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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Aldus Huxley on April 24, 2004, at 1:35:51
You had jokingly referred to my Valium prescription when I described my Effexor withdrawal. I know it was just a joke, but I now have a question...
Is Valium really a sought-after prescription (well, I know just about every benzo is on the web these days)? I get Xanax like its candy from my pdoc, but she is all nervous about giving me more scripts for Valium. I thought that since Valium was longer acting, the habituation/addicition potential was lower. I mainly ask to switch because I think it is helpful in decreaseing tolerance to one or the other.
That being said, what would you recommend I ask for from my pdoc as the best anxiolotic/tranquilizer/sedative from from benefits ranking as follows (i) euphoric/social disinhibition, and (ii) lower incidence of hangover. I really do not take them much (my Xanax) unless I am really stressed or have me insomnia (which is frequent, so I probably take about .5 to 1mg daily--but this doesn't seem like much based on what I read here).
However, the Xanax now just makes me sleepy, it doesn't help as much with my anxiety/social inhibitions. So...what would you ask for? Maybe Seconal? :)
Posted by chemist on April 24, 2004, at 23:43:43
In reply to ANOTHER question (easier) for CHEMIST re Benzos, posted by Aldus Huxley on April 24, 2004, at 1:35:51
> You had jokingly referred to my Valium prescription when I described my Effexor withdrawal. I know it was just a joke, but I now have a question...
>
> Is Valium really a sought-after prescription (well, I know just about every benzo is on the web these days)? I get Xanax like its candy from my pdoc, but she is all nervous about giving me more scripts for Valium. I thought that since Valium was longer acting, the habituation/addicition potential was lower. I mainly ask to switch because I think it is helpful in decreaseing tolerance to one or the other.
>
> That being said, what would you recommend I ask for from my pdoc as the best anxiolotic/tranquilizer/sedative from from benefits ranking as follows (i) euphoric/social disinhibition, and (ii) lower incidence of hangover. I really do not take them much (my Xanax) unless I am really stressed or have me insomnia (which is frequent, so I probably take about .5 to 1mg daily--but this doesn't seem like much based on what I read here).
>
> However, the Xanax now just makes me sleepy, it doesn't help as much with my anxiety/social inhibitions. So...what would you ask for? Maybe Seconal? :)hi there, you do NOT want to go down the barbituate raod, which is where you are heading with seconal. your doc is the exception rather than the rule in that many, many doctors shy away from xanax because there is an anti-depressant effect, a quick onset of action, and a short half-life, all of which spell ``dependency'' to the docs. valium has a very long half-life, and in chronic dosing is better than the others in that it is always in your system. on the down side, valium is always in your system, so you get sluggish and never really emerge from the fog. for your social problems, perhaps klonopin is the answer: shorter half-life than valium, longer than xanax, and no associated ``high'' or anti-depressant activity. xanax makes you sleepy, so that's not the answer, but before going onwards, how much xanax are you taking and how often? ativan is another alternative that might suit your needs...please let me know, and all the best, chemist
Posted by Aldus Huxley on April 25, 2004, at 14:35:16
In reply to Re: ANOTHER question (easier) for CHEMIST re Benzos » Aldus Huxley, posted by chemist on April 24, 2004, at 23:43:43
> hi there, you do NOT want to go down the barbituate raod, which is where you are heading with seconal. your doc is the exception rather than the rule in that many, many doctors shy away from xanax because there is an anti-depressant effect, a quick onset of action, and a short half-life, all of which spell ``dependency'' to the docs. valium has a very long half-life, and in chronic dosing is better than the others in that it is always in your system. on the down side, valium is always in your system, so you get sluggish and never really emerge from the fog. for your social problems, perhaps klonopin is the answer: shorter half-life than valium, longer than xanax, and no associated ``high'' or anti-depressant activity. xanax makes you sleepy, so that's not the answer, but before going onwards, how much xanax are you taking and how often? ativan is another alternative that might suit your needs...please let me know, and all the best, chemist
>Actually, I was sort of saying Seconal tongue-in-cheek; I know that is a bit overkill. Here it is: my pdcoc gave me xanax to take both for anti-aniety/social inhibition (for my job purposes as an attorney which, as a younger one, can be very stressful). I was supposed to take a .5mg twice daily or prn for anxiety and 1mg for insomnia (sometimes more, sometimes less (like on the weekends when stress is much lower and I can USUALLY sleep without it)) . At that time it provided a sense of calm and I terrific sedative--sometimes I would only take .5mg to sleep. So--on the average the answer to your question is anywhere from 1mg to 3mg per day. Then, after about 1 year, I found myself becoming tolerant to Xanax and taking a bit more (maybe 1mg more a day). 1 year later, I find it almost useless in that it makes me really sleepy as an anxiolytic, and when I do use it as a sedative, I wake up 3 hours later (after taking 2mg+). To me, that sounds like tolerance. Even after taking 3 week breaks, it just makes me sleepy--no inhibitory/calm effects.
