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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 33. This is the beginning of the thread.
Posted by Pluto on November 4, 2006, at 23:37:06
Hi all,I am under extreme stress in the workplace now. It has been found either Alcohol or 1 mg of Xanax is the only way to cope with. I don't want to go ahead with Alcohol, but what about 1 mg of Xanax? I must be on it for at least 16 months. Would it be safe to go with it such a long period of time? (I mean without developing significant dependence) Would it be then hard to get off the med in a changed atmosphere?
Please help.Cheers
PLS
Posted by tensor on November 5, 2006, at 7:15:39
In reply to Xanax to cope with a tough situation.., posted by Pluto on November 4, 2006, at 23:37:06
>
> Hi all,
>
> I am under extreme stress in the workplace now. It has been found either Alcohol or 1 mg of Xanax is the only way to cope with.No alcohol. What's your problem, why are you under extreme stress?
I don't want to go ahead with Alcohol, but what about 1 mg of Xanax? I must be on it for at least 16 months. Would it be safe to go with it such a long period of time? (I mean without developing significant dependence) Would it be then hard to get off the med in a changed atmosphere?
> Please help.You will develop a dependence long before 16months. It's decision you'll have to make on your own(along with your pdoc of course). If you think the benefits outweighs the drawbacks, then a benzo could be defendable.
However, this is adding a problem to a problem. Have you considered another job? Have you tried CBT, Cognitive-behavioral therapy?
Maybe try to find a solution in the following order.
1. Life situation, change job etc.
2. CBT
3. Try a SSRI, Paxil, Lexapro etc.Consider a benzo only as the last resort.
Good luck.
/Mattias
Posted by madeline on November 5, 2006, at 7:48:35
In reply to Xanax to cope with a tough situation.., posted by Pluto on November 4, 2006, at 23:37:06
I'm really sorry you are in a tough situation right now. Work stress just sucks doesn't it?
I absolutely support your decision NOT to self-medicate with alcohol. That takes guts and it is a very positive step to take.
In my mind, xanax is definately the better choice to manage your symptoms.
Why do you have to be on it for 16 months? Is that when your work situation changes?
If you are worried about dependence on xanax (which can be a concern), then maybe you could look into adjunct therapies to manage your stress.
It may sound very "new agey" but yoga, meditation, hobbies etc... can also work to help you manage your stress.
Now I'm not saying you can meditate yourself out of your situation (I don't know), but, especially for situational stress, I think it is optimal to learn strategies to manage it without drugs. Even 16 months is a temporary situation, whereas drug addiction can be permanent.
One thing about the Benzos is that they WORK. Xanax can provide almost immediate relief of symptoms and for me, just knowing that I have them is enough. I carry a bottle of klonopin with me all the time, but I rarely take it. And when I do I usually don't take the full dose. If I don't feel better within an hour or so, I take the rest of the dose (and yes, I talked to my doc about that).
I actually find myself thinking of other way to get by and I have been really surprised at how strong I can be. Everytime I get through a situation without the klonopin, it convinces me that I can get through the next one.
Finally, I would encourage you to work to change your work environment. I don't know the politics where you work, but a simple plea for improvement or at least a transfer, could really help your situation.
If its bad enough to drive you to drink, then is bad enough to warrant action on your part don't you think? (Again, if you've tried everything and still no change, then I'm sorry for even suggesting this).
Sorry this got so long, I guess I had some thoughts on this.
Maddie
Posted by Phillipa on November 5, 2006, at 10:31:10
In reply to Re: Xanax to cope with a tough situation.. » Pluto, posted by madeline on November 5, 2006, at 7:48:35
I wish I could work. But depression and anxiety have taken over my life. But why l6 months? Are you taking a new job with less stress then? Love Phillipa
Posted by bassman on November 5, 2006, at 16:52:41
In reply to Xanax to cope with a tough situation.., posted by Pluto on November 4, 2006, at 23:37:06
Yes, you will become dependent and you will probably be a bit uncomfortable withdrawing from it. But 1 mg isn't a large dose, so the withdrawal period is tolerable. If you must stay in the situation that you are in and you can't deal with it any way and your doc is O.K. with it, I'd just take the Xanax-if and only if that really seems to work. There is an argument for an AD-but frankly, if a benzo (or any other psychoactive drug) is working, my opinion is that you should just leave things alone. You could spend the next 16 months trying to find an AD that worked and had tolerable side effects for you. One of my favorite phrases is, "it worked until I fixed it". If the Xanax is really working, maybe just doing what you're doing makes the most sense.
