# Quitting Xanax XR cold turkey!?



## jealibeanz (Oct 1, 2005)

I'm on the verge of making the decision to stop taking my Xanax XR altogether. I know this is discouraged, but I may just do it.

I'll give a little history, even though many of you know my story:

- I began taking Xanax IR 1 year ago.

- My starting dose was .25 mg t.i.d.

- My highest dose, reached about 4-5 months into tx, was 1 mg q.i.d.

- In February my doctor switched me to Xanax XR, 3 mg, q.d.

- For the last few months I've been breaking the tablets and taking them PRN because that gives me some anxiety relief as opposed to the lack of efficacy when I swallow the tablet whole. (w/o my doc's knowledge)

So, my body is not fully "saturated" with a benzo because I'm not taking it consistently. I do take *some* every day, but at times that might be only .25 mg, other days I take the full 3 mg.

I'm slightly concerned about the risk of seizure. Has anyone gone through this? I've read that the risk is greatest in the first few days. 

Are there any "signs" to recognize that a seizure may be coming? If I knew what to look for I could keep some Xanax XR to break up and take if I think it would help.

I'm not terribly worried about discontinuation symptoms. I know it's not the same, but I've gone off of Wellbutrin, Paxil, and Effexor cold turkey. There were no problems. Either I just don't have a tendency toward withdrawal issues, or I have a high tolerance for discomfort and ignore them (I think both are true).


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## UltraShy (Nov 8, 2003)

jealibeanz said:


> Are there any "signs" to recognize that a seizure may be coming? If I knew what to look for I could keep some Xanax XR to break up and take if I think it would help.


I don't know if a seizure come with advance warning. Once you're having a seizure strikes me as a bit late to take a pill, so why not just wean off and reduce the risk of this?


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## jealibeanz (Oct 1, 2005)

I just wanted to see if I could do this completely. I hate the drug and don't want it in my body.

I can't really wean correctly with the pills I have becauses of the controlled-release formulation. Then again, I wasn't taking it correctly to begin with.

My doctor, I'm sure, would have me taper from 3 to 2 to 1 to .5 of the XR if I told him I wanted to stop it. That's why I'm not asking, because if I did, I'd still be taking the drug.

I want to be able to tell him next time I see him that I haven't taken it in weeks/months... that I felt it did no good (or not much good)... that I'm not addicted/dependent and can survive without it by choice and endure high levels of anxiety.

That being said, I want him to prescribe me regular Xanax again. At least it was effective.

Hmm... I don't know what I'm going to do. Just take everything one day at a time I guess.


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## UltraShy (Nov 8, 2003)

jealibeanz said:


> I want to be able to tell him next time I see him that I haven't taken it in weeks/months...


You could try lying. It works for our President.


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## jealibeanz (Oct 1, 2005)

I ended up taking it. I physically felt horrible and its only been a day. I've gone without it fairly recently and had no problems. I think this was just a poor choice of days as I was tired and not feeling my best to begin with.

I think I will stay on it and make an appointment to discuss a tentative long-term plan/goal.


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## Noca (Jun 24, 2005)

quitting benzos cold turkey is just as bad as quitting effexor or paxil cold turkey


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## Speak Easy (Jun 27, 2006)

Wean off! It's really not worth the withdrawal symptoms. If the withdrawal gets really bad, you could ask you doctor to use the Valium-benzo-withdrawal-easing approach.


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## jealibeanz (Oct 1, 2005)

Haha... well, if quitting benzo's is as easy as Effexor or Paxil it'll be a piece of cake! I had no problems there.

I've read several places, although I can't recall where, that Xanax is the only benzo that can't be cross-tapered due to it's unique structure. It must be tapered by using Xanax. I know the articles I've seen on the topic were very definite about this fact, but I don't think "rules" should ever be set in stone. There are probably many examples of those who cross-tapered without problems.

I honestly have no idea what my doctor is thinking. We never discussed the possibility of weaning off eventually past my first script a year ago. I drew my own conclusions when he lowered me slightly when deciding that XR would be a wonderful choice for me.

Yet... no follow up appointment since my last 2 months ago. He just renews via phone message. It's a little odd considering I expressed problems last time I'd seen him and have left messages.

I hope withdrawal isn't as horrible as I've heard... judging just from today, it could be bad... I was dizzy, muscles clenched, felt like I was about to black out... ekkk... not fun! This is, of course, due to the fact that I tried to go down to nothing.

