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Author Topic: When does it become a dependency on Xanax? Paranoid Doc reducing my prescription  (Read 1526 times)

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Offline Frotob

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I'm not sure who mentioned it - but that's just misinformation to say that SSRIs are of equal efficacy to placebos in treatment of Anxiety - It's true that they don't offer great advantages over placebo in treatment of mild depression, but as far as anxiety disorders their efficacy has been proven many times over.

As someone who is currently tapering off of Valium after developing a dependence on Ativan - I can say with a degree of certainty that while benzos have their place, they should probably be avoided in treating anxiety unless all else fails. . . They're extremely habit forming. . . and not very much fun to come off of, even if you switch to Valium.

SSRIs are first line anxiety medications for many reasons, one of them being that they do not affect your memory - unlike BZD's - which can hinder progress made during therapy such as CBT. Another being, while they do carry a discontinuation syndrome which can be pretty miserable - it is NOTHING compared to that of Alcohol/Barbiturates/Benzodiazepines.

I think the anti benzo publicity is warranted given the fact that many doctors in the US prescribe them too liberally and then give you a clueless look when you express difficulty in tapering off of them. I had to go to 3 different doctors/psychs before I found one who would allow me to crossover to Valium and do a slow taper.

I'm in no way bashing those who use benzos, but I do think they should be reserved for short term treatment only.
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A good friend of mine has been on .5mg Xanax daily along with 100mg Zoloft for about 4 years. He's doing fine. What are your thoughts on that?

I think it would be better for him to increase the Zoloft dose so that he could, hopefully, go without the Xanax. I don't see the point in taking a med at doses that aren't fully effective.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline comoso

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Frotob, How long were you on benzos and max dose?
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Offline joe2014

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Ian - do you think the .5 is harmful or just useless? I think it is mostly in his head why he doesn't give up the .5mg Xanax.
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It's true that they don't offer great advantages over placebo in treatment of mild depression

The claims that antidepressants are not better than placebo for mild depression often comes from an agenda, for example this nonsense which I demolished a few years ago.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline joe2014

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Ian - do you think the .5 is harmful or just useless? I think it is mostly in his head why he doesn't give up the .5mg Xanax.
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Ian - do you think the .5 is harmful or just useless?

I don't think it is either, however, given the growing propensity of doctors to turn benzophobes and then insist their patients get off these meds, all too often in record time, I don't think BZDs are good taken daily meds. But my main objection is simply I don't see the point of taking 2 meds when one will probably address the issue if taken at an effective dose. If your friends was maxed out on the Zoloft then a BZD might be warranted, but he is at the low end of the typical 100-200mg dose range.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline joe2014

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Ok - Thanks much for your input.
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Offline NeverAgain2

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I'm not sure who mentioned it - but that's just misinformation to say that SSRIs are of equal efficacy to placebos in treatment of Anxiety - It's true that they don't offer great advantages over placebo in treatment of mild depression, but as far as anxiety disorders their efficacy has been proven many times over.

As someone who is currently tapering off of Valium after developing a dependence on Ativan - I can say with a degree of certainty that while benzos have their place, they should probably be avoided in treating anxiety unless all else fails. . . They're extremely habit forming. . . and not very much fun to come off of, even if you switch to Valium.

SSRIs are first line anxiety medications for many reasons, one of them being that they do not affect your memory - unlike BZD's - which can hinder progress made during therapy such as CBT. Another being, while they do carry a discontinuation syndrome which can be pretty miserable - it is NOTHING compared to that of Alcohol/Barbiturates/Benzodiazepines.

I think the anti benzo publicity is warranted given the fact that many doctors in the US prescribe them too liberally and then give you a clueless look when you express difficulty in tapering off of them. I had to go to 3 different doctors/psychs before I found one who would allow me to crossover to Valium and do a slow taper.

I'm in no way bashing those who use benzos, but I do think they should be reserved for short term treatment only.

We must remember that each of us is different.  I think I was one of those who alluded to the effectiveness of SSRI's.  I believe I said that they do help some but others not, and in a number of double blind studies have shown not much more or the same effect as a placebo.  However, if a placebo works, great.   The point I was trying to make is the anti-science attack on SSRI's, Benzo's,  Opioids and others by those who have "Med Madness" (like Reefer Madness)  and think everything can be cured or helped by chewing on jimson weed.  They will get laws enacted, and the government will go along (due to the cost saving of it all) and then people will really suffer. In the late 80's, when the "War on Drugs" was rather young, my father was in a coma and in horrible pain from lung cancer that had spread throughout his body, and the doctors would not give him more morphine.  They were no doubt fearing it would repress his respiration and they would essentially be doing a mercy killing, but they also told me in no uncertain terms that they did not want my father to become an "addict".  Well, he didn't.  His last four days on earth were a torture I can't imagine.  After, I told the doctor he could stop worrying about my father becoming an addict.

The anti-med crowd will eventually have doctors so cowed about prescribing anything that many, many will suffer.  All out of ignorance.

Personally I had no trouble with withdrawal from Ativan.  I tapered and was done.  I'm also not an alcoholic or a street drug abuser.  I needed those meds, and they helped, god knows.
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Offline Frotob

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What study are you referring to? I'm interested to see a double blind study that shows SSRIs to be comparable to placebo in regards to anxiety.

Also, I believe much of the bad publicity benzos get is from the general lack of knowledge on the part of those who prescribe them. Like insights mentioned many doctors attempt to get you off of them in record time, without giving you a real taper schedule, or any information at all. The ones I encountered preferred I stay on them simply because they didn't know how to taper me off correctly. Like I said, I was met with blank stares and referrals to other doctors when I asked to be tapered off of Ativan, I eventually had to find a psych on my own who had some experience in it, and was open to letting me go at a reasonable pace. They simply weren't designed to be long term (over a few months) solution.

Being an alcoholic or a street drug user is really a moot point, I never took more than was prescribed. It's not an addiction, it's a physical dependance happening.

Until doctors get wise to the fact that people do have trouble coming off of BZDs, I have no problem with them being more conservative in prescribing them. Had I known then what I do now, I would have refused the prescription and dealt with the anxiety I was having while starting an SSRI. I just can't see an argument for them being anything other than a last resort option for long term use in dealing with anxiety. As far as the Reefer Madness analogy I would imagine anyone dealing with issues getting off of Opiates/BZDs or even SSRIs for that matter would much prefer to have a "dependance" on pot lol.

Sorry to hear about your father. Hospitals often have to abide by the "first, do no harm" deal to absolve themselves from responsibility in the case of malpractice suits.
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