Tolerance, Taper, Reinstatement? Xanax help!

[march]

I am really sick right now and need some guidance. A bit of a saga...

I mainly took Xanax in very low doses .125-.25 as needed for several years. I would go through periods of a constant panic feeling, take Xanax and beta blockers, feel better then wean myself off. Then just kept taking the Xanax as needed. Usually for hangovers which I know now is not the best.

In Oct. 2013, I took diphenhydramine and dextromethorphan for a cold and had to go to the ER. I was messed up with a crazy reaction! After that, the constant panic feeling was back. I did the Xanax/beta-blocker thing again and by early Dec. I was feeling fine. Then I took a Xanax before Christmas and my world turned upside down. After that one, I felt worse than ever. The worst constant panic/adrenaline. I took up to 1mg once and it did nothing. I was told by a natural health Facebook group I was in "tolerance" and that I had to taper. My dr told me to keep taking more even though it wasn't really working. My usual dose at that time was .5-.6mg quite a bit more than I was used to taking. And nothing was killing the adrenaline feeling.

I started the taper at .8mg and it was a nightmare for the first few months. I was so sick, like a heroin addict getting clean. Tons of adrenaline. The taper lasted 1 year and got much better 6-7 months in. After the taper, I continued to have nights with the adrenaline. Every month or 2 with no apparent trigger. I'd go to sleep, then wake up with adrenaline surges, vomiting, diarrhea, shaking, fear, panic, lasting until morning. Then I'd be tired but fine.

In April, the bad nights wouldn't stop. I was diagnosed with "adrenal disfunction" from an integrative dr. It was very hard, but I finally got better (using only natural things) in July, and now I'm sick again like I was but even worse!

My therapist is threatening to put me in the mental hospital because I can't eat or sleep. I'm suicidal. None of this is mental when it starts! It's just pure fight or flight adrenaline. For hours and hours. Every morning until the afternoon. Then every other night starting around 12am. It's cyclical. My therapist wants me to try a benzo again. I have Xanax still, and my mom has Valium. Probably expired but still.

Just not sure what to do, what it is, what's going on. I feel fucked.

If you made it this far, thank you!

 

 

[melissaw72]

Wow ... I am sorry you are going through all of what you describe!  It all sounds so distressing. 

To me it sounds like panic attacks.  (I'm not a DR though, not diagnosing).

I can understand why your therapist (tdoc) wants to put you in the hospital, especially because you cant eat or sleep, and you're suicidal.  Does your psychiatrist agree?

Hopefully all of this will be gone soon.

 

Otherwise A few questions to clarify things (only answer if you feel comfortable to do so).

Do you have a diagnosis?  Are you on other meds?

Was/Is your psychiatrist (pdoc) aware of how you are feeling and doing now (the symptoms you've been having off and on for awhile), as well as all the changes you were making and the tapering off of with the xanax, etc?

Has your pdoc offered you another benzo to try, or if not another benzo, a beta blocker (propranolol, if your blood pressure is ok)?

I know your tdoc knows about this, and aside from her wanting you to go to the hospital, what does she think of all of this?

 

I'm sorry for all the questions!  I just needed to know more to answer your post more.

[HAL9000]

I'm also not a doctor so this is just my experiences and guesses.  Were you taking Xanax daily?  Or was it always taken just as needed?  .25 is a pretty small dose.  I started with .5 and that was even at the start not very useful.  It would extinguish the anxiety like a hammer but didn't last long enough.  When it wore off I often was back to square one.   Before Xanax I took Valium and now after talking to my PDoc went off Xanax and back to Valium which I take only as needed.  It seems to me to be a lot more "subtle" because it just turns off the anxiety there is no "buzz" or whatever.

He (PDox) made a comment about Xanax and said he disliked it because its short (sudden strong) action gave it the greatest potential for abuse. 

I would not change doses or taper on and off without having you doctor directly involved.  Mine said that patients who stop without telling her are her main pet peeve.  Some things have to be done in certain ways because of other drugs that a patient is taking or as in one instance she told me she does not (As a rule) take people off anti depressants in the Minn Winter.   *Just an example

[march]

10 hours ago, melissaw72 said:

Wow ... I am sorry you are going through all of what you describe!  It all sounds so distressing. 

To me it sounds like panic attacks.  (I'm not a DR though, not diagnosing).

I can understand why your therapist (tdoc) wants to put you in the hospital, especially because you cant eat or sleep, and you're suicidal.  Does your psychiatrist agree?

Hopefully all of this will be gone soon.

 

Otherwise A few questions to clarify things (only answer if you feel comfortable to do so).

Do you have a diagnosis?  Are you on other meds?

