![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by rainyday on April 26, 2004, at 8:05:26
I have been on .5mg xanax for anxiety and panic attacks. Lately I have noticed that I get really agitated and panic-y by about 3pm every day. I am thinking it's withdrawal from the xanax, as opposed to the jumped up side effects of 300mg wellbutrin I take for bp2 (along with 75mg effexor xr).
Can't say that I am not depressed either. I keep having days when it's not possible to stop crying.
Am I counting angels on the head of a pin here? Would the wb and effexor make me this jumpy or is it that I am becoming addicted to this small amount of xanax?
I am frightened of becoming dependent on this drug. I didn't take any over the weekend, and I was pretty miserable.
Thanks for any insights. Please keep it non-technical for my understanding!!
Posted by Bill LL on April 26, 2004, at 9:03:48
In reply to Xanax question, posted by rainyday on April 26, 2004, at 8:05:26
I have never taken Xanax. My thought would be that Xanax does not cause anxiety as a withdrawal effect. Keep in mind that anxiety can often be a side effect of Wellbutrin.
As for depression, Effexor is generally very effective for depression, but most people need a much larger dose than 75 mg.
Posted by rainyday on April 26, 2004, at 9:11:46
In reply to Re: Xanax question, posted by Bill LL on April 26, 2004, at 9:03:48
Thanks, Bill. We added the wb to the effexor because I couldn't tolerate a higher, more effective dose. 150mg made me feel great, but my blood pressure went up to 165 over 115. Yikes! I was hoping the wellbutrin would fill the void but I can't say that I feel anything but agitated on it. It gets really bad in the afternoon and now I have to take ambien to sleep. My mind racing makes it very hard to concentrate on reading, working, like I've had a zillion expressos. And mind you, I cut out caffeine last October.
Thanks for your input re anxiety and xanax. I feel a bit better for it!
rainyday
Posted by greywolf on April 26, 2004, at 13:55:07
In reply to Re: Xanax question and others » Bill LL, posted by rainyday on April 26, 2004, at 9:11:46
Rainyday:
I doubt it's the Xanax. I had a similar experience when I increased the Wb from 150 to 300. Had really severe anxiety/panic that I normally do not experience. My doctor gave me .5 Xanax up to 3x/day. Used it for a few days, then the agitation dissipated seemingly on its own. Haven't had to use the Xanax since then.
I would bring this to your doctor's attention, but it may be that you're going through an adjustment period with the Wb. I'd be interested in your long-term experience because I've acclimated myself to 300 mg Wb, but have experienced no therapeutic benefit thus far. I suspect that we'll up it further, but I wonder if the Wb is simply ineffectual for some people.
Best of luck.
Posted by rainyday on April 26, 2004, at 14:43:37
In reply to Re: Xanax question and others » rainyday, posted by greywolf on April 26, 2004, at 13:55:07
I ended up taking .5mg of xanax this morning when I was climbing the walls. My daily 3pm meltdown never arrived, much to my relief. I feel, dare I say it, NORMAL??!!!
I felt very "up" on the 300mg of wellbutrin at first, and then it seemed to make me not as depressed as I had been, but still prone to weepy days. I am still having some really bad days with depression, but the side effects of the wellbutrin have been annoying.
I think I have to remind myself what I went through getting used to effexor. It took a full 12 weeks before the side effects went away. Then we tried to up the dosage to 150mg and I couldn't do it. Hence the WB. We are keeping our collective fingers crossed that the combo will work. I think it takes me a long time to respond to these meds. My main concern has been keeping myself together enough to hold down my job.
I go for another appointment in a week, and I have been keeping track of the side effects I'm experiencing. I'll let you know how it goes.
Thanks so much,
rainyday
Posted by chemist on April 26, 2004, at 23:09:13
In reply to Re: Xanax question and others, posted by rainyday on April 26, 2004, at 14:43:37
> I ended up taking .5mg of xanax this morning when I was climbing the walls. My daily 3pm meltdown never arrived, much to my relief. I feel, dare I say it, NORMAL??!!!
