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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by FredPotter on December 29, 2002, at 19:51:01
I am now in the situation of clinging on to an ongoing script for Xanax, knowing that if it's curtailed, I will be unable to restart it. That is because this would need the sanction of a psychiatrist to restart it, and the current medical opinion of benzodiazepines in New Zealand is that they are sinful.
However my Doc will continue to renew the script so long as I say I'm trying to gradually come off them and to not take more than 1 mg a day. Never mind that an effective dose of Xanax is more like 8 to 10 mg a day.
I feel bound to tell him on my visits that all is not well with me regarding anxiety, but I must never let him think that Xanax is ineffective or the supply will dry up. I realise the word "supply" is an emotive one, however I'm not "feeding a habit" but holding on to the small amount of relief that Xanax affords me from constant anxiety. It's very slight but better than nothing, given I can't drink alcohol.
Can anyone recommend a solution to this?
Posted by FredPotter on December 29, 2002, at 19:58:53
In reply to Benzodiazepines ineffective or dosage ineffective?, posted by FredPotter on December 29, 2002, at 19:51:01
I'm sorry I should have said 4 to 5 mg a day is the effective dose. Still they do say that the lethal dose of Xanax is the amount it would take to suffocate you.
Posted by Jackster on December 30, 2002, at 1:54:35
In reply to Benzodiazepines ineffective or dosage ineffective?, posted by FredPotter on December 29, 2002, at 19:51:01
Hi Fred from a fellow kiwi. (I know what it's like to see all of the wonderous drugs discussed on this board that we can't get in NZ)
Have you thought about going onto klonopin (rivitrol in NZ) which is longer acting and might not be so frowned upon? I know a lot of docs here prefer it to Xanax.
Jackie
> I am now in the situation of clinging on to an ongoing script for Xanax, knowing that if it's curtailed, I will be unable to restart it. That is because this would need the sanction of a psychiatrist to restart it, and the current medical opinion of benzodiazepines in New Zealand is that they are sinful.
>
> However my Doc will continue to renew the script so long as I say I'm trying to gradually come off them and to not take more than 1 mg a day. Never mind that an effective dose of Xanax is more like 8 to 10 mg a day.
>
> I feel bound to tell him on my visits that all is not well with me regarding anxiety, but I must never let him think that Xanax is ineffective or the supply will dry up. I realise the word "supply" is an emotive one, however I'm not "feeding a habit" but holding on to the small amount of relief that Xanax affords me from constant anxiety. It's very slight but better than nothing, given I can't drink alcohol.
>
> Can anyone recommend a solution to this?
Posted by gheld on December 30, 2002, at 8:49:24
In reply to Benzodiazepines ineffective or dosage ineffective?, posted by FredPotter on December 29, 2002, at 19:51:01
So why not see a phychiatrist to continue the Xanax? Some therapy may be very helpful for your panic in addition to the meds.
From what I read, it's virtually impossible to take enough benzo's to kill you.
Posted by fachad on December 30, 2002, at 12:37:19
In reply to Benzodiazepines ineffective or dosage ineffective?, posted by FredPotter on December 29, 2002, at 19:51:01
Fred,
I put up a post a few months back about the inherent Catch 22 involved in being treated / helped by a medication that is a controlled substance.
It's a bit of a rambling diatribe, but I think you will see that there are very real, very important issues in situations like yours. These issues are far deeper than the simple issue of being treated effectively or not treated effectively.
Take a look here:
The Controlled Substance Catch-22 - My Worst Fear
http://www.dr-bob.org/babble/20020416/msgs/103521.htmlYou may also find comfort and solidarity in the post by Elizabeth that inspired my post:
help! (rant; advice?)
http://www.dr-bob.org/babble/20020416/msgs/103496.htmlThere are other issues besides medication response and potential problems that go into pdocs reluctance to prescribe benzodiazepines. The marketing machine of the pharmaceutical companies shapes treatment models and prescribing tendencies.
Here's my take on that situation, inspired by someone asking why Ritalin is not an AD:
Ritalin is not marketed as AD
http://www.dr-bob.org/babble/20020307/msgs/97442.htmlHope this gives you a few new ways to think about your Xanax dilemma.
-fachad
Posted by BrittPark on December 30, 2002, at 16:44:56
In reply to The Eternal Return of The Catch 22 » FredPotter, posted by fachad on December 30, 2002, at 12:37:19
Thanks for the references to those excellent posts.
I think, actually, that things are even crazier than Catch 22. Consider the adult depression patient who one way or another happens to know the Schedule II stimulants are very effective for his/her depression. Catch 22. Now consider the large number of GPs prescribing stimulants to children willy nilly, given the slightest evidence of ADHD. I don't mean to say that most children prescribed stimulants don't need them. I don't know. I hope, however, that people will appreciate the irony of the two prescribing attitudes.
Cheers to all,
Britt
Posted by FredPotter on December 30, 2002, at 16:48:56
In reply to The Eternal Return of The Catch 22 » FredPotter, posted by fachad on December 30, 2002, at 12:37:19
Thanks everyone especially fachad. I attended an in-patient rehab centre a year ago. This was for alcohol. They were horrified to find me with Xanax on my person. They said that they were like "solid alcohol". When I asked them what they meant they said, "Xanax and alcohol are chemically related". "So are CO and CO2 but their mechanism of action is somewhat different", I thought to myself. They took them off me along with Zopiclone, which they said was also a benzo. "No it's not", I thought. There was also a patient in there who abused Klonopin. What sort of abuse is it that doesn't give you euphoria? This is the only reason I can think of for abusing a drug. I think I know enough about Xanax to know that no amount would give me euphoria.
On another occasion in a hospital setting the Xanax was stopped almost abruptly and I was in a very bad way. Their reasons were "addicive potential" and "paradoxical anxiety". I don't know about the second one, but what does addictive potential mean to someone who has been taking that drug or another from the same family for 35 years, on and off, mostly on? Does this confirm that I'm hooked? If so it must mean that I'm hooked but not abusing . And it was the British National Health Service back then which coerced me into taking the drug in the first place (Librium it was back then).
How frustrated this makes me feel. I have a close friend who starts calling me a "druggie" when I talk in this way (and she smokes pot which is for some reason not considered a "drug" in this sense). Sorry to vent
Posted by fachad on December 31, 2002, at 0:09:20
In reply to Re: The Eternal Return of The Catch 22 » fachad, posted by BrittPark on December 30, 2002, at 16:44:56
Actually, it seems like psychiatrists are prescribing C-II stimulants pretty freely these days. I was originally prescribed Ritalin to augment Serzone, after allot of failed meds.
The real weird thing to me is how stingy and suspicious pdocs are of benzos. I think pdocs are generally much more cautions and reluctant to write for benzos than stims, even though benzos are only C-IV, can be called in with refills, etc.
This is the end of the thread.
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