xanax

So, I saw my pdoc this morning. I have been pretty depressed and anxious, but it's largely due to the huge amounts of stress I am currently under. I think it is to be expected, given the current situation I'm in, and not requiring any kind of intervention.

He disagreed.

So I'm being introduced to the wonderful world of Xanax, and my next appointment is in two weeks -- back to the "officially crazy person" schedule I was on right before I went into the hospital.

I just went and picked up the script. I'd like to hear others' experiences with it, but I'm also dying to know why grapefruit juice is a no-no!

Candy

I have been taking it since February with virtually no side effects. I cannot function without it - the anxiety is just too strong. When I did not get my refill in time I started to try to stretch out the time between pills and realized that just does not work. If I forget a pill, or take it late, I go into hyper drive while also depressed. It is a decidedly uncomfortable experience. If I take it as directed - every 4 hours (3 1/2 works better) I stay smoothed out and functional. I will probably be on it for the rest of my life and I have no problems with it. I know they say it can be addictive and you have to be careful - but the choice between that and what I feel without it makes it imperative I take it. My T and my regular Doc work together in getting me medicated - seems they are pretty positive that it is a brain chemical problem and the Xanax works directly on that part of my brain that is malfunctioning. I hope you get as good a result as I have. I swear by it!

Candy:

Maybe this will help. I also take Xanax daily and I believe that the grapefruit juice DECREASES the effects, is why it's a big no-no but there's some more info below:

Possible food and drug interactions when taking this medication

Xanax may intensify the effect of alcohol. Do not drink alcohol while taking this medication.

Never combine Xanax with Sporanox or Nizoral. These drugs cause a buildup of Xanax in the body.

If Xanax is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is important to check with your doctor before combining Xanax with the following:

Amiodarone (Cordarone)
Antihistamines such as Benadryl and Tavist
Carbamazepine (Tegretol)
Certain antibiotics such as Biaxin and erythromycin
Certain antidepressant drugs, including Elavil, Norpramin, and Tofranil
Cimetidine (Tagamet)
Cyclosporine (Neoral, Sandimmune)
Digoxin (Lanoxin)
Diltiazem (Cardizem)
Disulfiram (Antabuse)
Ergotamine
Fluoxetine (Prozac)
Fluvoxamine (Luvox)
Grapefruit juice
Isoniazid (Rifamate)
Major tranquilizers such as Mellaril and Thorazine
Nefazodone (Serzone)
Nicardipine (Cardene)
Nifedipine (Adalat, Procardia)
Oral contraceptives
Other central nervous system depressants such as Valium and Demerol
Paroxetine (Paxil)
Propoxyphene (Darvon)
Sertraline (Zoloft)

Hope this helps. Take Care,
Kimberly.

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.

Lar

Thanks Larry for clarifying.

That is even more frightening than the decrease! I know now that I definitely want to forgo the grapefruit juice.

Can I ask you a question...

Do you know how Prozac interacts with Xanax ? I am taking both medications and I'm worried about it because I have read on several sites that you shouldn't mix the two. My doctor and my pharmacist were like it's okay to take together, but I have the feeling they're telling me "don't worry. it won't kill you.", but the interaction or possible interactions scare me. It must be the paranoia.

Take Care, (and thanks in advance )
Kimberly.

Oh, yeah, Candy....I forgot to tell my experiences.

I have had no real side effects from it and it really does make me feel better. The anxiety is lessened significantly and I am able to sleep better. I've had no real side effects, well, excessive sleepiness when I first started taking it, it's winding down now. My husband said it wasn't sleepiness, it was relaxation but with three kids, heck if I know what that is

I have had a bit of a problem with hyperventilation, very very mild and its just usually when I really exert myself and usually only if I take it with another med. Really, though, it might not be a side effect, as I suffer from panic attacks, it could be that.

Other than that, no real problems at all.

Hope it works well for you too!
Kimberly.

If you've already taken them together, then you already have some idea how Prozac and Xanax feel together, right?

Prozac (fluoxetine) is a minor inhibitor of enzyme 3A4, the same one grapefruit acts at, but to a lesser degree. The interaction between these two drugs is noticeable in a small percentage of people, probably just because of their own unique biochemical differences. The effect is as I described for the interaction with grapefruit, i.e. a more pronounced sedative effect from the Xanax.

