Is it normal? Alprazolam (Xanax) acted about 7 hours at me

[NihilBoni]

Hi,

I noticed that alprazolam was taking effect at me for about 6 - 7 hours. It was only the 0,75 mg dose.

It's pretty curious, as I read it pretty often acts shorter.

But maybe it's individual. Anyone else who has such a perception?

Cheers to you!

[korey]

Do you take any heartburn medication or happen to drink grapefruit juice or eat any grapefruit itself? There are certain enzyme inhibitors found in certain heartburn medications (Tagmet aka Cimetidine) as well as grapefruit juice that usually cause higher concentrations of alprazolam (along with other benzos, too). If you'd taken anything that might affect the enzymes in your body responsible for metabolizing alprazolam, then it might've contributed to the much longer duration of action you experienced.

If not, then maybe you're just special Everyone reacts to benzos differently. Most people find benzos sedating, but some don't even so much as nod off a little at unusually high doses. Perhaps your benzo-metabolizing enzymes are inefficient, making it take more time for your body to process the alprazolam and excrete it.

This is a silly question, but are you certain that you were not taking the time-released version of it? Some doctors will prescribe the time-released version of alprazolam and not give their patients a heads-up about what to expect. Just a possibility

[Speak Easy]

NihilBoni, consider yourself lucky that it lasted so long for you. I only feel effects for about 2 hours max. Korey, are you saying that if I were wash my Xanax down with some grapefruit juice and then sip on it for the remained of the day that my Xanax would last longer? Is this slowing down the metabolization process by messing up my liver, or is it a healthy way around the short period of effects of my Xanax?

[korey]

Originally Posted by LDG 124

Korey, are you saying that if I were wash my Xanax down with some grapefruit juice and then sip on it for the remained of the day that my Xanax would last longer? Is this slowing down the metabolization process by messing up my liver, or is it a healthy way around the short period of effects of my Xanax?

First of all, yes.

Second, grapefruit juice is a "potent inhibitor of the Cytochrome_P450 enzyme CYP3A4, which can impact the metabolism of a variety of drugs, increasing their bioavailability" (Wikipedia). Benzodiazepines just so happen to be a substrate of that particular enzyme, so inhibiting the production/action (not sure which) of CYP3A4 by drinking grapefruit juice stops this enzyme from reacting with the substrates (benzos, in this case), leaving the benzos in your blood stream for a longer amount of time.

http://en.wikipedia.org/wiki/CYP3A4#CYP3A4_ligands

There is a list of inducers (things that promote the enzyme's actions), inhibitors (things that slow/stop the enzyme's actions), and substrates (things that can potentially be affected by the enzyme's actions). Benzos fall under the substrate category while grapefruit juice falls under the inhibitor category.

From what I have read of some people here at SAS, utilizing grapefruit juice for such reasons is a good way to stretch those tiny amounts of benzos that most people are prescibed.

I would assume that grapefruit juice doesn't mess up your liver being as they sell it by the 6-pack at the grocery store. They also sell it in those big cartons that they tell orange juice in.

Using grapefruit juice to prolong the effects of benzos is healthy, as far as I know. Grapefruit juice tastes horrible, though, so you might want to pour some sugar in it before you drink it. Also, if you get acid heartburn like me, you might want to pop a Tagmet(Cimetidine) tablet beforehand (it's also an enzyme inhibitor available OTC...might as well get the bang for your buck).

[arthur56]

the time a benzo lasts varies a lot from person to person, xanax is a short acting one clonazepam is a long acting one
unless you know exactly what to do, I think grapefruit and grapefruit juice should be avoided if on any prescription meds
it seems all the other citrus fruits are OK

[foxtrot]

re the whole grapefruit thing, this particular thread disagrees wholly with it potentiating xanax:-

http://www.drugs-forum.co.uk/forum/show ... hp?t=26819

[jealibeanz]

Yeah, unfortunately I learned a while back that certain drugs either induce or inhibit benzo metabolism. As soon as I started with Provigil last fall, my anxiety was sky-high, thus, I had to increase the dose. I never wanted to point this out to my doc (most would not be aware of this interaction) because I dion't want to insult him by saying, "Hey, you know, the only reason why I need more Xanax right now is because Provigil is a CYA34A inducer, not because I'm becoming more tolerant." That might be a little rude/obnoxious, IMO.