It makes me sad to think about the fact that Xanax makes my quality of life better, it really honestly does help, because I've had it ingrained in my brain (in class) that benzo's=meds from hell! Plus, I'm not sure I have much of a choice of continuing them.

I'd love to hold out and hope for one of the several medications that should be released in the next 5 years or so to work for me. Yet, in the mean time, if I don't take anything for anxiety, I know I'm going to have a difficult time laying the path for my future (completing the rest of my grad courses w/o hyperventilating every night when I have 10 classes to study for and 5 tests or quizzes the next day, or an observation of skills... interning/rotations... the first new job out of school).

I want to buy myself time. Too bad I wasn't a 20-something in the 70's. 

I don't belong in the high-tech computerized multi-media electronic world we live in right now anyway! I like paper and pencils and books and my one rotary phone attached to the wall.


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## foxtrot (Feb 17, 2007)

jealibeanz said:


> I've read several places, although I can't recall where, that Xanax is the only benzo that can't be cross-tapered due to it's unique structure. It must be tapered by using Xanax. I know the articles I've seen on the topic were very definite about this fact, but I don't think "rules" should ever be set in stone. There are probably many examples of those who cross-tapered without problems.


there's something about that on crazymeds.org


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## korey (Apr 25, 2006)

DEAR NON-EXISTENT GOD, WEANNNN!!

Last July, I ran out of my 0.5mg 4x/day Xanax prescription (2mg/day) much too soon because I was using high doses of it at night to get to sleep (which my psych knew about). However, my psych decided to go on vacation for that whole month, so I was forced to stop Xanax cold turkey at only 2mg/day. I was bedridden for the whole month with flu-like symptoms that persisted and worsened each day. I could not walk without being dizzy, and I could not carry anything because my muscles were simply not under my control. At the end of the month when it was time to go see my psych (who had returned from vacation), I had finally gotten over the withdrawal - without a seizure, thankfully. I told my psych about it, and he said that as long as I wasn't taking it to get high, then he didn't mind if I used it as a sleep aid. I think he missed the point about me being left without any psychiatric help for a month, though. Oh well. He eventually upped my dosage to where it is now. If I were ever forced to quit my current dosage cold turkey, I would probably have a seizure. Luckily, I have a refill of Xanax left at the pharmacy, plus plenty of my current fill left in the bottle being as my benzo of the month has been Valium 30mg/day. Taking the Valium in place of the Xanax staves off any potential withdrawal, it seems.

Like I said, though: WEAN. Don't try to make an example of yourself to your doctor. There probably are signs of an imminent seizure (such as pupil dialation, muscular collapse, and the like....I've seen it happen before to people back in high school who had neurological conditions that usually ended in seizures), but don't risk it. Seizures can kill people, regardless of the whole choking-on-tongue/vomit issue. Seizures scramble your brain and can leave permanent damage. Be safe in whatever you choose to do.


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## korey (Apr 25, 2006)

foxtrot said:


> jealibeanz said:
> 
> 
> > I've read several places, although I can't recall where, that Xanax is the only benzo that can't be cross-tapered due to it's unique structure. It must be tapered by using Xanax. I know the articles I've seen on the topic were very definite about this fact, but I don't think "rules" should ever be set in stone. There are probably many examples of those who cross-tapered without problems.
> ...


I can say from personal experience that the assertion that Xanax can only be tapered using Xanax is faulty. I've switched from Xanax to Valium twice without any problems.

Quitting Xanax cold turkey really does make your teeth feel like they're falling out, though. I read that in an article similar to the one you're talking about, and it is true (and weird).


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## jealibeanz (Oct 1, 2005)

I've given up on the idea of my own d/c of Xanax XR. I actually took the tab whole today, which I haven't done in a while. It helps with anxiety more than taking nothing, but it's not great. It also makes me much more tired than regular Xanax and feels slightly depressing like Klonopin. Normal Xanax lifts my mood. I don't understand why this is.


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## Speak Easy (Jun 27, 2006)

jealibeanz said:


> I've read several places, although I can't recall where, that Xanax is the only benzo that can't be cross-tapered due to it's unique structure. It must be tapered by using Xanax.


