking. I've already had a medication *trigger* depression, and don't want another.
Posted by Viridis on March 12, 2004, at 2:49:45
In reply to Re: How to ask doctor for Xanax?, posted by Fred23 on March 11, 2004, at 22:01:06
Hi Fred,
Just based on my experience, Xanax is indeed a "mood lifter" (nothing euphoric, just a more positive attitude). The funny thing is that the improvement seems to be most pronounced the next day, when the active metabolites are supposed to be pretty much gone. Others here have reported the same thing.
As I think I mentioned, my concern about Xanax is that before long, I found that it took 3-4 times as much to achieve the same anti-anxiety effect that I had at first. I discussed this with my pdoc and he said yes, Xanax can be like that for some people (which is why he's even more cautious with it than with other benzos). But, since I don't abuse it or even take it often, he continues to prescribe it. His approach is that I can take as much as I need (within reason), but he won't increase the total amount he gives me -- it's up to me to "ration" it as necessary. This seems to work out fine, and in fact I always have a lot left over, even though the quantities he prescribes per month are very small (not much more than some people take in a day).
I 've also been using Klonopin long-term (same pdoc) and find it great but extremely subtle. I take it every day and have never had to increase the dose (well, I do take an extra pill once every couple of months, but only when things are very stressful).
Some people have reported that Klonopin promotes depression, but I find that it has the opposite effect for me, and there's also some evidence in the literature to suggest that it can have antidepressant properties. Most of my depression appears to be anxiety-based, so reducing the anxiety seems to stop the worst of the depression.
I'd just see how it goes -- if you can get Xanax, great, but just be sure you don't find yourself needing more if you take it often. As you say, your doctor can control this anyway. But if Klonopin is the only option, I'd try it for a couple of weeks and see how you feel. You might find it helpful.
One other thing: I started on Lamictal (not a benzo) a couple of months ago and really like it. I find it very mild, but it seems to keep me mellower and less "reactive" to stresses, without any noticeable side effects. It's not for everyone, but can really help some people. Depending on your situation, this seems to a promising mood stabilizer and potential antidepressant, so if your doctor refuses to prescribe benzos, Lamictal might be worth a shot.
One other suggestion (this is a "alternative" approach): try L-theanine. It's available from health food stores etc. and does seem to have a mild calming effect. It's unlikely to be as effective as benzos, but is very safe, relatively cheap, and might help to smooth out the rough edges a bit.
Posted by Fred23 on March 12, 2004, at 22:22:27
In reply to Re: How to ask doctor for Xanax? » Fred23, posted by Viridis on March 12, 2004, at 2:49:45
>Just based on my experience, Xanax is indeed a "mood lifter" (nothing
>euphoric, just a more positive attitude). The funny thing is that the
>improvement seems to be most pronounced the next day, when the active
>metabolites are supposed to be pretty much gone. Others here have
>reported the same thing.My tests show that it has a constant effect throughout the day taken,
with enough left by the next morning, but the next morning dose is
needed to start the cycle over.>As I think I mentioned, my concern about Xanax is that before long, I
>found that it took 3-4 times as much to achieve the same anti-anxiety
>effect that I had at first. I discussed this with my pdoc and he said
>yes, Xanax can be like that for some peopleI have reason to believe that I'm the type for won't develop a
tolerance for the anxiolytic properties.>Some people have reported that Klonopin promotes depression,
It seems that on this board, a *lot* of people are not happy with
Klonopin.In fact, a good percentage of the posts on this board overall are
people unhappy with the medications their doctors have prescribed, and
my idea is to approach my doctor with something I already *know* that
works. Also, alprazolam seems to cause *no* side effects, which must
mean that its a good "fit" to my body.>mood stabilizer and potential antidepressant, so if your doctor
>refuses to prescribe benzos, Lamictal might be worth a shot.I'm going to stress that I don't want to spend the next two years
experimenting with everything under the sun, and feeling bad
throughout. Finding the "right" generic alprazolam may be the
challenge, though.Now that I have a reference point of what "normal" feels like, I'll
have a better time describing my goals to whatever doctors I have to.>One other suggestion (this is a "alternative" approach): try
I've tried a lot of the alternative approaches, and admitting the need
for western pharmaceuticals is sort of a defeat, of sorts.
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