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Re: more about Xanax and depression » Elizabeth

Posted by paulk on June 16, 2001, at 15:07:23

In reply to Re: more about Xanax and depression » paulk, posted by Elizabeth on June 15, 2001, at 22:10:17

>That's true, although there is something called a "use patent" (which is why you still can't get generic Prozac in the US

Tell me more – how much longer can they stretch it out with this?

> > Do you know if the low BP side effect is a ‘primary’ effect of the drug or a result of the lowering of the MO enzyme level?

>I'm not sure I understand the question. Orthostatic hypotension (slowed cardiovascular adaptation to changes in posture) is probably due to central activation of alpha-adrenergic receptors (which results from increased norepinephrine, which results from destruction of MAO).

From what you said that would be a secondary effect – the primary effect of the drug would be the destruction of MAO. A secondary effect would be the increase in neuro transmitters. I saw some lowering of my BP quite as soon as I took the med – I’m thinking it might be a primary effect?

> > Unfortunately, it was quite a bear to manage frequent dosing at a low level, so I stopped it many years ago. Xanax quits so fast and nasty that I can see why it would be addictive. Sure wish there was an XR version to try.

>Addiction results from using large doses of a drug to get high. Anybody who's been taking Xanax for a long time will get withdrawal symptoms; that's not drug addiction, it's a normal reaction.

Not sure I’m tracking you here – my father gave some of his terminal patients enough painkiller for them to become ‘physically addicted’ – in my mind if there are physical side effects from withdrawal one is physically addicted. On the other hand, I would say there are lots of people who are psychologically addicted to coffee.

I think we agree on this – I might be using a different definition of addiction? I would even call the fever I got discontinuing Effexor a physical addiction. Perhaps I’m just not being PC enough< grin >. I see no problem in getting physically addicted to a drug if it is beneficial in the long term.

I think I remember hearing a ‘modern’ definition about addiction being where one loses the ability do deny oneself the drug (I guess I might be addicted to food - some of the amino acids can make me feel much better - (unfortunatley they tend to be found in association with high fat content)).

> > I understand why one shouldn’t take SSRIs and the like but I don’t understand why there would be a need to discontinue other MOAIs when switching between types? After all, the Nardil would wash out in a day or so? Are they acting on different enzymes?

>That one is a mystery. It may only be a problem when switching between Nardil or Marplan (the hydrazide MAOIs) to Parnate (an amphetamine-like MAOI).

My guess is that the different MAOIs must be knocking out different MAOs or they would all have the same effect other than their side effects.

> > I’m also wondering if I should get a med-alert bracelet - I understand that Demerol (meperidine) can be fatal – I would hate to be in a car accident and get Demerol in the ER that could kill me.

>Demerol's pretty crappy anyway. They should use morphine. :-)

Or heroin – it is supposed to be the best painkiller (there might be some new synthetics – I don’t know about). Back when heroin was used as a painkiller most folks had no problem becoming dependent on it. The name had something to do with the heroic effect it had combating pain. It probably got its bad reputation because so many coming back from the war had been treated with it at one time. Out of this large number enough had addiction problems that it earned its ‘bad drug’ status. If a different opiate had been popular for pain control at that time it would have earned the same ‘bad drug’ status. (I suppose one could make some points about the half-life of some opiates makes them more addicting.) Anyway – many people who were given large amounts of heroin for pain had no problems getting off the drug.

There are times when I have a bad influenza that I wish I could get some opiate for a day or two while I recover – it is near impossible to get codeine cough syrup and when I’m sick, I’m not likely to go to more than one drug store.

I also, have had a run-in with opiates=bad when I had my second kidney stone. (I had no idea what was happening with the first one.) I came into the emergency room – told them I was having a kidney stone. The ER thought I was an addict and just put me on hold for 45 min – until I got mad and demanded they run an IVP on me so I could prove I really did have a stone and get the pain med I needed. I didn’t get pain med for over 2 ½ hours.




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