Not sure where you read this, but it's untrue. Crazymeds.org, although an appealing website just like Wikipedia, isn't an accepted APA source. Try quoting Wikipedia or Crazymeds in a college essay and you will have some serious issues with the professor. This is from the _Encyclopedia of Mental Health_:

"Benzodiazepines should not be stopped suddenly if taken regularly over two weeks because of possible withdrawal symptoms (nausea, sweats, tremulous feelings, possibly seizures) but should be gradually tapered or reduced in dose over two to four weeks. All benzodiazepines have cross-tolerance within their drug class".


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## jealibeanz (Oct 1, 2005)

LDG 124 said:


> jealibeanz said:
> 
> 
> > I've read several places, although I can't recall where, that Xanax is the only benzo that can't be cross-tapered due to it's unique structure. It must be tapered by using Xanax.
> ...


I wasn't the one who said I found it on crazymeds.org. I've seen it in medical literature. I'll have to look for it. I'm not saying I think that Xanax can't be cross-tapered with Valium, just that some medical professionals feel this way.

When you source stated that benzodiazepines have a cross-tolerance, that's not the same thing as saying they can be interchanged while tapering.


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## UltraShy (Nov 8, 2003)

jealibeanz said:


> I've read several places, although I can't recall where, that Xanax is the only benzo that can't be cross-tapered due to it's unique structure. It must be tapered by using Xanax.


Others would disagree. My psychiatrist thinks one can taper off high dose Xanax using either Valium or phenobarbital over a couple months.

Even the UK's grand queen of benzo bashing, Prof. C. Heather Ashton, shows how to wean off Xanax (over 18 months) using Valium.


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## Speak Easy (Jun 27, 2006)

jealibeanz said:


> When you source stated that benzodiazepines have a cross-tolerance, that's not the same thing as saying they can be interchanged while tapering.


If 2 medications are cross-tolerant it means they generally affect the same region of the brain and work in the same general manner and do not contraindicate each other (i.e., someone can take Klonopin for an undefined period of time and switch over to Valium without having to wait a certain amount of time as one would if he/she were switching from Nardil to Paxil). Thus said, it can be surmised that a benzo with a long half-life (i.e., Valium), could easily be used to come off of a different benzo (i.e., Xaxax). If you have a different interpretation, please share, since I may easily be misinformed.


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## jealibeanz (Oct 1, 2005)

Just to clarify again, I don't agree with the fact that Xanax can only be tapered with Xanax. I was simply stating that some physicians feel that way.


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## jealibeanz (Oct 1, 2005)

LDG 124 said:


> jealibeanz said:
> 
> 
> > When you source stated that benzodiazepines have a cross-tolerance, that's not the same thing as saying they can be interchanged while tapering.
> ...


This is what I mean:

Cross-tolerance means that, for example, someone who becomes tolerant of Xanax and needs a high dosage to feel a therapeutic effect, will also need a high dosage of Valium to feel a therapeutic effect. It's not like starting from scratch.

I'm not a pharmaceutical expert by any means.

My take on the theory that some hold on tapering off of Xanax with Xanax is that some of the "cravings" and withdrawal symptoms may not be satisfied by a different benzo since they have slightly different mechanisms.

I'm not sure though. I've never read a thorough explaination. That's just my guess.


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## Speak Easy (Jun 27, 2006)

jealibeanz said:


> My take on the theory that some hold on tapering off of Xanax with Xanax is that some of the "cravings" and withdrawal symptoms may not be satisfied by a different benzo since they have slightly different mechanisms.


Why would someone taper off of Xanax with Xanax?


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## jealibeanz (Oct 1, 2005)

LDG 124 said:


> jealibeanz said:
> 
> 
> > My take on the theory that some hold on tapering off of Xanax with Xanax is that some of the "cravings" and withdrawal symptoms may not be satisfied by a different benzo since they have slightly different mechanisms.
> ...


Haha, guys! I'm not supporting the idea that Xanax can only be tapered with Xanax. I just wrote about a theory that some prescribe to. I'm not a specialist!

However, my question to you is, why can't you taper off Xanax with Xanax?

I'd think you could just slowly decrease the dosage and spread it out over the day as necessary.

Most medications of any kind are tapered without switching to another in it's class.

For example:

-prednisone is tapered with prednisone

-Prozac is tapered with Prozac

Annnnyway... I'm not a doctor and not pretending to know what is the best way to handle the situation.


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## Noca (Jun 24, 2005)

does one really need to taper Prozac?