Posted by Pluto on November 7, 2006, at 2:57:58
In reply to Re: Xanax to cope with a tough situation.. » Pluto, posted by madeline on November 5, 2006, at 7:48:35
Hi all,Thanks for your feedbacks. Now, let me tell you something.
I have just shifted to Middle East on a special assignment which lasts probably sixteen months. I am already on 40mg of Prozac which is not doing much to alleviate my depressive symptoms. I am not new to Xanax, took it on and off for a long time. But this time, staying away from my native land, leaving my family behind and to make the matters worse, stress in the workplace. All contribute to the hell I am in now. It is not for anxiolysis I crave Xanax, but is to dissipate depressive thoughts. And Yes, 1mg regularly, or occassionally 1.5mg does the job quite effectively. I don't experience any interdose withdrawal, because anxiety is not my problem. I do experience severe bouts of depression plus social unfriendliness if I skip a dose. If there was an expedient antidepressant for me, I wouldn't have been taking Xanax. But unfortunately, all SSRIs, Stablons, Moclobemides failed to bring at least a 50% reduction. Prozac helps but effects are not satisfactory.
I hope everybody understands what I mean. Now, tell me, is there anything wrong with going three 0.5mg of Xanax daily? At least for sixteen months? After finishing this tough job, I will be joining my family where depression will not be an issue then. Do you think I will get addicted to Xanax? To the point of no return?
Once again waiting for your valuable inputs.
Cheers
Percy LahS
Posted by tensor on November 7, 2006, at 3:16:08
In reply to Re: Xanax to cope with ..THANKS to all » madeline, posted by Pluto on November 7, 2006, at 2:57:58
Ok, i mistook you for being a newbie in psych meds.
Now, tell me, is there anything wrong with going three 0.5mg of Xanax daily?...........Do you think I will get addicted to Xanax? To the point of no return?
If you've tried SSRIs etc. there's nothing wrong with it, they are Safe, there's a long record for that, and they do always work. But you will become addicted, but don't let that discourage you, there's also something called quality of life, which is far more important.
I've been on clonazepam 2-4mg for years. However, i've tried all the most common benzos in search for a relief for my social phobia and i found clon to be the most effective for SP. Xanax is very effective for anxiety, but it is the benzo/benzo-like drug that is hardest to taper off. And if you plan to take it for definite period, perhaps Klonopin, Valium or Ativan would do the job and easier to come off.
I don't find it too hard coming off a benzo, you just have to be patient, because it will probably take several months, with slow gradual decreases in dose.
/Mattias
Posted by Pluto on November 7, 2006, at 3:31:00
In reply to Re: Xanax to cope with ..THANKS to all » Pluto, posted by tensor on November 7, 2006, at 3:16:08
Hi Mattias,You are quite nice to me.
But sorry once again, you fail to get me right. I take Xanax as an antidepressant or at least as an augmenter to Prozac. Klonopin isn't suitable for depression. Nor is Valium.
Once again to be precise, I am only enjoying the antidepressant like properties of Xanax which takes away depressive thoughts while I am on it. And yes, missing a dose brings back depression too. I know this depression or lack of complance to 40mg of Prozac is due to my parting with my family and dear ones. After a period of time, I am going to reunite with them then I hope depression will not be a problem.
Do you think, I will get addicted to Xanax?Sorry for asking again and again. But it is out of curiousity.
Cheers
PLS
Posted by tensor on November 7, 2006, at 3:43:48
In reply to Re: Xanax to cope with ..THANKS to all, posted by Pluto on November 7, 2006, at 3:31:00
Yes you will be addicted to it. But if that's your only concern and it's working great for you, i see no problems. Go for it. You shouldn't put so much attention to the addiction thing, it's harder to quit smoking than coming off a benzo. Remember that most AD's requires that you come off them slowly, as with benzos. And i'm also addicted to coffee..
It's gonna be allright.
/Mattias
Posted by bassman on November 7, 2006, at 5:43:47
In reply to Re: Xanax to cope with ..THANKS to all » Pluto, posted by tensor on November 7, 2006, at 3:43:48
Ahhhh!! Not "addicted" - "dependent". Big difference.
But I agree with the "let's fix you now, worry about dependence later" philosophy. The odd things is that many people (myself included) experience NO withdrawal symptoms even after years of benzo use, depending on the benzo.
Posted by madeline on November 7, 2006, at 5:56:03
In reply to In Middle East: Xanax is the only way out, posted by Pluto on November 7, 2006, at 3:00:00
I would take the xanax. There is absolutely nothing wrong with taking a legally prescribed medication. Especially if it helps you deal with your situation.
Whether or not you will become addicted is tough to say. Some people do, some people don't.
