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Xanax to stunt hypomanic episodes


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My psychiatrist has decided that I need a prn med to block hypomanic episodes before they turn into full blown manic episodes.

I agree with him.

Although I can usually control hypomanic episodes via auto-suggestion, I sometimes do not have the will to.

Sometimes the racing thoughts become very uncomfortable.

I am on risperidone which does not help.

We do not want to try an anti-convulsant.

I have tried some nasty APs like chorpromazine and haloperidol prn, but they do not cut the mustard.

I have used diazepam, temazepam and lorazepam in the past.  I doubt that any of these are powerful enough to stop these episodes.

I am in the UK and am not sure if I can even get Xanax, but if it would help my pdoc would let me use it.  Because docs do not have much experience with it, they do not tend to use it.

Would Xanax help my cause?

I understand that it is one of the few benzos that make most people feel quite pleasant.  This would only be a problem if it is going to feed the hypomania.

I will discuss this all in detail with my pdoc, but any advice regarding the nature of Xanax would be appreciated.

Cheers.

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This is one of the precautions I found on a site about Xanax

"Episodes of hypomania and mania have been reported in association with the use of alprazolam in patients with depression."

(http://www.healthyplace.com/medications/alprazolam.asp)

If you are already hypomanic and take Xanax, wouldn't it make you worse?

My husband uses zyprexa to swash full blown mania, and to stop hypomania. (It also seems to work very well for anxiety attacks.) You may want to ask your doctor about it...

http://www.zyprexa.com/understanding/index.jsp

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When hypomania starts to increase and the potential for mania seems real, I have been Rx'd klonopin. I may or may not be on Zyprexa at the time but klonopin seems to help certain symptoms for me. I don't know about Xanax. Will wait to see what others have to say.

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I know when I got really bad only an AP seemed to do the trick (i.e. not my benzos) but I've never tried Xanax.  We are all different and respond uniquely to meds.  It might work for you.  Like Erika said, let's see what some other people have to say.

Karen

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Heya username,

Benzos like Xanax etc. are used for acute mania.

But, there is a risk of a paradoxical reaction -- the opposite from what's intended -- i.e., agitation instead of sedation.

Bipolar is one of the risks for the paradoxical reaction.

Here's part of an abstract of an article I found at Medscape:

Paradoxical Reactions to Benzodiazepines: Literature Review and Treatment Options

Carissa E. Mancuso, Pharm.D.; Maria G. Tanzi, Pharm.D.; Michael Gabay, Pharm.D.

Pharmacotherapy 24(9):1177-1185, 2004.

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Hey there!

I take Xanax, although it's for my extreme anxiety, not manic behavior.  I would think that Xanax could help with that though, because it acts as a sedative for me and slows my cyclical thoughts and relieves my obsessive anxiety.  I'd say give it a try if you have exhausted all the mood stabilizer possibilities.

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I used to take Xanax for hypomania. Doesn't do shit if I'm already in real manialand though. AND, it gives me a hangover, which is why I prefer a tiny dose of Zyprexa.

Or better yet, an anticonvulsant to stop the manic signs before they even appear.

Good luck in finding the right med for you.

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Thankyou all for the input.  I have found some of these comments very valuabe B)

At the moment I am using sulpride prn in addition to my resperidone and duluxetine.

The episodes that I have are very disturbing.  They start of with me feeling WEIRDLY happy, and sometimes, especially if fed with caffiene (I obviously do not do this anymore!) can turn into somethng horrible.  I have been controlling my depression very well indeed (I have not felt this good in years) with hypnotherapy (incorporating NLP and cognitive behavioral therapy) and duloxetine.  Duloxetine STOPS any big depressive dips, whilst my self therapy has helped me to achieve happiness.

I did however make a very serious suicide attempt recently when in one of these states.

When these episodes do turn, I feel an urgent urge to talk, my thoughts are RACING and going off at a million tangents at once.  It becomes uncomfortable.  I feel the need to discuss philosohical issues on forums until I can type no more.  I feel the need to learn every thing that there is to know about string theory in half an hour.  If I do not get some sleep at this point, I become confused - trying to find deeper meanings in billboards and sign posts.

Because these episodes usually become more nasty at night, I am using zopiclone as well to get a good nights sleep, and to keep my daily routine in order (something I have found that helps).

Oh, and I am not drinking at all anymore. 

I am having a year out of Uni to get these issues sorted out.  My self therapy has Stopped my anxiety and agorophobia.  So I am making outstanding progress despite the problems.

Some noted that Xanax can feed a hypomania due to its euphoric effects.  This was something that I was also concerned about.  If I was to use a benzo perhaps clonazepam would be a bit easier on my mood.  It is not used often in the UK, but it is licensed.

Thanks again everybody.

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  • 2 weeks later...

If a benzo is warranted, clonozepam (klonopin) may well be the one to consider.  Its the second strongest benzo next to xanax, but is a longer acting drug and generally safer for long term use. It also has anti-convulsant proprties, and is often prescribed to people with mania and/or epilepsy over other benzos.

Talk to your dr about this option. Xanax is great, if used as required, but it can become habitual quickly because it has such a short half life and you develop tolerance quickly.  I personally have been addicted to xanax in the past and withdrawal was a bitch, so I wouldnt recommend it generally.

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  • 2 years later...
Guest jackson36067

I just started zyprexa and lamictal two weeks ago and was prescribed Klonopin 3 times a day. For me, the Klonopin did not seem to calm my racing thoughts, but I was early in the other meds. Even so, my pdoc was compassionate enough to prescribe ten days' worth of xanax at my last visit. I woke up today and had to admit to my wife that I felt GOOD for the first time in memory. Not just recent memory, I mean, ever. She was brought to tears of happiness for me.

Yes, I will force myself to dose as directed and even use less whenever I can because I believe that it is a big part f my recovery, and I do not want it ruled out in my future because I abused it.

Good luck. One last thing. My wife attends all my pdoc sessions with me. Her description of my symptoms of BPD made the difference and got my pdoc to prescribe the xanax.I don't know if it is common to have a couple attend an individual's therapy, but it is what got me diagnosed correctly, put me to rest for a month and on the right meds. Thirty years of trying on my own failed.

Best wishes to you.

I've been on Lamictal for 4 yrs, added trazadone 3 yrs ago to help with the sleep problems and Xanax prn for 3 yrs. Typically I take 0.25 mg Xanax 2-3 x's a week, but when I notice hypomania, or someone else does & tells me, I bump the Xanax up to 2 x's a day till my family tells me I'm coming down.

My family has helped me keep my BPD in check from diagnosis on. They are really good about checking on me every day, I live alone, and if I don't take calls - they come see me. Family interaction is a key ingredient in managing.

But, back on topic...Xanax levels me out once I realize I'm getting on the roller coaster.

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