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## jealibeanz (Oct 1, 2005)

Noca said:


> does one really need to taper Prozac?


It's standard practice to taper SSRI's. I've heard of some people dosing Prozac every other day or even less frequently in some cases when tapering because it has a long half-life.


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## Speak Easy (Jun 27, 2006)

Speaking of Xanax withdrawal, my car is in the shop to get a bumper replaced and guess who left their ****ing Xanax bottle in the ****ing dash! I've only been taking Xanax (at pretty minimal doses compared to others) for about a week now, so I know most of my frustration right now is just psychological, but STILL! :mum


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## jealibeanz (Oct 1, 2005)

wow... this topic has really gotten off track!


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## Speak Easy (Jun 27, 2006)

jealibeanz said:


> wow... this topic has really gotten off track!


Yes it has, but those always turn out to be the best ones! :b


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## jealibeanz (Oct 1, 2005)

Alright... well, steering back in the original direction somewhat...

Has anyone here taken Xanax XR and noticed that it seems to lack to muscle relaxant qualities of regular Xanax?


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## korey (Apr 25, 2006)

Back when I took Xanax XR, it was my first experience with Xanax, so I had nothing to compare it to. Also, as most benzo-takers know, benzos lose their magical fairyland abilities after the first couple of weeks, so I can't really compare my current regular Xanax to those "funny feelings" I got from taking 1mg/day of Xanax XR in the beginning (or from biting it in half before I swallowed it, either).

Now, Xanax only has muscle relaxant (and even analgesic) effects on me when I take it in grossly large amounts, which I've only done a few times after particularly harsh incidents. The first time was after I totaled my car on Christmas Eve this past Christmas...Let's just say that I took more Xanax in one gulp than Karl is prescribed per day. I don't remember much of Christmas, needless to say. I do remember the Xanax having some noticable muscle relaxant effects on me. I don't know if the analgesia came from the Xanax practically numbing my brain, or if there was a legitimate suppression of pain reception in my CNS.


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## jealibeanz (Oct 1, 2005)

korey said:


> Back when I took Xanax XR, it was my first experience with Xanax, so I had nothing to compare it to. Also, as most benzo-takers know, benzos lose their magical fairyland abilities after the first couple of weeks, so I can't really compare my current regular Xanax to those "funny feelings" I got from taking 1mg/day of Xanax XR in the beginning (or from biting it in half before I swallowed it, either).
> 
> Now, Xanax only has muscle relaxant (and even analgesic) effects on me when I take it in grossly large amounts, which I've only done a few times after particularly harsh incidents. The first time was after I totaled my car on Christmas Eve this past Christmas...Let's just say that I took more Xanax in one gulp than Karl is prescribed per day. I don't remember much of Christmas, needless to say. I do remember the Xanax having some noticable muscle relaxant effects on me. I don't know if the analgesia came from the Xanax practically numbing my brain, or if there was a legitimate suppression of pain reception in my CNS.


Did you not do well on Xanax XR? Is that why you stopped after a few weeks?

I can't day that I *enjoyed* that very first time I took Klonopin or Xanax. Klonopin just made me super tired and uncoordinated. Xanax made me very emotional, irrational, weepy, and put me into a deep 12 hour sleep. Oddly enough, after that first Xanax dose, my reaction was nothing of the sort. Xanax lifts my mood, while Klonopin lowers it. I don't understand why my first dose have such a bizarre effect.

Are some benzo's known be better at relaxing muscles than others? Is there a general rule of thumb in terms of muscle relaxation, sedation, anxiety relief, and mood? Or does this fall back to the idea that everyone has a different preferred med and it can't be compared?

Haha, Korey, did you break the rules too by biting your Xanax XR. I feel like such a non-compliant patient when I do this... because I am.

You didn't mean you took the Xanax before your car accident, right? That's understandable if you did it afterward... I know anyone psychologist would beg to differ, but oh well. Maybe your dose was really pushing it, but taking more than prescribed on one isolated day because of a devastating event isn't really setting you so far back in terms of coping skills. At least you weren't miserable on Christmas... you just don't remember the day. I'd rather have that than a negative association with the holiday for years to come.

I do think Xanax can help with pain. For one thing, it's probably diminishing that message in your brain and peripheral nervous system that you should be feeling pain. Plus, if it does relax your muscles, that tends to lessen pain.