If you see yourself escalating your dose, thinking about your next dose, those are danger signs.
Do not mix xanax with alcohol.
I wish you the best of luck and will be thinking about you.
Keep us posted as to your progress (deployment?).
I will be here rooting for you.
Maddie
Posted by Racer on November 7, 2006, at 10:12:45
In reply to Re: In Middle East: Xanax is the only way out, posted by madeline on November 7, 2006, at 5:56:03
Kinda depends on how you define addiction. If you're talking about physical dependence, then yeah -- you're likely to become physically dependent on it. That's not addiction, though.
Addiction is usually considered to be a cycle of increasing doses and increasing obsession with the substance of choice. It's like the alcoholic with a ritual of drinking, or the heroin addict who ritualizes the process of shooting up. It takes larger and larger amounts to satisfy you, etc.
Good luck with it. Does the fact that Xanax helps with your depression give your doctor any hints about other possibilities for you?
Posted by Phillipa on November 7, 2006, at 11:58:43
In reply to Re: In Middle East: Xanax is the only way out, posted by Racer on November 7, 2006, at 10:12:45
Racer PLEASE what kind of hints as that's what happens with me too. Thanks Love Phllipa and take the xanax if it works it has a noted mild antidepressant effect.
Posted by ed_uk on November 7, 2006, at 13:43:28
In reply to In Middle East: Xanax is the only way out, posted by Pluto on November 7, 2006, at 3:00:00
Hi
Do you have a doctor in the middle east who will prescribe Xanax on a long term basis?
Ed
Posted by Squiggles on November 8, 2006, at 9:15:08
In reply to In Middle East: Xanax is the only way out, posted by Pluto on November 7, 2006, at 3:00:00
I just noticed your message Pluto.
By all means, take the Xanax. Under such
conditions, I don't think that you have to
worry about addiction, especially at such
a tiny dose. After 16 months you can ask
your doctor to help you get off it. If anything I would say that perhaps a longer-life benzo might be better, because the Xanax is for abrupt situational anxiety and does not last long.Good luck.
Squiggles
Posted by blueberry on November 8, 2006, at 21:03:22
In reply to In Middle East: Xanax is the only way out, posted by Pluto on November 7, 2006, at 3:00:00
Take the xanax! That's actually a very low dose of one of the most common medications in the world.
The thing is though, we spend months and years trialing and testing all kinds of things to find something that helps. You already have found it. That's quite a blessing.
While on xanax, you and your doctors in the weeks ahead can have time to think about what it means that xanax helps, what might be wrong chemically or genetically that allows xanax to work as well as it does, and to think of possible alternatives if you ever want to go back to the trial game. For just one example, I know someone else whos mood improves a lot with lorazepam, very similar to xanax, and he's been on it for many years and is still at a low dose and the goodness just keeps on.
Posted by blueberry on November 8, 2006, at 21:03:48
In reply to In Middle East: Xanax is the only way out, posted by Pluto on November 7, 2006, at 3:00:00
Take the xanax! That's actually a very low dose of one of the most common medications in the world.
The thing is though, we spend months and years trialing and testing all kinds of things to find something that helps. You already have found it. That's quite a blessing.
While on xanax, you and your doctors in the weeks ahead can have time to think about what it means that xanax helps, what might be wrong chemically or genetically that allows xanax to work as well as it does, and to think of possible alternatives if you ever want to go back to the trial game. For just one example, I know someone else whos mood improves a lot with lorazepam, very similar to xanax, and he's been on it for many years and is still at a low dose and the goodness just keeps on.
Posted by Pluto on November 9, 2006, at 5:03:12
In reply to Re: In Middle East: Xanax is the only way out » Pluto, posted by ed_uk on November 7, 2006, at 13:43:28
> Hi
>
> Do you have a doctor in the middle east who will prescribe Xanax on a long term basis?
>
> Ed
Hi Ed,No. Just like in Europe, Xanax is a controlled substance here. Even psychiatrists rarely prescribe them, and if they do it would be ten or twenty days supply maximum.
But I found a source outside to get generic alprazolam regularly. I would say Indian generic is as good as the real stuff.
Cheers
PLS
Posted by Pluto on November 9, 2006, at 5:07:51
In reply to Re: In Middle East: Xanax is the only way out, posted by blueberry on November 8, 2006, at 21:03:22
> Take the xanax! That's actually a very low dose of one of the most common medications in the world.
Hi blueberry,
You mean 1.5mg of Xanax is a VERY low dose? That much is sufficient for me to function. Going with the regimen, I am nearly perfect. But still the obsessive thought about the stuff! Wouldn't it be a high dose? High enough to get me to somewhere where there is no return?
