adding a longer acting benzo into my regimen along with xanax

[zachnotzack]

I have a doctors appointment coming up soon and I want to know what I should discuss with my doctor about trying a new medication. I have been on xanax .5mg/3x daily for about a year now for Social Anxiety, Panic attacks, anxiety attacks, etc. I have never thought the dose to be strong enough, but my doctor seems to disagreee. I dont want to just jump right out there and ask to up my dosage, but I have been doing a lot of reading lately and everyone else who seems to have my symptoms or conditions take up to 4-5 mg of xanax a day. Now I would rather not jump to that high of a dose, but instead ask for a longer acting benzo in combination with my xanax like clonzepam or valium, or even a switch to the mixture of those two. please, someone tell me they have had this problem!

[chrisz]

I had my first panic attack when I was 26. I am now 60.
When I first started having panic attacks, my Pdoc prescribed xanax .5mg 3 X day. I STILL HAD PANIC ATTACKS but just less often, and sometimes intense. For 10 years I suffered, but then my Pdoc left town and I had to find another. This doctor wanted me to have NO panic attacks. He immediately doubled my dosage 1mg 3 times a day.That did it !!!!!!! I had Zero Panic Attacks !!!! He added 10mg of Inderal 3 x day for my heart pounding thing. It worked great also !!

Those Pdocs don't like to prescribe large doses, but most will do it if it helps the patient. If not, find another doctor.
BTW, over 30 some years and now I take 4 day. The Pdocs know that many people will have NeuroAdaptation by there brain, and the Liver starts to make chemicals that neutralizes the Benzo. While others just hit a "Plateau" and do not develop this tolerance issue thing.

It's gotten so that I make the decision on what treatment I will take. So far NONE of the SSRI's help me.
Only Xanax seems to work the best. Pdocs usually won't prescribe two Benzos at the same time. But I've read some of the will.

It is addictive. But if " I need it to function " like HOUSE said about is pain medication.

Be Assertive with your Pdoc. It's your life !

Chrisz

[alankay]

Zach, well because docs are often concerned about long term benzo use you should have a trial of an ssri. If successful the strategy will be to help you become less anxious and reduce, not necessarily eliminate, your xanax use. Drs are MUCH more comfortable prescribing xanax(or any benzo) long term to be used "as needed"(situationally). This is because over time many, not all, will go down the road of regular dosage increases to keep the desired anti-anxiety effects as tolerance develops(no, it doesn't always develop). Problem can be that as the dosage increases so do the risks(drowsiness leads to increased chance for accidents, foggy thinking, memory issues, dependence) and then it may be becomes necessary to come off the benzo which I can tell you is no fun. A better scenario(which I use) is the use off all methods(SSRI, relaxation practice, deep breathing, positive self dialog, counseling in the beginning, reading good books on anxiety what it is, etc,) IN ADDITION to occasional benzo use. That's what the dr, would want to you to do(if that all fails a benzo might be required by a reluctant dr.). Yep, some folks will need that route. Just remember it's his med. license and he needs to try to limit benzo use for the most part as there are risks with it. Dependence among them. He was trained that way and should be really trying to add a ssri to help you feel less anxious and lower the benzo use OVER TIME. I'm just saying what is more medically accepted and for the right reasons(IMHO). Having said all that IF you get relief NO OTHER WAY and have tried all they recommend you may be one that needs benzo long term. I use valium but drs. these days often like klonopin as a long acter. The reason long/intermediate acters are sometimes preferred is that they can be dosed less often and rebound/inter dose anxiety is less. Also a bit less likely to be abused since the action is not so obviously strong to the patient and he'll perhaps not notice so much, their sometimes remarkable anti-anxiety effects and become too attached to always having them in the blood stream(I did). Some docs also like to "in and out" of short acters for situational anxiety since they don't like to have you under a benzos' effect any longer than needed. .5mg is not much at all but you don't want to get on a trajectory to way much more(like 4-5mg daily)......unless nothing else works at all. Chris sure is right, it's your life but it's also you drs. license and they won't want to just keep upping the benzo if they haven't tried the safer, more medically recommended efforts to reduce/control your anxiety. Work with you dr. on this and indeed let him know what you think. Valium or klonopin are good long acting choices and you and your dr. will have to adjust for the dosage and see how one works for you. Message me any time.