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## korey (Apr 25, 2006)

Well, 30 tablets of 1mg Xanax XR cost close to $60, so I do much better on the 120 tablets of 1mg Xanax IR that costs $10. I don't mind taking pills multiple times per day. Plus, the handout my psych gave me said that Xanax XR is for panic disorder patients because it gives 24 hour control (at the proper dosage), so I'm not quite sure why he gave me the option for it (or Klonopin ODT, the 24-release form of Klonopin). Probably to thwart any terrible addiction that might occur from this CIV substance, despite his flagrant prescription of strangely large amounts of methylphenidate (CII).

I think most would probably tell you that the muscle relaxant effects are more subjective than anything, but Valium is the only benzo I know of that is indicated as a muscle relaxant under certain circumstances. I know some people claim that Klonopin makes their pain go away, and that I have even already stated that Xanax has muscle relaxant effects, though only after taking much more than prescribed. I take Valium 30mg/day right now for muscle relaxation in my upper back muscles, and it works for that to an extent, but it doesn't really do anything for my anxiety. I have a note in my medication log that I am out of ideas as far as benzos go since Valium only helps my muscle pain while Xanax is what helps my anxiety (and taking two benzos at once is blasphemy). I suggested going back on Xanax at 8mg/day, which is supposedly around the max for anxiety/panic patients, in hopes that it would relieve my anxiety so deeply that the muscle pain in my back would dissipate along with the rest of my anxiety. I have a feeling that he's going to sternly shake his head No and then suggest taking me off benzos altogether seeing as how I must be a druggy if I'm not responding to 4mg/day of Xanax :roll. I hope he is in a good mood being as he will be going on vacation soon after my appointment with him on the 31st, and by good mood, I been _giving_ mood .

Yes, I broke the rules and bit my Xanax XR in half. I remember taking one regular 1mg Xanax XR and then biting another one in half on my graduation night. I was supposed to give a speech, but I finaggled my way out of that weeks before graduation. Still, though, I could feel everyone's curiosity bearing down on me...."Isn't he supposed to give a speech?" ... "Why isn't he giving a speech?" ... "Ha, what a *****!" ... It was unpleasant. Thankfully, I was fairly Xanax'ed out for that night being as 2mg was an unspeakable amount for me at the time, so all those unpleasant feelings were met with thoughts of "orly? stfu :banana :lol"

I took that large amount of Xanax the night I made it home from the car wreck. I couldn't stand all the thoughts of how I had ruined Christmas running through my head. Looking back, I still know I ruined Christmas, but my parents kept trying to reassure me that they weren't angry and "what was done was done."

I'm still going to have negative associations with Christmas, I'm sure. In fact, I wouldn't be surprised if it becomes holiday tradition for me to stuff my stocking with Xanax every Christmas Eve to come. I remember crying that night, even after I had taken all that Xanax but before I finally passed out. People aren't supposed to cry on Christmas. It just seems wrong to me :stu That'll teach me to go last-minute giftshopping, I suppose.


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## jealibeanz (Oct 1, 2005)

Are you Klonopin Wafers (ODT) are the 24 hour version of Klonopin? The prescribing info lists dosing as bi.d. or t.i.d. I thought it was just a faster acting medication since it easily passes into the capillaries while dissolving under the tongue, instead of swallowing the pill and waiting an hour or 2.


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## korey (Apr 25, 2006)

Klonopin ODT is supposed to be Klonopin Once-Daily-Treatment. I assume anything form of Klonopin with ODT after it means it's the 24-hour form.


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## jealibeanz (Oct 1, 2005)

ODT = orally dissolving tablets

It's not controlled release. It's just a different method of delivery for those who can't swallow pills or need the medication to work quickly.


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## UltraShy (Nov 8, 2003)

jealibeanz said:


> It's just a different method of delivery for those who can't swallow pills or need the medication to work quickly.


Or for a drug company in need of a patent extension.


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## Speak Easy (Jun 27, 2006)

UltraShy said:


> jealibeanz said:
> 
> 
> > It's just a different method of delivery for those who can't swallow pills or need the medication to work quickly.
> ...


Exactly so.


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## korey (Apr 25, 2006)

Why the hell did my psych claim that both Xanax XR and Klonopin ODT were time-released medications? :con

Sorry for giving false information as to the meaning of ODT. I swear I have read "once daily treatment" somewhere before pertaining to a time-released version of Klonopin. Must be going nutsier. :troll


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## jealibeanz (Oct 1, 2005)

Maybe he just meant that they had similar durations of action.