>
> I felt very "up" on the 300mg of wellbutrin at first, and then it seemed to make me not as depressed as I had been, but still prone to weepy days. I am still having some really bad days with depression, but the side effects of the wellbutrin have been annoying.
>
> I think I have to remind myself what I went through getting used to effexor. It took a full 12 weeks before the side effects went away. Then we tried to up the dosage to 150mg and I couldn't do it. Hence the WB. We are keeping our collective fingers crossed that the combo will work. I think it takes me a long time to respond to these meds. My main concern has been keeping myself together enough to hold down my job.
>
> I go for another appointment in a week, and I have been keeping track of the side effects I'm experiencing. I'll let you know how it goes.
>
> Thanks so much,
> rainydayhi rainyday, from chemist....your xanax fears are unfounded, as confirmed by previous posters. blame the effexor and/or wellbutrin titration for the jitters....all the best, chemist
Posted by rainyday on April 27, 2004, at 7:24:04
In reply to Re: Xanax question and others » rainyday, posted by chemist on April 26, 2004, at 23:09:13
It is so helpful to have your contributions here! Thanks for putting my mind (ha!) at rest.
rainyday
Posted by chemist on April 27, 2004, at 22:43:33
In reply to Thank you, chemist!, posted by rainyday on April 27, 2004, at 7:24:04
> It is so helpful to have your contributions here! Thanks for putting my mind (ha!) at rest.
> rainyday
hope it all turns out okay...keep me posted, and all the best, chemist
Posted by SLS on April 28, 2004, at 6:12:01
In reply to Xanax question, posted by rainyday on April 26, 2004, at 8:05:26
> I have been on .5mg xanax for anxiety and panic attacks. Lately I have noticed that I get really agitated and panic-y by about 3pm every day. I am thinking it's withdrawal from the xanax,
You might be right. It could be rebound anxiety. Instead of guessing, why don't you just take a bit more Xanax as an experiment to see if your anxiety appears again at 3:00? Perhaps you could talk to your doctor about this?
- Scott
Posted by SLS on April 28, 2004, at 6:17:50
In reply to Xanax question, posted by rainyday on April 26, 2004, at 8:05:26
> > I have been on .5mg xanax for anxiety and panic attacks. Lately I have noticed that I get really agitated and panic-y by about 3pm every day. I am thinking it's withdrawal from the xanax,
>
> You might be right. It could be rebound anxiety. Instead of guessing, why don't you just take a bit more Xanax as an experiment to see if your anxiety appears again at 3:00? Perhaps you could talk to your doctor about this?I forgot to ask. Are you taking the controlled release Xanax CR?
- Scott
Posted by rainyday on April 28, 2004, at 7:34:56
In reply to Re: Xanax question, posted by SLS on April 28, 2004, at 6:12:01
I am on the regular xanax. I have put a call in to m p-doc because the panic attacks are creeping back. I would think this would be due to my tolerance for xanax increasing. Also anxiety and depression are flaring up. I also take effexor xr and wellbutrin sr. Or whatever I can't keep track of all the initials, but they are the long acting ones.
Posted by SLS on April 28, 2004, at 8:02:36
In reply to Re: Xanax question » SLS, posted by rainyday on April 28, 2004, at 7:34:56
> I am on the regular xanax. I have put a call in to m p-doc because the panic attacks are creeping back. I would think this would be due to my tolerance for xanax increasing. Also anxiety and depression are flaring up. I also take effexor xr and wellbutrin sr. Or whatever I can't keep track of all the initials, but they are the long acting ones.
It is no crime to be physiologically dependant on a drug that works for you. After all, what's the difference? People depend on any drug that they must continue taking in order to successfully treat their illness. How is Xanax any different from Effexor or Paxil? For those people who are fortunate enough to respond them, many must continue taking them to stay well. When it is time to discontinue any of them, there is a withdrawal syndrome that must be managed. If my grandmother stops taking isosorbide, she dies almost immediately. She is dependant on that drug. How is this any different from your current dependance on Xanax? When you find a treatment that allows you to discontinue it, you will, and you might have to manage a withdrawal syndrome, just like what is necessary with so many other drugs, including antidepressants.