My therapist feels its psychosomatic. Not made up but a physical manifestation of something emotional/mental. I am not taking any medications however I just started taking benedryl to help sleep.

10 hours ago, melissaw72 said:

Was/Is your psychiatrist (pdoc) aware of how you are feeling and doing now (the symptoms you've been having off and on for awhile), as well as all the changes you were making and the tapering off of with the xanax, etc?

I don't have a pdoc. Never have. The Xanax was given to me by multiple drs. My dr at the time was fine with the Xanax taper.

10 hours ago, melissaw72 said:

Has your pdoc offered you another benzo to try, or if not another benzo, a beta blocker (propranolol, if your blood pressure is ok)?

I have propranolol. It makes me feel really bad even on low doses though. My dr wants me to take it no matter how bad the side effects are.

10 hours ago, melissaw72 said:

I know your tdoc knows about this, and aside from her wanting you to go to the hospital, what does she think of all of this?

My tdoc thinks I should try a benzo. I gave Xanax leftover from the taper but I'd rather try something different. My mom gave me some Valium but I'm scared I'm going to mess up my brain.

10 hours ago, melissaw72 said:

 

I'm sorry for all the questions!  I just needed to know more to answer your post more.

Thank you so much for responding! I think there's something wrong with my adrenals. I've had tests, and nothing comes up very conclusive. Panic attacks just don't last this long.  I just need the adrenaline(or whatever it is) to stop. I'm only suicidal when it won't quit for hours. Because the Xanax didn't help the first time this happened and I had to taper off because I guess I was in tolerance... I don't know. I'd love to be able to take a benzo but I'm really scared to. Horror stories about "kindling" and tolerance and all that.

I slept a bit last night. Felt okay this morning and right after I ate some breakfast, boom! Terrible adrenaline again. 

[march]

10 hours ago, HAL9000 said:

I'm also not a doctor so this is just my experiences and guesses.  Were you taking Xanax daily?  Or was it always taken just as needed?

Sometimes I took it daily, sometimes not for months.

 

10 hours ago, HAL9000 said:

 

  .25 is a pretty small dose.  I started with .5 and that was even at the start not very useful.  It would extinguish the anxiety like a hammer but didn't last long enough.  When it wore off I often was back to square one.   Before Xanax I took Valium and now after talking to my PDoc went off Xanax and back to Valium which I take only as needed.  It seems to me to be a lot more "subtle" because it just turns off the anxiety there is no "buzz" or whatever.

He (PDox) made a comment about Xanax and said he disliked it because its short (sudden strong) action gave it the greatest potential for abuse. 

I would not change doses or taper on and off without having you doctor directly involved.  Mine said that patients who stop without telling her are her main pet peeve.  Some things have to be done in certain ways because of other drugs that a patient is taking or as in one instance she told me she does not (As a rule) take people off anti depressants in the Minn Winter.   *Just an example

I have so much adrenaline. It just doesn't seem like classic panic. I've been off all benzos for over a year. I'm afraid of kindling, or being in tolerance again or feeling worse. I want to take one so badly but I'm afraid to.

Thank you for your response!

[jt07]

SSRIs can sometimes be used to combat anxiety and a lot of the symptoms you are describing. I take Celexa (citalopram) and it is excellent for my anxiety. I've had panic attacks last for an entire day to the point where I thought I was dying, but I've had none since I've been on citalopram.

 

[melissaw72]

1 hour ago, march said:

My therapist feels its psychosomatic. Not made up but a physical manifestation of something emotional/mental. I am not taking any medications however I just started taking benedryl to help sleep.

I don't have a pdoc. Never have. The Xanax was given to me by multiple drs. My dr at the time was fine with the Xanax taper.

I have propranolol. It makes me feel really bad even on low doses though. My dr wants me to take it no matter how bad the side effects are.

My tdoc thinks I should try a benzo. I gave Xanax leftover from the taper but I'd rather try something different. My mom gave me some Valium but I'm scared I'm going to mess up my brain.

Thank you so much for responding! I think there's something wrong with my adrenals. I've had tests, and nothing comes up very conclusive. Panic attacks just don't last this long.  I just need the adrenaline(or whatever it is) to stop. I'm only suicidal when it won't quit for hours. Because the Xanax didn't help the first time this happened and I had to taper off because I guess I was in tolerance... I don't know. I'd love to be able to take a benzo but I'm really scared to. Horror stories about "kindling" and tolerance and all that.

I slept a bit last night. Felt okay this morning and right after I ate some breakfast, boom! Terrible adrenaline again. 

I think it would be in your best interest to find a pdoc (keeping your tdoc, but having a pdoc also to manage meds) so other multiple DRs aren't prescribing meds to you.  One DR might not know you are on one med, another DR another med etc.

