Dr will not prescribe xanax... need suggestions please

[stressed444]

So my Psych will not prescribe me Xanax.  Instead he has me on 1mg of ativan 3x per day,  100mg of zoloft and 75mg of seroquel which I am about to stop taking.  The seroquel makes my eyes cross and hits me like a ton of bricks. I cannot function on this stuff.

I have never felt better in my life than when I took xanax and 50mg of zoloft.   Is there any other medication I can ask him for that will make me feel normal again like the Xanax did?  I am about to see another psych if he will not listen to me.

His reasoning is that Xanax gets you high.  I am 33 years old.  I have a family, I don't smoke or drink.  I work a full time job and I also build houses.  I pay my bills and I have health insurance.  My anxiety is destroying my life and my work.  I am just frustrated to no end with this guy.   

He tells me to let the seroquel work.  I cannot do that because it makes me a zombie for 15 hours.  I see no point in taking 3 different meds.

[Noahs Mom]

Every medicine is different for every person...  I prefer ativan over the xanax for emergencies... but rarely take it because it's highly addictive...
At some point you have to work with your doc... you know?   
I know it's stressful and I don't really have any good advice for you, but wanted to say that I can relate.

[stressed444]

the thing is.... he has me on Ativan 3x per day.  All I feel is sedation.  Xanax actually made me feel like a person again instead of a drugged zombie

[laura124]

Find a new doctor!  xanax and ativan are basically the same.  There would be no reason your doctor wouldn't prescribe the drug that has proven to be most effective for you in the past.  Ativan has the same addictive qualities as the xanax.  So I do not understand his/her reasoning.  Some doctors just have to have it their way....or perhaps the manufacturer of ativan has given your doctor incentives to prescribe their drug.  In any case, I think it's time to move on.

[stressed444]

I have already made an attempt to see someone new.  I have to call on Monday when the secretary is in. 

[Door]

When you call new psychiatrists, ask them if they are open to prescribing Xanax.  Some are anti-Xanax.  You wouldn't want to waste your time and money meeting with doctors who want to mess with medication that is working for you.

I have to do this whenever I move to a new city.  I know it sounds weird to say, "Hey, what's your Xanax policy?"  But it's well worth the awkward feeling.

[AnxiouSteve]

How much Xanax do you think you would need? 

http://meds.queensu.ca/~clpsych/orientation/Benzodiazepine%20comparison%20chart.pdf

3mg of Ativan would be about 1.5mg of Xanax.  There's not much of a difference...  perhaps Xanax makes you feel a little more high, but Ativan will relax your muscles more.  Ativan lasts longer, too.  I prefer Ativan as the Saint John's Wort I take causes the Xanax to be less effective.

I see you p-doc likes the Neuroleptics too (Seroquel).  I'm just coming off it, but it worked well for me (i guess).  I liked how Seroquel facilitated sleep and stimulated my appetite.  How long have you been on it?  You should give it a few weeks, or it was all for naught anyway.  I was taking 100mg Pm and 50mg AM at one point...  Then again, I'm the type of person who inst easily sedated, anxiety or no, so I had no problem with Zombie mode...  Didn't feel much but hunger from it, tbh.

As far as suggestions...  Lyrica (Pregabalin) and Neurontin (Gabapentin) are anti-seizure meds that have some effect on GABA like benzos.  Kava Kava is not quite a benzo, but it's considered safe in the short term...

Xanax really is quite addictive, and its relatively short half life makes the rebound tough...  A lot of MDs refuse to Rx it...  I'm sure you can find one that will, but the fact that you are complaining that 3mg of Ativan isn't enough (I take .25mg as needed) would be troublesome to me.  What if you find that you need 2 or 3mg of Xanax per day to make you feel right, either?

Maybe you can bargain with the guy:  "Switch me to Xanax and I'll only take .75mg per day (3 x .25)"

[Noahs Mom]

Stay away from Lyrica... far, far away....

[studdmuffin]

ativan has been known to make some people feel very sedated and foggy headed before the anxiolitic effects take hold. when a psychiatrist does his or her residency at a hospital they learn to use ativan a lot. the injectable form of it has a good track record. the oral form is more difficult to utilize though, especially with so many different manufacturers. i can see why it is more of a hit and miss drug especially when compared to other benzos.

[stressed444]

I am not saying Ativan 3x per day does not work.  The issue I have is it puts me in a zombie mode.  Mix that with Seroquel and I am nearly falling down the stairs in the morning on my way to work.  This is the first time I have been affraid to drive a car to work in the morning.  I am definitely dumping the seroquel.  This stuff is potent and not for me.  It hits me like a ton of bricks.  I have a 10 month old son to take care of and my wife is ready to dump all of my meds down the toilet at this point. 

for me seroquel is a no no.   if I ever develop insomnia, I am open for it.