I didn't mean to scare anybody with my earlier use of the word overdose. A tall glass of grapefruit juice might have the effect of roughly doubling the effective dose of Xanax. 1 mg might feel more like 2 mg. There would be a lesser effect from the Prozac, perhaps not even noticeable by most people.

Lar

Thanks Larry....

It wasn't too awful scary for me because I understood what you meant by "overdose" i.e. taking more than you're prescribed to take and it would affect you in a different way than taking the prescribed dose WITHOUT the grapefruit juice.

I appreciate you responding to me. Yes, I do notice that when I take the Xanax, it just as I put it "knocks me for a loop" when others on the same dosage without the Prozac feel considerably milder effects.

I do thank you so much for responding to me and so quickly too! You're very knowledgable about meds.

Take care,
Kimberly.

OK, let me preface this by saying that I know everyone is different and reacts to meds differently. But I am curious as to what is the lowest dose of Xanax anyone has had good luck with.

My pdoc wrote the script for 60 of the .5 milligram size. He wanted me to be able to have some left over. On the bottle it says "take one twice daily," but he told me to cut them in half and take a quarter in the morning and a quarter in the afternoon.

Tried it. Didn't touch me.

In the meantime, I've heard a credible rumor about goings-on at work, and my anxiety is through the ceiling 24/7. I *cannot* survive being unemployed again. I was unemployed for 10 months of 2002. Not only have I never recovered financially, I've never recovered from the emotional stress of it either. To wake up every morning and know no one needs you, and then to have endless hours to fill till you can go to bed and await another day -- it's hell on your self-worth.

So I'm VERY VERY sensitive to the prospect of going through that again, and now I'm hearing there's a chance, and I'm freaking out bigtime. So I tried a whole .5 milligram twice a day. That hasn't touched me either.

I have some leftover, non-expired Zyprexa from a previous script and that seems to work OK -- I'm wondering if I should just ask for that or ask for an upping of the Xanax.

Experiences appreciated! Thanks.

Candy

Candy:

I have a script for .5 mg ONCE a day, to take in halves. I think the reason mine knock me on my butt at first is because of the combination of it and Prozac. It still relaxes me quite alot. Ofcourse, in times of panic I've had to take a whole extra one (this is full blown panic attacks) and discussed with my doc about being short one last month, so you would think they would allow extras for times of extreme stress, like you're in now. Like I'm in when I'm in a panic attack.

If it's not helping at .5 mg. X 2 per day, then definitely discuss it with your doctor. What's the sense in taking a med that is not working. You could discuss changing meds or perhaps upping the dosage of Xanax. I know some folks who take 2.0 mg. twice a day with some results and some have no results.

That's what I'm supposed to be doing, .5 mg cut in half, one in the morning, one in the afternoon. I skipped this morning because I felt OK, and took one about 20 minutes before coming back to work from lunch, so that I could survive the rest of the day (work is a large part of what's causing my very much higher than normal anxiety). By the time I got here, I was a little drowsy, but not all that much less anxious.

I see my pdoc again on the 8th, and if this doesn't get any better, I will take it up with him then. I've also tried Zyprexa (not bad) and Ativan (loved it, but had to get it out of the house when I was suicidal and now he won't give it to me anymore).

Thanks for letting me know how it works for you.

Candy

If you need xanax, then by all means take it. But, if you take it for more than about 6 weeks or so, you can just plan on staying on it forever unless you take Zyprexa or something similar. Xanax and Klonopin are sooo helpful, but they are also sooo addicting, that to get off you have to decrease by tiny smidgets and then you Might be able to totally discontinue it. I have been taking 2 mg daily since 1994, except when I was taking Zyprexa I never needed the xanax. But Zyprexa has benzo qualities just like xanax (and klonopin). Sooo, if you have anxiety and /or panic attacks, you will feel so much better taking xanax (or longer lasting, but longer to work, klonopin). Just be extra careful if you try to stop taking it. You'll know right away, because your anxiety will pop up again like a mean monster... so if you want to quit.. go very gradually.

Just FYI

Larry, I haven't heard that there are problems taking xanax with paxil or zoloft. Paxil and zoloft are the main anti-depressants that I alternate with. So, what is the problem or potential problem? I took zyprexa for 4 years, but have quit it in April, 2004, and have been taking xanax full time 2 mg a day.. with an upcoming increase to add a .5 prn. I have had depression that has never completely gone away since April when I stopped the zyprexa because of the risk of developing Diabetes 2. Could this be related to xanax and paxil OR xanax and zoloft?