So last year, I asked for Valium--knowing it was a good anxiolytic. She reluctantly agreed (I was having a particularly stressful personal event), and it worked great--I took about 2.5mg 2x/day and maybe 5-10mg for insomnia. After 2 months she wanted me back on Xanax and said no more valium--even though I felt it was still working fine (for the momnet).
My thoughts on this that although both of these drugs are from the same family, I think I just got tolerant to Xanax, and switching to valium would allow me to use it for awhile, and then switch to Xanax because, perhaps after a few months not taking it (and Valium instead), my tolerance would go back to normal with Xanax, and hence, allow me to take lower dosages of each.
So, since she is not keen on prescribing valium (I could probably convince her, but society has made me feel guilty whenever I tried to "argue" for a particular medication), I wanted to know what you think would be a good replacement...similar to Xanax (before I became tolerant)containing some mild euphoria (which I deem to be the same thing as social inhibition -- I mean when do we enjoy speaking to people the most? Answer: When we are happy.).
Like some other poster likes to say, I am looking for the "3 beer effect" -- except, for me it is more a "1.5 beer effect".. Meaning--if memory serves--I wasn't an idiot when I took .5mg Xanax during the day (I mean I was at work after all). I was just calmer and more congeial and did my work performance increased. At work, I just did what I had to do--interrelate to people, etc.
Are there alternatives? Thanks a lot for reading.
Posted by jlbl2l on April 25, 2004, at 21:21:16
In reply to Re: ANOTHER question (easier) for CHEMIST re Benzos » Aldus Huxley, posted by chemist on April 24, 2004, at 23:43:43
what about xanax XR. wouldnt that avoid (more or less) dependence problem (not any more than any SSRI withdrawl)...
Posted by chemist on April 25, 2004, at 21:35:28
In reply to Re: ANOTHER question (easier) for CHEMIST re Benzos, posted by jlbl2l on April 25, 2004, at 21:21:16
> what about xanax XR. wouldnt that avoid (more or less) dependence problem (not any more than any SSRI withdrawl)...
>
>
perhaps. i did 4 mg qd xanax (tablet) and spent 9 months in hades getting off of it. but am back on in low dose - up to 2 mg qd prn anxiety - and no problems. the sustained release is supposed to be a godsend, but watch it with xanax in general! all the best, chemist
Posted by Aldus Huxley on April 26, 2004, at 13:02:42
In reply to Re: ANOTHER question (easier) for CHEMIST re Benzos, posted by jlbl2l on April 25, 2004, at 21:21:16
I was seeking an alternative to Xanax since I seem to be tolerant to it.
I need to take 3mg just to get sleepy and sleep maybe 2.5-3 hours. If I take 4mg, I will sleep maybe 5 hours. (In the beginning, .5mg would help me sleep for 7 hours!). If I take 1mg for anxiety now it doesn't really do much except begin to make me tired.
Even if I have 5mg/day for several weeks, I can stop without a porblem (other than having NORMAL anxiety from my GAD), i.e. no withdrawals. Therefore, I do not think I have any physical or psychological dependence to it. I do not want to up the dosage on the Xanax because obviously, due to my tolerance, it has diminishing returns.
Since valium worked as well as Xanax did when I first started taking Xanax, I was interested in that, because my pdoc prescribed it to me for 2 months in 2003 (after which my Xanax worked again like it once did), but when I asked recently, my pdoc was hesitant (strangely). I was asking here to see what others have used with good results as an anxiolytic/somnolence.
The last time I told her the Xanax wasn't working for insomnia she gave me some samples or Seroquel which made me feel almost as ill as trazadone...I just want my old Xanax back (pre-tolerance) and do not know what to ask for instead.