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## jealibeanz (Oct 1, 2005)

Again, not agreeing that Xanax must be tapered with Xanax. But I'm providing a link because, no, my info does not come from crazymeds.

http://www.medscape.com/viewarticle/504383_3


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## Speak Easy (Jun 27, 2006)

jealibeanz said:


> Again, not agreeing that Xanax must be tapered with Xanax. But I'm providing a link because, no, my info does not come from crazymeds.
> 
> http://www.medscape.com/viewarticle/504383_3


It brought me to a login page. Try to copy and paste or provide a different link.


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## foxtrot (Feb 17, 2007)

jealibeanz said:


> Are you Klonopin Wafers (ODT) are the 24 hour version of Klonopin? The prescribing info lists dosing as *bi.d. or t.i.d. * I thought it was just a faster acting medication since it easily passes into the capillaries while dissolving under the tongue, instead of swallowing the pill and waiting an hour or 2.


just wondering, what does b.i.d/t.i.d mean? thanks


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## jealibeanz (Oct 1, 2005)

LDG 124 said:


> jealibeanz said:
> 
> 
> > Again, not agreeing that Xanax must be tapered with Xanax. But I'm providing a link because, no, my info does not come from crazymeds.
> ...


That wouldn't help you view it. I forgot that you have to be a member to read the articles.


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## jealibeanz (Oct 1, 2005)

foxtrot said:


> jealibeanz said:
> 
> 
> > Are you Klonopin Wafers (ODT) are the 24 hour version of Klonopin? The prescribing info lists dosing as *bi.d. or t.i.d. * I thought it was just a faster acting medication since it easily passes into the capillaries while dissolving under the tongue, instead of swallowing the pill and waiting an hour or 2.
> ...


Latin... it's what the doc's write on scripts.

b.i.d. = twice a day

t.i.d. = three times a day


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## jealibeanz (Oct 1, 2005)

UltraShy said:


> jealibeanz said:
> 
> 
> > It's just a different method of delivery for those who can't swallow pills or need the medication to work quickly.
> ...


Maybe so, but I'm all for new FDA approvals on benzo's. It gets the name out there with marketing and the idea implanted in the heads of doctors that it might not be a horrible useless drug if it's just been given a new approval.


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## jealibeanz (Oct 1, 2005)

I stopped taking the Xanax XR, whole, in the morning. I'm back to biting pieces off the tablet. I already feel so much better... less groggy, tired, anxious, and I'm happier, and this is from the medication that I feel is much less therapeutic.

I'd probably think regular Xanax was a gift from god if I had it right now.

XR = bad for me.


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## UltraShy (Nov 8, 2003)

korey said:


> Why the hell did my psych claim that both Xanax XR and Klonopin ODT were time-released medications? :con
> 
> Sorry for giving false information as to the meaning of ODT. I swear I have read "once daily treatment" somewhere before pertaining to a time-released version of Klonopin. Must be going nutsier. :troll


Perhaps Roche one day will come up with Klonopin XR to resurect an old drug with a new patent. It's what you do when you run out of ideas for drugs that are actually new.


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## UltraShy (Nov 8, 2003)

jealibeanz said:


> UltraShy said:
> 
> 
> > jealibeanz said:
> ...


While I frequently bash drug companies and mock Xanax XR, I long ago saw the positive side that you point out.

The only positive of this is that it gets drug reps back into doctors' offices pushing a benzo. Many could use a firm reminder that benzos still exist, so there is some positive I must admit.

In the world of pain management the use of opiods went way up once Purdue Pharma got a patent on OxyContin back in 1996, simply a 12-hour version of oxycodone that had already been around for the prior 50 years. Clearly, a profit motive and marketing gets attention for drug classes that are actually needed.


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## jealibeanz (Oct 1, 2005)

For some reason I question whether or not many drug reps went around promoting Xanax XR or Klonopin Wafers... at least not at GP's offices. Maybe with the pdocs. However, the drugs were approved, so doc's are aware of the products, for the most part.


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## UltraShy (Nov 8, 2003)

jealibeanz said:


> For some reason I question whether or not many drug reps went around promoting Xanax XR or Klonopin Wafers... at least not at GP's offices. Maybe with the pdocs. However, the drugs were approved, so doc's are aware of the products, for the most part.