Why does the DR who prescribed propranolol want you to take it no matter what the side effects are?

So your tdoc wants to prescribe a benzo despite what you went through with the xanax taper? 
I think the meds should be prescribed by one DR.  Panic attacks can last a long time for some people.  Some they last for an hour or 2, sometimes all day.  And one panic attack might differ in length than another panic attack (with one person).

(in bold) This is something your tdoc (and hopefully pdoc) need to know.  I think they would like to know how bad things are for you, for you to become suicidal when the feelings won't lessen/go away.

Sometimes with meds you wont know if a med works for you or not until you try it, and give it time to work (unless you have a side effects that is unbearable or life threatening).  You won't know until you try it. 

If you are reading about things on the internet, I would suggest not doing that.  Most people only write about the bad stories they had with a med/s.  You don't find as many people writing about a good experience/s.

I'm glad you slept a little last night.  Without a pdoc evaluation, it is really hard to figure things out, IMO at least.

[march]

10 minutes ago, melissaw72 said:

I think it would be in your best interest to find a pdoc (keeping your tdoc, but having a pdoc also to manage meds) so other multiple DRs aren't prescribing meds to you.  One DR might not know you are on one med, another DR another med etc.

My tdoc suggested I see a pdoc. This is all very overwhelming because I truly feel it is physical and no one is doing the right testing. I'm used to doing everything naturally!with herbs and supplements. I'm really freaked out by medication. I feel like I always have a bad reaction.

10 minutes ago, melissaw72 said:

Why does the DR who prescribed propranolol want you to take it no matter what the side effects are?

See above.  She thinks I'm being a baby because 5mg of propranolol make me feel weird. When I'm in this state I'd rather feel everything naturally than side effects of a drug.

10 minutes ago, melissaw72 said:

So your tdoc wants to prescribe a benzo despite what you went through with the xanax taper?

Yes, she thinks it's either I try a benzo again or get drugged up at the hospital. She's not believing the "tolerance" aspect. All I know is the Xanax worked one day, and then I had horrible panic/adrenaline the next, and when I took some it barely touched it. So either it was rebound panic from the Xanax or tolerance or something bigger in my body Xanax couldn't help. I wish I knew what went wrong with the Xanax. Maybe nothing! I'm all messed up from being on benzobuddies!  

10 minutes ago, melissaw72 said:

I think the meds should be prescribed by one DR.  Panic attacks can last a long time for some people.  Some they last for an hour or 2, sometimes all day.  And one panic attack might differ in length than another panic attack (with one person).

I just don't get that if it's a panic attack why is it cyclical, at the same time every day. I have no doubt parts are panic and anxiety because it sucks to feel this way. But the cyclical nature is where I'm scratching my head.

10 minutes ago, melissaw72 said:

(in bold) This is something your tdoc (and hopefully pdoc) need to know.  I think they would like to know how bad things are for you, for you to become suicidal when the feelings won't lessen/go away.

I've told my tdoc and that's why she's stressing I start the benzo up again. She is in a tough position because she has to commit me if I keep talking suicide.

10 minutes ago, melissaw72 said:

Sometimes with meds you wont know if a med works for you or not until you try it, and give it time to work (unless you have a side effects that is unbearable or life threatening).  You won't know until you try it. 

You are so right! I should give the full 10mg of propranolol a chance. It's very hard for me. So much medication fear.

10 minutes ago, melissaw72 said:

If you are reading about things on the internet, I would suggest not doing that.  Most people only write about the bad stories they had with a med/s.  You don't find as many people writing about a good experience/s.

I'm glad you slept a little last night.  Without a pdoc evaluation, it is really hard to figure things out, IMO at least.

You are very patient and wise. Thank you for reaching out to me. This has been very hard because I feel very alone. I have no one bigger than me who can help call the shots. My poor husband feels helpless. And my mom cares but she's tired of it too.

Thank you again for your advice. I appreciate it! ?

 

[HAL9000]

The PDoc I see is maybe as concerned as you are about Xanax but there are other Benzos.  I'm not wanting to sound like a salesman for Valium but it does work much better for me then Xanax and my PDoc seemed to think it was a lot less riskier.  How about buspar?

[Alien Navel Cord]

Here is my opinion, YMMV of course, but I would ask your pdoc, if you choose to get one, that you actually go up in dosage. Sounds like the negative aspects of your panic attacks and anxiety outweigh the negative aspects of taking a higher dose of the medication. Well at least that is what all of my pdocs have done. It's not working well/side effects? Try upping your dose, it'll work better. <--- not always the best, but that's what they tend to do. 

Medication can be your friend, when you need it. I wouldn't shy away from getting help by taking meds, if it were me. I'd be glad to have something, anything, that would help me feel better.

Just a thought.