I did mention this to my pharmacology prof (but didn't give names of the drugs) and asked her if it's common for doc's to have no idea about such things, she just laughed and said yes. But this was coming from a PharmD, who basically only deals with medications. GP's have soo much on their plate, I don't expect them to know every odd little interaction.

[jealibeanz]

How does Tagament help to make benzo's last longer? Have you had personal experience?

[Speak Easy]

Cool korey, very interesting. I'll definitely try this

[jealibeanz]

Straying from the OT for a minute...

I looked up a little more on Provigil (via wiki... does anyone else think this site is a pretty good and straight forward place for information about soo many things? I'm always slightly skeptical, but impressed and intrigued at the same time.)

In addition to being a CYP34A inhibitor, it's thought to inhibit the transmission of GABA. Hmm... that certainly is not a good thing for someone with anxiety.

[Speak Easy]

Originally Posted by jealibeanz

(via wiki... does anyone else think this site is a pretty good and straight forward place for information about soo many things?

Wikipedia blows. Don't quote wiki. Anyone can edit anything they want. Rather, go check out a book from the library or simply find a more renound type of site such as an accepted database and/or an encyclopedia

[jealibeanz]

I do take what I read with a grain of salt and am aware of the fact that things can be edited (This can be a good thing, esp. with medical topics. I know many medical practitioners and those in the science or healthcare field like to write in whenever they find and error or an update. They aren't there just writting or suggesting b/s.

Much of the information is valid though and provides added information that is often omitted from other sources (not just talking about medical issues). It's comprehensive and provides the opportunity to fully explore topics with links within wiki and to external sites.

It doesn't "blow". There may be some errors, as is the case with any source, printed or not.

Actually, as far as pharmacology goes, wiki is very good for the most part. In many drug classes, it goes above and beyond any prescribing info or text books. I supplemented my pharmacology notes with wiki frequently and it was very beneficial and reliable. I never found errors and was actually better able to learn the information because the additional detailed info helped me to fully integrate drug mechanisms into physiology.

Most encyclopedias do not have in depth information regarding pharmacology. They're good for little summaries on topics. The advances in medicine and understanding of mechanisms changes theories all the time., even with medications that have been around for decades. Many printed encyclopedias would not be able to keep up with the changes and choose not to because they are drug references.

I do recognize that wiki would not be accepted as a proper source of reference for a medical practitioner, but it does have some good use for the general public.

I'm not entirely sure what *reknowned* sources you are referring to when you mention books in the library. That's pretty vague. Unless you're visiting a medical library in a hospital or med school, you're not going to find a great deal of useful information about detailed drug mechanisms and their influences on human physiology.

The medical books at my own colleges I've attened have been few and far between, out-dated, and simply never gave me the info I was looking for. I think this is common with any average library. Does your high school library have a better selection?

Do you have any suggestions in terms of an "accepted database"? Does this mean a more credible online encyclopedia (which as I stated before, will likely have scarce details about pharmacolgy).

The only other database I can think of that you might be referring to when discussing medications would be PubMed, but they publish primary research studies about the effectiveness of medications during trials and studies. There are some studies published on theoretical mechanisms (which is what we're talking about when discussing psycho meds), but they are less common and it is not a database solely designed for looking up details about the meds themselves, rather, how they've been studied.

[Speak Easy]

Originally Posted by jealibeanz

It's comprehensive and provides the opportunity to fully explore topics with links within wiki and to external sites.

Yes, it's a very nicely set up website. It's very easy to use, even for the most inept internet user, but it's the validity of the facts that often comes into question.

Originally Posted by jealibeanz

There may be some errors, as is the case with any source, printed or not.

If a source is printed, such as an encyclopedia of mental health, medical encyclopedia, etc, I can guarantee that the text would be the closest one could get to impeccable information, since the individuals writing are obviously professionals/doctors/professors/PhDs/etc.

Originally Posted by jealibeanz

Does your high school library have a better selection?