[Noahs Mom]

Yup, definitely time for a new medication. If you have a wife and child, they need you to be alert (or at least semi conscious).

[ocdengineer]

Xanax and Ativan work pretty much the same way and both carry the risk of dependency, however, both work very well and are the best medication for the reduction of anxiety.  Simple as that.  There is nothing out there that will work like a benzodiazepene.  I would be willing to bet that all the additional meds you are on are making you feel strange and that if you were on just the Ativan, you'd probably be feeling better.  It makes me a little nervous when a doctor is willing to hand out antipsychotics (Seroquel) like candy and not anti anxiety medication that has been around for decades and has proven to be very effective.  I'd suggest also looking for another doctor.  Sounds like the one you are talking with is not willing to listen to what you are saying. 

I am on 2 mg per day of Xanax alone and it works great.  I have been on the same dose for over 2 years and it is still working well.  I have my days, but I live in a stressful world of 60+ hour work weeks and a young family.  I haven't had a panic attack in over two years either. 

I hope the new doctor works out for you.

Take care,
OE

[stressed444]

Dr was willing to listen to reason.  I stopped the Seroquel after 2 days of use.  He also gave me a script for Xanax which is working like a charm.  Puts me in an excellent mood also.  He wants me to try Buspar as well to see if it will work but if I am taking Xanax at the same time how will I ever know?  He also is switching me from Zoloft to Cymbalta due to some sexual side effects.

thanks for the help

[studdmuffin]

is this the a new doc or the same one?

[stressed444]

same one.. he was willing to listen to reason...


is it ok to take buspar and xanax at the same time?  I'm only taking maybe up to .75mg of Xanax per day.  yesterday I only took 2 .25mg.

[AnxiouSteve]

is it ok to take buspar and xanax at the same time?  I'm only taking maybe up to .75mg of Xanax per day.  yesterday I only took 2 .25mg.

I've never been able to convince my pdoc to give me buspar, and even though I'm not a doctor I can assure you that it's safe. 

The good news is that buspar has a low side-effect profile...  the bad news is that it also has a low 'regular effect' profile.  No one on here likes it.  From what I read, it works best as an augmentive agent, meaning it can make your SSRI work better.

[Door]

is it ok to take buspar and xanax at the same time?  I'm only taking maybe up to .75mg of Xanax per day.  yesterday I only took 2 .25mg.

]

From what I know, yes.

One thing about Buspar:  It will take a very long time for you to feel any effect, even an initial effect.  By "long time," I mean 2-3 months.  The full effect might not come until 5 months of use.  Also, Buspar works for about 50% of people with anxiety.  I guess that one way of seeing if it is working is for you to assess your anxiety every week (ex: rate it on a scale of 1-10), and around month 4 or 5, look at your self assessments to see if there is a reduction in anxiety.

[studdmuffin]

they don't interact.

from what i understand it can be very useful in offsetting sexual problems caused by SSRIs. other than that it is relatively useless. one study i read, found that it was only useful in patients who have never taken a benzodiazepine. think about that. common sense tells me that this means it can offer nothing more than a placebo effect.
i have also heard that it is useful only at 60mg. that is relatively high. 7.5mg made me feel very spaced out and dizzy. 7.5-15mg is a normal starting dose.

while it is a very safe drug, it is a very poor first line treatment and cannot be used as a last resort option either.

[ocdengineer]

You might as well take a sugar pill...

[gridder]

xanax and ativan are basically the same. 

Not true - m doc gave me a perfectly cogent reason why she didn't prescribe Xanax  - it had something to do with it being faster acting, which makes the addictive potential higher. The week I went to see her, someone was shot trying to steal Xanax from a dealer -- can't see that happening with Ativan.

[AnxiouSteve]

xanax and ativan are basically the same. 

Not true - m doc gave me a perfectly cogent reason why she didn't prescribe Xanax  - it had something to do with it being faster acting, which makes the addictive potential higher.  The week I went to see her, someone was shot trying to steal Xanax from a dealer -- can't see that happening with Ativan.

True, but we are talking about a 12 hour half life vs a 15 hour half life.  The difference is one of degree and not of kind.  There is also a black market for Ativan, though I will say that from experience Xanax makes me feel 'higher' whereas Ativan makes me feel more sedated.

[studdmuffin]

ativan has a very poor lipid solubility and higher protein binding as compared to other benzodiazepines. this one reason reason there is a deference in how a person feels on them. the poor lipid solubility makes ativan differ greatly amongst manufacturers of the oral solution. 

[ocdengineer]

People have been abusing benzos since the very first one hit the market, Valium.  There are always going to be people who abuse the medication, and in most cases these people are also into other more powerful drugs.  I don't think there is a very good argument for anyone of the benzos over the others.  They all have the potential to cause dependency, they all have street value, and they all work really well for anxiety.

Later,
OE

[Noahs Mom]

I agree with OE.