Thank you for any information.

Carol

Hi Candy,

I don't know if anyone here has mentioned this to you, but there is Xanax XR. It is a time-released version of the regular Xanax.

I have found that I do so much better taking the XR version than the regular Xanax.

Of course, there is not a generic for the XR so it is rather pricey, but ask your pdoc about it and see if it is for you.

Pam

Thanks, Pam. My pdoc gave me Klonopin instead, which has been working very, very well, so I'll probably be sticking to that. My med co-pays are out of sight ($30 apiece for brand names!), but the generics are only $15, so he tries to help me out that way as much as he can. He's good about samples, too, which is a good thing, or I'd end up homeless just from paying for meds.

I appreciate the info, though, and will ask my pdoc about it if the Klonopin stops working for some reason!

Candy

Candy,

I'm so glad to hear that you have found something that helps!!!

I have a on-line friend that uses Klonopin, too, and she is very well satisfied.

All the best,
Pam

I just wanted to add be carefull on xanax if you have a history of poor impulse control. I took about 1mg before a dental app. because of paralyzing fear. I walked home from the dentist fine but don't remember any of it. Crossing the busy street and what have you. I suffer from self harm and all that xanax didn't put me to sleep or K.O. but made me go somewhere beyond conciousness where I had no control over my body or much awareness but unfortunately impulsively acted on my desire to self injure. I found out after this aweful day according to the doc in the psych hospital that xanax really should be contraindacaited in the presence of poor impulse control. Not to say it isn't a miracle for some or anything just wanted to give people some food for thought. Best wishes.

MLucky:

Oh, I agree. I am taking .5 mg of Xanax per day and it helps me quite a bit, not as much as it did in the beginning but thinking maybe upping it will help, but that wasn't what I was gonna say LOL...

My brother is schizophrenic and when he had to be admitted to hospital for a suicide attempt, they found Xanax in his system and it was his pdoc's professional opinion that (his words) "Xanax is the absolute worst thing to give to a schizophrenic" for the very reason that you were mentioning. Ofcourse, my brother was in psychosis when admitted, but thanks for sharing it, it is food for thought.

Best wishes,
Kimberly.

Candy, I didn't look to see if you got an answer to your question but Grapefruit juice is said to slightly decrease the way alprolazam is excrited from your liver because it is an cyp 3a inhibitor, meaning that it will help slow the elimination process from your body. I hope this helps.

Greg

</font><blockquote><div id="quote"><font class="small">Quote:</font>
... but the choice between that and what I feel without it makes it imperative I take it. My T and my regular Doc work together in getting me medicated - seems they are pretty positive that it is a brain chemical problem and the Xanax works directly on that part of my brain that is malfunctioning.

</div></font></blockquote><font class="post"> 1. How did they determine that it was a "brain chemical problem"? (Did GABA regulation figure into it?)

2. Do you take anything else? (E.g., an AD.)

(I'm new to this board, and looking for discussions of the benzodiazepines vs SSRIs issue.)

</font><blockquote><div id="quote"><font class="small">Quote:</font>
2. Do you take anything else? (E.g., an AD.)

</div></font></blockquote><font class="post">
Silly me -- on the next page I see your (Maya's) 11-6-04 post My T wants me on an antidepressant & it scares me"

I take 1mg of Xanax 2X daily only when needed, which lately has been every day. I've been so stressed. I have been known to add an extra 1mg in the middle of the day if I'm still over-stressed. I have absolutely no side-effects whatsoever from Xanax. It works fantastic. I call it a wonder drug. I don't know what I would do without it. I also take Klonopin 2x daily but not as an anti-anxiety med, I take it for Restless Leg Syndrome. I need it so that I don't have any problems with my legs when I go to bed. Also, my Klonopin does absolutely nothing for me as far as anxiety is concerned. Doesn't even touch it.

Larry - I noticed that Xanax was listed as maybe having some sort of problem with Tegretol, which I also take. Do you know what effect there is? Oh, and btw, nice to see yet another familiar face over here.

Angel Girl

2 mgs... yummy. benzodiazepines are great but just make me too drowsy to really function well.
only side effect i ever noticed was thirst, they kinda dehydrate me a little.

Hi cottoncandy, love your name btw, I find that all my meds dehydrate me, especially my Effexor XR. I'm always drinking something.

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