My pdoc had coupons for 7 free Xanax XR tablets, so I know a rep visited him. I'm sure pdocs are more fertile ground for pushing a psych med.


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## jealibeanz (Oct 1, 2005)

Yeah, I bet they don't even bother with GP's. I didn't even know samples existed until I saw a picture of a Xanax sample blister pack online a few weeks ago. If my doctor had samples, especially of Xanax XR because that was a change in a long-term plan, he would have given some to me.

On another note...

I'm not sure how long I should keep up this breaking Xanax XR plan of mine. At least it's a fairly decent dosage and I can get some benefit from breaking the tabs.

I'm afraid that if I tell him it makes me tired (plus isn't very therapeutic), he'll suggest lowering the dosage to 2 mg. 

I'd hope he wouldn't want to raise my stimulant doses. I take 400 mg of Provigil. That's high. Any more makes my head hurt and gives me nausea. I've never been pleased with my Ritalin LA and certainly don't want more. 

I'm interested in Shire's new stim though, Vyvanse (Lis-dexamphetamine), because I've heard that dexamphetamine can help some with anxiety and comorbid ADHD, even OCD... and because it's new, it's long-acting, marketed for adults, and has a very low abuse potential because it can't be injected or snorted... new and safe makes the doc's happy and excited.

He also may assume that I've become tolerant of the medication and will increasingly need more, which I don't think is true for me at this point (if I were considering staying on Xanax for 20 years... yup, probably). This might lead him to realllly push toward getting me off completely if he thinks "addiction", or whatever you'd like to call it, is going to be an issue.

This is why I'm keeping quiet for a while. Fear!


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## Noca (Jun 24, 2005)

hand your excess ritalin over here


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## korey (Apr 25, 2006)

UltraShy said:


> jealibeanz said:
> 
> 
> > For some reason I question whether or not many drug reps went around promoting Xanax XR or Klonopin Wafers... at least not at GP's offices. Maybe with the pdocs. However, the drugs were approved, so doc's are aware of the products, for the most part.
> ...


This reminds me of the first time I requested something specifically for anxiety from my psychiatrist, and we settled on Xanax XR. He wrote a prescription for seven 1mg tablets of it and then stuck one of those "Free 7-day trial" coupons to the back of it. When I went to the pharmacy to fill it, turned out that the coupon had expired long ago and I had to pay for the prescription out of pocket. Just those 7 pills cost $20. I told my psych about it on the following appointment, and he didn't seem surprised, but then he asked, "But they _did_ honor the coupon, correct?" and when I told him no, he got angry. It was funny.

The only reason I told him was so he could throw out the batch he had and hope to get a new, non-expired batch in.


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## Nae (Nov 10, 2003)

Something like 40-50% of drugs for mental illness are written by primary care doctors, although psychiatrists tend to write prescriptions for the scheduled or more complicated stuff.


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## jealibeanz (Oct 1, 2005)

Yeah GP's prescribe the majority of the SSRI's, SNRI's, Wellbutrin, etc for depression and anxiety. They treat ADHD pretty commonly. Insomnia too.

I think most like to refer for bipolar because they aren't comfortable treating it. The same goes for schizophrenia and phychotic depression.

I doubt many GP'd would consider precribing a TCA or MAOI.

Most are afraid of benzo's. They either tell you they're a horrible idea, addictive, and a "crutch", or that they'll prescribe just a few, PRN, or that they think in some cases they're OK, but they personally won't prescribe them.

I guess I'm lucky enough to have a doc who was really open minded with them for a while... getting reluctant, but hasn't totally pulled the rug out from under me yet.


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## Noca (Jun 24, 2005)

Here in Canada, at least in Ontario, eventually all your specialists (pysch, pain doc, ortho etc) eventually hand over prescribing to your family doc.


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## jealibeanz (Oct 1, 2005)

Noca said:


> Here in Canada, at least in Ontario, eventually all your specialists (pysch, pain doc, ortho etc) eventually hand over prescribing to your family doc.


Hi... I'm resurrecting my old topic because I'm trying to do anything but study genetics and biochem!  Molecules can become so boring!

I'm surprised that all your specialists hand over your tx plan to your GP. With psych a lot of people need changes every now and then. Those who don't probably did just fine going to their family doc initially and did well on one of the newer generation AD's.

I did ask my GP to take over form my derm and allergy scripts, but that's because they were so basic and simple.


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