Posted by BobS, on April 26, 2004, at 19:24:55
In reply to Re: ANOTHER question (easier) for CHEMIST re Benzos » jlbl2l, posted by Aldus Huxley on April 26, 2004, at 13:02:42
After a long year of exogenous stressors, I succumbed to depression (I think, more on that later) and naturally went the SSRI route even though I spent years getting off of them about three years ago.
My pdoc tried some magic with Pindolol which made things worse, then wanted me to go to Zyprexa. I had a miserable time starting SSRIs in the mid nineties. BTW, I read an Oct. 2003 study out of Stanford, that identified a mutant gene for SSRI intolerance.
I argued for Remeron and won. Now after just 6 days, two at 7.5 and four at 15 mgs, I feel almost as good as a year ago. I dropped my Xanax from 4 mgs to 3 mgs qd in those 6 days and will begin further reductions shortly. I crossed the 2 mg barrier, upward, about three months ago. I plan to take about 1.5 mg qd for the rest of my life and reduce slower from this point forward.
The point here is Remeron provided me with outstanding sleep and restored my appetite, which allowed me to begin to work out again further reducing my horrid feelings. It could be placebo, merely removing the fear of SSRI and Zyprexa hell, or maybe I wasn't even that depressed, just sleep deprived. I can't imagine that Remeron made me manic when SSRIs didn't do so previously. There has to be something of value in good sleep and a concomitant anxiety reduction that I experienced after 3 days of dosing. I really find it hard to believe, but the story is true and dramatic. If it changes I will post quickly to this thread.
BTW, what are your dx Aldous and Chemist?
I am supposed to be "harm-avoidant OCD with atypical depression"
Regards,
BobS.
Posted by chemist on April 26, 2004, at 21:14:12
In reply to Try Remeron for great sleep - long post, posted by BobS, on April 26, 2004, at 19:24:55
> After a long year of exogenous stressors, I succumbed to depression (I think, more on that later) and naturally went the SSRI route even though I spent years getting off of them about three years ago.
>
> My pdoc tried some magic with Pindolol which made things worse, then wanted me to go to Zyprexa. I had a miserable time starting SSRIs in the mid nineties. BTW, I read an Oct. 2003 study out of Stanford, that identified a mutant gene for SSRI intolerance.
>
> I argued for Remeron and won. Now after just 6 days, two at 7.5 and four at 15 mgs, I feel almost as good as a year ago. I dropped my Xanax from 4 mgs to 3 mgs qd in those 6 days and will begin further reductions shortly. I crossed the 2 mg barrier, upward, about three months ago. I plan to take about 1.5 mg qd for the rest of my life and reduce slower from this point forward.
>
> The point here is Remeron provided me with outstanding sleep and restored my appetite, which allowed me to begin to work out again further reducing my horrid feelings. It could be placebo, merely removing the fear of SSRI and Zyprexa hell, or maybe I wasn't even that depressed, just sleep deprived. I can't imagine that Remeron made me manic when SSRIs didn't do so previously. There has to be something of value in good sleep and a concomitant anxiety reduction that I experienced after 3 days of dosing. I really find it hard to believe, but the story is true and dramatic. If it changes I will post quickly to this thread.
>
> BTW, what are your dx Aldous and Chemist?
>
> I am supposed to be "harm-avoidant OCD with atypical depression"
> Regards,
> BobS.hi bob, have had several diagnoses, ranging from unipolar depression to OCD to GAD to panic attacks/agoraphobia to bipolar II, all of which may be right or may be wrong. what i can say for syre is that i am behind you 100% in that there are essentially 2 things that will cure most ills: good sleep and anxiety reduction. all the best, chemist
Posted by Aldus Huxley on April 27, 2004, at 1:29:34
In reply to Try Remeron for great sleep - long post, posted by BobS, on April 26, 2004, at 19:24:55
Hey Bob...thanks for the suggestion...I will look into it and ask my pdoc what she thinks.
I have really only one diagnosis told me (though she may think more perhaps). I was diagnosed with GAD and ADD. Depression is a result of the GAD, which I think, in general is caused both directly and indirectly by the ADD. I also take Adderall which has helped immensley with everything. Still occassionally during the day I will get overtly anxious (and not due to the Adderall crash), and try to take a walk or an axiolytic (Xanax). I have been off Effexor for 4 months, unbeknownst to my pdoc, who I suspect would have advocated the continuation of it.
Again, thanks for the suggestion!
This is the end of the thread.
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