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Switching benzos

mmaryland
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mmaryland

mmaryland

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So I have been on xanax 1mg two to three times daily for about 1-1.5 years now; Paxil is great and I don't need xanax when on paxil but it makes me manic as hell so that isn't really an option. Been thinking whether Zoloft would be any different.... Anyway, still on xanax same dosage, but just doubled my valium from 10mg at night to 20mg at night because I was waking up from sleep with difficulty breathing and panic symptoms. I asked to try ativan, eliminate the antipsychotic i use for sleep mainly since ativan 2mg really helps with insomnia, and get rid of the valium. Well she said lets try increasing the valium first then we will go from there.

Valium honestly does nothing for me. At 10mg I legit feel nothing. It takes at least 40-60mg for minimal anxiety relief. I respect its long half-life but if it's not benefiting much for sleep, or other anxiety problems in the morning I feel like why should I continue it. Switching to ativan 2mg at bedtime could get me off valium and saphris for sleep 
(would love to not be on an antipsychotic mainly for sleep anyway). Ativan very little to no next day drowsiness, cognitive impairment, lethargy, flat mood. Refreshing sleep is what ativan gives me. Any ideas why the dr might be pushing for valium instead even after I explained it doesn't help for sleep, for anxiety, only thing it is good for is if i dont take my xanax for 1-2 weeks and I wont have a seizure, but my neurologist said lamital should cover that since it's an anticonvulsant. 

I don't know whether to stay on 2 benzos as the same time, whether it's xanax and valium or xanax and ativan, or to ask for an increase in xanax to maybe 5-6mg/day in divided doses, maybe 2mg twice per day and 1mg once per day, or 2mg 3x a day. My neurologist said if you need to be on these types of medications than it is warranted and pretty much OK in my case. Klonopin sucks, not as much as valium, but it does barely anything for anxiety, esp. panic, or sleep. Makes me have a depressed mood actually, while xanax uplifts my mood and helps me enjoy life without having anxious mood and panic attack symptoms. Ativan just makes me drowsy so I prefer that for sleep.

My main question is regarding how i could proceed. Adding ativan, stopping valium maybe saphris, or upping xanax dose and being on only one benzodiazepine. I do have a tolerance so higher doses than 1mg sometimes are needed to stop anticipatory anxiety, avoidance anxiety, and esp. panic attacks. Restoril doesn't help with sleep surprisingly. Never tried triazolam but would love to due to its short half-life and potency/efficacy for insomnia, but my dr thinks it wouldn't be a good idea. Dr says stims may be increasing my anxiety but don't think that is the case. Really want an effective benzo combo or pick to be on xanax only, just at a higher dose. My parents think its crazy to take 3 xanax a day but it's what helps and lets me live life. Somtimes i take more than prescribed because 1mg will not help my symptoms. I just want to be on a stable dose, whether its xanax 3mg xr 1x daily with 1mg 3x daily or 2mg 3x daily. Something has got to give, and the hardest part is even bringing up increasing my xanax dose with my dr because of its bad reputation since everyone seems to abuse it nowadays. I'm ready to take a trip to mexico and take a visit to their pharmacies...

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Wooster

Wooster

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Clonazepam does wonders for my sleep, 0.25 to 0.5 mg makes a huge difference. I also take gabapentin at bedtime with it. I can see why you'd say it sucks for panic, though, as it's slower acting and not really designed to be taken reactively.

It was a hard sell to get me to consider clonazepam instead of lorazepam during the day when I was taking a benzo during the day. However, I found that when I switched over to clonazepam the longer-acting quality made a HUGE difference in terms of slowing down rebound anxiety.

It's shitty that people abusing xanax makes all of us looked at with more cautious eyes by prescribers, and taking more than prescribed is one sure way to end up on the short path to getting cut off.

I've found that propranolol (usually given for performance anxiety) is actually quite helpful for me as a rescue med for anticipatory and/or social and/or going to therapy induced anxiety.

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  • 3 weeks later...
mmaryland

mmaryland

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On 1/14/2018 at 2:50 PM, Iceberg said:

You could also do Xr in the am and then again in the pm to help you sleep. I would be careful going above six mgs. U could try the Xr 2 at am and 1 at pm (or something like that) and still have the 1mgs for breakthrough 

This is something I might bring up this Friday, even though I have tried Xanax XR in the past and it didn't quite help my anxiety as much as regular Xanax. In theory, it would probably be better to take XR while I am trying to taper off so it stays in my system longer, but I guess that's why I am also on Valium. I just don't know how comfortable my doctor would be giving me 2mg XR plus 1mg instant, but it's worth bringing up and discussing whether or not it should be considered. I would love if I was able to just take 2mg XR daily and be fine, only for some reason I don't see that working out well. We are trying to not go above 3mg a day of alprazolam, we're actually aiming for 2mg a day and have been for a couple months now, it's just been a long journey trying to go down on my dose without complications. I might just reconsider switching alprazolam to clonazepam for my own health and well-being

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crtclms

crtclms

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Yeah, I want to second the not going up to 6mg a day (at least not yet). That's the upper end. You're already on a fairly solid dosage, you could go up .5 or 1 mg, and see how that does, rather than just doubling your dosage. You don't need to leap to the highest amount right off the bat.

 

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mmaryland

mmaryland

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On 4/1/2018 at 10:45 AM, looking for answers said:

whast the rationale for coming off

I was taking more than prescribed of Xanax and as a result, I would run out 1-2 weeks early. I had a couple of seizures due to the withdrawal and Dr said it's time to come off. I really did abuse them before but now I am scared because when I took them right they really helped. And after researching and trying Xanax XR, I think it could be the solution to all of this because 1. they are hard to get high off of 2. I don't have a compulsion to take more than prescribed and 3. its only 1 pill per day. Idk what will happen when im off the benzos (except triazolam hopefully, i love it for sleep) because SSRIs dont go well with my bipolar. Shes more comfortable with klonopin, and might let me stay on valium 10mg/day once completely off xanax, but klonopin more or less feels weak for my anxiety and valium, for me, does nothing except prevent seizures. i love my psychiatrist and dont want to get a new one so i am trying to work something out so I can stay on the Xanax, and honestly take the XR version responsibly, with the possibility of having a script of 3-5 xanax 1mg per month for panic attacks.

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