xanax

Hi,

I have Panic Disorder and have taken Xanax for 4 or 5 years. It and a combination of other drugs have literally made my life worth living again.

There are things to consider about Xanax though and I thought I should share them:

1. Xanax is addictive. (When you're in full blown panic, you don't really care, but it is addictive.)

2, I have reached "tolerance", which means I need more Xanax to get the same results I had before. It just happens when you take it all the time.

3. I am addicted to caffiene, which doesn't help the Xanax work right. It's like taking ice and pouring hot water over it. You have no or little ice left...

4. Never go off Xanax by yourself! Please talk to your Dr. or Pdoc about it and work out a schedule for it. You must reduce it by tiny, tiny increments. You can have seizures if you don't I was in the hospital in Aug, and they decided to not give me the Xanax because I was on so much pain medication. By the 3rd day, my back started arching, which was a precursor to seizures. You better believe they gave me my Xanax!.

I take 4 mg a day and hope to reduce it so that smaller amounts do the job, but it won't be easy and I will do it with the help of my pdoc.

I hope this helps.

January

Fred - Why does the idea of taking an antidepressant scare you? Most of todays antidepressants are relatively safe when taken properly, and they can augment the treatment that you are receiving from your therapist.

Antidepressants aren't a cure, but they may help to increase your ability to understand (and thus act upon) the advise you are receiving from your therapist.

- Cam

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Grapefruit juice contains flavones which inhibit the liver enzyme 3A4. Xanax (alprazolam) is metabolized by that enzyme. Grapefruit juice will increase the peak plasma concentration of Xanax (as if you took more of the drug than you really did), and extend the half-life (causing the length of the effect itself to increase). Grapefruit juice will make it like you took an overdose of Xanax.

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I just came across this study that says that grapefruit juice has no effect on Xanax. The known effect of grapefruit juice is to inhibit enzyme 3A4, and as Xanax is broken down by that enzyme, it would be logical to presume that blood concentrations of Xanax would be higher and stay higher longer than would normally be the case. Apparently, the effect is undetectable in real live human beings.

Lar

Psychopharmacology (Berl). 2000 Jun;150(2):185-90.

Effects of repeated ingestion of grapefruit juice on the single and multiple oral-dose pharmacokinetics and pharmacodynamics of alprazolam.

Yasui N, Kondo T, Furukori H, Kaneko S, Ohkubo T, Uno T, Osanai T, Sugawara K, Otani K.

Department of Neuropsychiatry, Hirosaki University School of Medicine, Japan.

The effects of repeated ingestion of grapefruit juice, an inhibitor of cytochrome P450 3A4 (CYP3A4), on the pharmacokinetics and pharmacodynamics of both single and multiple oral doses of alprazolam, a substrate of CYP3A4, were examined. In study 1, eight healthy volunteers ingesting 600 ml/day water or grapefruit juice for 10 days took a single oral 0.8-mg dose of alprazolam on the eighth day. Plasma drug concentrations were monitored up to 48 h after alprazolam dosing together with evaluation of psychomotor function. Grapefruit juice altered neither the plasma concentrations of alprazolam at any time points, any pharmacokinetic parameters, nor the majority of psychomotor function parameters in subjects. In study 2, 11 patients with anxiety disorders receiving alprazolam (0.8-2.4 mg/day) ingested grapefruit juice (600 ml/day) for 7 days. Blood samples were collected before and during grapefruit juice ingestion and 1 week after its discontinuation together with an assessment of clinical status. Grapefruit juice altered neither the steady-state plasma concentration of alprazolam nor the clinical status in patients. The present study shows that grapefruit juice is unlikely to affect pharmacokinetics or pharmacodynamics of alprazolam due to its high bioavailability.

Carol, your experience with taking the combination of these drugs already speaks against an interaction of any significance. If there was one, it would just be as if you took a little stronger dose of Xanax than you really did (that's the objective view), but subjectively, you probably wouldn't even notice.

Some people do get depressed from benzodiazepines, but that isn't because of interactions with antidepressant meds.

I'm sorry you haven't yet hit on an optimal treatment regime, but I wouldn't be blaming drug interactions for the lack of success in your case.

Best,
Lar

Hey Lar - Thanks for the info!. Much appreciated. - cam

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AG - I think that's supposed to be beverages like WATER, not the hard stuff!

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Shush it girl!!! Now don't go giving away my secrets or you'll get me in trouble with my pdoc.

Hey Lar

You missed my question to you on page 3. Do you think that you could please address it.

Thanks in advance.

Didn't see your question....

Xanax (alprazolam) and Tegretol (carbamazapine) use the same liver enzyme (3A4). Carbamazapine induces that enzyme (increases the rate of function). So, one could predict that the Xanax would have a slightly weaker effect, and might wear off a little quicker. Nothing adverse, in particular.

Lar

Hmmmmmmmm!!! That would maybe answer why I can tend to be bad and take more Xanax than prescribed if I'm going through an extremely bad time.

Thanks Lar, nice to see another familiar name from PB, not sure if you remember me from quite awhile back, probably not, I was pretty quiet then, mostly talked about how none of my meds worked, hmmmmm, seems things don't change much eh!!!