You have not developed cravings for Xanax. You do not have a psychological compulsion to take it. You are not addicted to it. Period.
Please let us know how you make out. Good luck.
- Scott
Posted by chemist on April 28, 2004, at 22:43:30
In reply to Re: Xanax question » rainyday, posted by SLS on April 28, 2004, at 8:02:36
> > I am on the regular xanax. I have put a call in to m p-doc because the panic attacks are creeping back. I would think this would be due to my tolerance for xanax increasing. Also anxiety and depression are flaring up. I also take effexor xr and wellbutrin sr. Or whatever I can't keep track of all the initials, but they are the long acting ones.
>
> It is no crime to be physiologically dependant on a drug that works for you. After all, what's the difference? People depend on any drug that they must continue taking in order to successfully treat their illness. How is Xanax any different from Effexor or Paxil? For those people who are fortunate enough to respond them, many must continue taking them to stay well. When it is time to discontinue any of them, there is a withdrawal syndrome that must be managed. If my grandmother stops taking isosorbide, she dies almost immediately. She is dependant on that drug. How is this any different from your current dependance on Xanax? When you find a treatment that allows you to discontinue it, you will, and you might have to manage a withdrawal syndrome, just like what is necessary with so many other drugs, including antidepressants.
>
> You have not developed cravings for Xanax. You do not have a psychological compulsion to take it. You are not addicted to it. Period.
>
> Please let us know how you make out. Good luck.
>
>
> - Scott
>
for what it's worth, i agree with Scott's post in toto....all the best, chemist
Posted by Viridis on April 29, 2004, at 4:23:05
In reply to Re: Xanax question » SLS, posted by rainyday on April 28, 2004, at 7:34:56
I agree with the other posters that this is not an "addiction" issue, any more than dependency on other, non-psychiatric meds. However, I have found that Xanax has some odd qualities (for me) re: tolerance. It's extremely helpful for anxiety, yet if I take it often at all, I quickly find that I need higher and higher doses to achieve the same effect. I don't "enjoy" or "crave" it -- I just develop tolerance quickly.
My pdoc says he's seen this before with Xanax. He still prescribes it and tells me to take as much as I need for severe anxiety, but doesn't want the dosage to keep going up (neither do I) so limits the amount..
On the other hand, Klonopin (another benzodiazepine) has been great for me and remains effective at the same dose, taken daily. Have you tried this one?
Posted by rainyday on April 29, 2004, at 6:57:37
In reply to Re: Xanax question » rainyday, posted by Viridis on April 29, 2004, at 4:23:05
No, I haven't tried klonopin. I was once on ativan for a crisis period. I have a history of alcohol addiction so we are really careful about what I take for anxiety. I tried vistaril, which was a joke!
Thankfully, the anxiety and panic attacks are slowly receding.
Posted by Viridis on April 30, 2004, at 1:19:40
In reply to Re: Xanax question » Viridis, posted by rainyday on April 29, 2004, at 6:57:37
Please consider Klonopin (clonazepam). It doesn't seem to have the "gratification" effects of alcohol etc. for most people, nor do most develop tolerance easily. It simply relieves anxiety. It will induce dependency with long-term use, but this is a different issue common to all sorts of medications. It might make you sleepy for the first week or so, but I and many others have found it extremely effective without side effects or need for dosage escalation.
Posted by chemist on May 2, 2004, at 0:11:40
In reply to Re: Xanax question » rainyday, posted by Viridis on April 30, 2004, at 1:19:40
> Please consider Klonopin (clonazepam). It doesn't seem to have the "gratification" effects of alcohol etc. for most people, nor do most develop tolerance easily. It simply relieves anxiety. It will induce dependency with long-term use, but this is a different issue common to all sorts of medications. It might make you sleepy for the first week or so, but I and many others have found it extremely effective without side effects or need for dosage escalation.
chemist here....the advice presented for long-term klonopin use is spot-on...if you have had or have addiction-prone behavior, klonopin is the way to go in terms of lack of a ``high'' or escalating dose. concur with previous postes, for what it is worth....all the best, chemist
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.