Cheers
PLS
Posted by tensor on November 9, 2006, at 5:48:39
In reply to Re: In Middle East: Xanax is the only way out, posted by blueberry on November 8, 2006, at 21:03:22
>That's actually a very low dose of one of the most common medications in the world.
No, it's actually not, it's a common dose.
Posted by bassman on November 9, 2006, at 6:42:40
In reply to Re: In Middle East: Xanax is the only way out, posted by Pluto on November 9, 2006, at 5:07:51
The only pdoc I ever went to that I thought knew what he was doing looked at me quizzically when I said I want to withdraw from 1 mg Xanax/day. His comment was, "at such a low dose, there's nothing wrong with you taking that for 10 years-more than that. If you were taking 3-5 mg, I'd say ‘wait a minute here’..."
But I do get the "Xanax dependence" fear thing that you are experiencing. Again, I agree with the "it's working, leave it alone" advice you've gotten from several folks. Take care of yourself now and concern yourself if and when that day comes-and it is very unlikely you’ll be so dependent that you’ll have problem withdrawing. In withdrawal trials with Xanax, there wasn’t much difference between those that were able to withdraw from Xanax or placebo. Imagine being dependent (“addicted” is a fun word to use, it’s just incorrect in this usage) to placebo!:>} I wonder what you switch to to withdraw from a placebo? Valium, via Ms. Ashton?
Posted by ed_uk on November 9, 2006, at 14:10:27
In reply to Re: In Middle East: Xanax is the only way out » ed_uk, posted by Pluto on November 9, 2006, at 5:03:12
Hi Pluto
Is there a risk that you might get into legal trouble by importing or possessing alprazolam? (particularly large quantities). Also, will you be able to get a consistent supply? There's nothing worse than taking a benzo regularly then having to withdraw abruptly because you can't get it anymore.
>1.5mg, low dose
IMO, it's not especially low. Xanax is a very potent benzodiazepine.
Take care
Ed
Posted by Pluto on November 11, 2006, at 22:05:47
In reply to Re: In Middle East: Xanax is the only way out » Pluto, posted by ed_uk on November 9, 2006, at 14:10:27
Hi Ed,
I had a short visit to New Delhi to find a psychiatrist who will prescribe alprazolam. So, I don't possess the stuff without a prescription. I don't think there ever will be a legal problem in possessing alprazolam for personal use especially with a proper prescription. I have my case history with me to produce in any court which will always justify my use of substances like benzos.
Besides, I have registered in the local psychiatric clinic as an anxious depressive. Though they won't prescribe alprazolam for anxiety or panic, they don't seem to have any problem, if I can obtain it from outside sources.I have months long supply with me now. In case of it running out, it would just take another short visit to the same destination to acquire more. I always keep in touch with my Indian doctor.
Thanks for your concerns. Do you still sense any problem?
Cheers
PLS
Posted by BUCKEYE FANATIC on November 13, 2006, at 8:16:42
In reply to Re: In Middle East: Xanax is the only way out » Pluto, posted by ed_uk on November 9, 2006, at 14:10:27
Sorry your situation is so tough....
My opinion as a long time xanax user and after years of research and practical real-life experience with this benzo is "Do Not Use"...
It does work...but it is as addictive a drug as exists anywhere.
It affects your entire GABBA and nervous system,
you reach tolerance and need more to not go through withdrawl, and once your body has experienced the un-natural relaxing effects of xanax....NOTHING can ever take its place.In my opinion..it is downright criminal for MD's to continue prescribing this drug, now that they have had at least 2 decades to study its short AND long term effects.
I wish I had never taken that first .25mg pill.
It is now 10 years later, and I have recently cut from 6MG's per day to 4.....and my case is NOT unususal ...it is the norm.
Please do everything you can to avoid this highly addictive drug.BF
Posted by bassman on November 13, 2006, at 9:03:12
In reply to Re: In Middle East: Xanax is the only way out, posted by BUCKEYE FANATIC on November 13, 2006, at 8:16:42
Here's another opinion...I think Xanax is a wonderful med and AD's don't work for me without it. I do think you have to say, "this is the dose I take" and not go up because you have a couple anxious days. Also, after a short period of time, you won't feel it "kick in"...don't increase the dose anyway. I never felt I built up a tolerance, even after years of use. I am currently taking Xanax and decided to decrease the dose a few days ago...no withdrawal except waking up a little early for a few days. I can't take more than about 2 mg a day consistently or it sort of becomes a different drug for me. Just my personal experience...
bassman
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