Yea, I have access to over 15 updated databases (one of them being Facts on File Health Reference Center, which is a "renound" medical database)

Originally Posted by jealibeanz

Do you have any suggestions in terms of an "accepted database"? Does this mean a more credible online encyclopedia (which as I stated before, will likely have scarce details about pharmacolgy)

Yeah, but the student isn't the one to judge the "credibility" of an accepted database, it's the teacher who makes the judging, and I have never met a teacher who accepts wikipedia in any sort of scientifical or psychological APA/MLA style paper. And come university, I know for a fact that we aren't allowed to quote Wiki, and this is coming from professors of biochem, chem, bio (i.e., pre-medical studies) and psychology.

[NihilBoni]

Originally Posted by korey

Do you take any heartburn medication or happen to drink grapefruit juice or eat any grapefruit itself? There are certain enzyme inhibitors found in certain heartburn medications (Tagmet aka Cimetidine) as well as grapefruit juice that usually cause higher concentrations of alprazolam (along with other benzos, too). (...)
If not, then maybe you're just special Everyone reacts to benzos differently. Most people find benzos sedating, but some don't even so much as nod off a little at unusually high doses. Perhaps your benzo-metabolizing enzymes are inefficient, making it take more time for your body to process the alprazolam and excrete it.(...)
This is a silly question, but are you certain that you were not taking the time-released version of it? Some doctors will prescribe the time-released version of alprazolam and not give their patients a heads-up about what to expect. Just a possibility

Well, I've been wondering if grapefruit juice has any impact on it - I've even made a topic about it in the Voting Booth (if anybody here knew about such effects). Not yet - so no such a correlation happened.

Well, if I'm special, it'd be nice... Some one thing which'd be positive at me...

It's definitely a normal tablet, without any covering or so - its bitter taste ensures it.

I read on that Drugs forum, that just alprazolam doesn't interact with this juice. It'd be a pity - just the finest cure'd be not affected by it...

Cheers!

[foxtrot]

jealibeanz and LDG, couldnt help but notice you two putting quotation marks around "renound"/"reknowned", making it look like you were duelling with the spelling! (maybe im wrong). as i didnt have a clue (aswell as being the master of procrastination) i thought id look it up. neither spelling exists in the dictionary and i think the correct spelling is "renowned" for what it's worth

[jealibeanz]

Hahaha! Thanks for the spelling correction. I knew neither seemed correct.

Annnyway, I'm not saying that wiki is 100% credible and that all info there should be trusted. I'm saying that overall, it has a great deal of valid and useful info. I don't read everything and immediately trust it, but if it's a topic I already am familiar with, I can get a good sense as to whether or not the facts are true.

I'd never cite wiki as a source while researching. However, I think it can be good for one's own personal use, especially if you know enough not to blindly trust everything you read.

[foxtrot]

Originally Posted by jealibeanz

Annnyway, I'm not saying that wiki is 100% credible and that all info there should be trusted. I'm saying that overall, it has a great deal of valid and useful info. I don't read everything and immediately trust it, but if it's a topic I already am familiar with, I can get a good sense as to whether or not the facts are true.

I'd never cite wiki as a source while researching. However, I think it can be good for one's own personal use, especially if you know enough not to blindly trust everything you read.

i would agree with that.

i think you and LDG both made valid comments. basically i think it's an extremely helpful and easily accessible source but i can understand why you cannot cite it as a source

[Nae]

Wiki is amazing for looking up eclectic subjects, like when I was trying to find out what type of ant colony was moving in next to my tomato plants. For more recent or popular subjects, I'd be skeptical right off the bat. Barely a minute after American Dad aired in which Lincoln's wife discovered peanut butter to end the civil war (or something like that) I saw wiki update on all 3 subjects considering this new fact.

[jealibeanz]

Is Pepcid supposed to prolong the effects of benzo's too? I still don't completely understand the theory.

I don't think Tagamet has anything to do with affecting enzymes. I could be wrong about that. Maybe it does indirectly. But the mechanism of the drug is to block the H2-histamine receptors in the mucosa of the stomach. Right? How does that influence the duration of a benzo?

Tagamet is metabolized by the liver, so that would have an effect, but I'm still not fully understanding what is the main reason for the theory.

[NihilBoni]

Originally Posted by jealibeanz

Tagamet is metabolized by the liver, so that would have an effect, but I'm still not fully understanding what is the main reason for the theory.

Well, it refers to some special enzyme. Maybe check here:

http://en.wikipedia.org/wiki/CYP3A4

and look on the inhibitors and substrates. It seems to has a correaltion, but I'm not sure.

Cheers!