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Old 05-03-2013, 09:59 AM   #1 (permalink)
 
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Question Possible to be Non-responsive to Benzos?

Hi

I have tried Valium (5MG) and all it did was make me sleepy. No effect on anxiety.

I was prescribed Xanax (.25MG), 3 times daily.

Xanax has done nothing for me... except making me a little tired. Was placed in a simple situation today and still felt as nervous/anxious as ever.

I know 0.25MG is a low dose, but surely I would feel something the first few times I took it? I only had ever taken Valium around 5 times before, so am not 'accustomed' to benzos.

My understanding is that Xanax is the most potent of benzos and so if I don't feel anything on Xanax, I won't get much success from any other benzos.


I am currently taking Wellbutrin and this has given me motivation and "drive".


Why don't benzos seem to work with me? Is it possible to be non-responsive to benzos?
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Old 05-03-2013, 11:12 AM   #2 (permalink)
 
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Why don't you try a higher dose on Alprazolam? Maybe 0.5mg to start, if 1mg doesn't work then change medication.
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Old 05-03-2013, 11:18 AM   #3 (permalink)
 
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Well, as you said, it is a low dose. And you did feel slight sedation, so you're not completely non-responsive. First, I'd suggest increasing the dose and seeing if that helps.

That said, there are several factors that can make a person "non-responsive" to benzos. Both Valium and Xanax are metabolized by the CYP3A4 enzyme, and you may be a fast metabolizer with that enzyme. This seems unlikely however because Valium's metabolite through CYP3A4 is also active, so its duration and efficacy wouldn't be too severely reduced.

The other one is an overexpression of MDR proteins in the blood-brain barrier (BBB). This condition is associated with many cases of epilepsy, and is believed to be responsible for treatment-resistance. It may be possible in non-epileptic people, it's just that most studies of the phenomenon so far have focused on its occurrence in epileptic patients. Basically, MDR proteins "grab" the drug as it enters cells of the BBB, and kick it back out before it can cross over to the other side and into the brain.

Try Ativan as well if increasing the dose doesn't help. Its metabolism is completely different from most other benzos. Unfortunately, it's one of the most side-effect heavy. Also, maybe benzos just aren't the right medication for you; they don't help everyone. If you're looking for "drive," stimulants may be better suited.
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Old 05-03-2013, 11:19 AM   #4 (permalink)
 
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Seems way too low of a dose to me. They tried to start me at 0.25 but I bumped it up to .50 (Klonopin) almost immediately.

Xanax is fast acting but not long lasting. Klonopin is long lasting but not fast acting. Klonopin has a rather impressive half life.

If the WB is working for you I am wondering why you are trying benzos? Are you having anxiety attacks? I would recommend Xanax in that case because it takes anywhere from 30 min to over an hour for Klonopin to kick in.

Benzos work great at the right dosage but I will throw out the caveat that I always do--they are addicting. I take anywhere from 2 to 3 mg a day but will be tapering soon. I have been taking them for well over two years now. It's kind of sad how I had to stop typing and really think about that. It was December 2010 when I first started. For some users (NOTICE SOME NOT ALL) long term use can affect one's memory and that is very much the case with me. Not at first, but over time.
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Old 05-03-2013, 05:08 PM   #5 (permalink)
 
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Thanks for the responses, guys Much appreciated.

I used to take Ritalin and Modafinil (at different periods) for fatigue. Ritalin wore off with stimulation (tolerance, I suppose) and modafinil was always like a sugar pill for me (I never felt more awake on it).

I then went on Wellbutrin which has been great for energy, motivation, etc.

I have tried most all types of meds for anxiety (not MAOIs... yet) - and no effect.

My psych wanted me to go on Xanax. He said despite the bad press, etc. he has successfully treated people on a low dose for years without any problems.

I do not have an addictive personality so am not so worried about the addictive nature of benzos. The physical dependence is a different matter, but I am happy to take it long-term if it will help me - like a diabetic with insulin.

Very frustrated I felt nothing with Xanax - I was hoping I might at least get temporary relief, just to see what life could be like...

Will consider upping to 0.5MG, but am not sure how my psych will see this.

I tried Mirtazapine and doubled my dose secretly when feeling nothing, but where I live, you need to call a special phone number to get government authorisation before prescribing Zanax. Because it's more restricted, I don't know how I can tell him I tried doubling it without him being annoyed/suspicious. I see him in 4 weeks.

He's generally very nice, and has always been open to my suggestions. He prescribed me mirtazapine on my suggestion, Wellbutrin, etc.

Might look into Ativan to, if this works in a different way.


Many thanks again guys
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Old 05-03-2013, 05:22 PM   #6 (permalink)
 
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OK so I just called my psych's paging service and he called me back in 10 minutes.

What service!

He said I could double to 0.5MG three times daily. Yay for me.

Hopefully this works!


EDIT: Took two tabs (0.5MG) and slept like a log for 4 hours.

Xanax is not for me
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Old 05-03-2013, 11:27 PM   #7 (permalink)
 
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Quote:
Originally Posted by robtyl View Post
OK so I just called my psych's paging service and he called me back in 10 minutes.

What service!

He said I could double to 0.5MG three times daily. Yay for me.

Hopefully this works!


EDIT: Took two tabs (0.5MG) and slept like a log for 4 hours.

Xanax is not for me
So 0.25mg is too low and 0.5mg is too high. I think 0.25mg is enough for you but you're just expecting a different feeling. Alprazolam isn't supposed to give you euphoria and make you feel good, it's just gonna make your anxiety go away, that's it.
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Old 05-04-2013, 04:07 PM   #8 (permalink)
 
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Hi

I can see where you're coming from, but I felt the same level of anxiousness with 0.25MG.

I wasn't expecting a high or anything.

I realised I wasn't feeling any different when I was in the office and had to speak to someone I'd never met about something and started choking up and mumbling, as I usually do. A simple conversation about a very basic topic.

And answering the phone was no easier than it usually is
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Old 05-05-2013, 12:55 AM   #9 (permalink)
 
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The sedative effect of benzos goes away the longer you take it. It doesn't make me tired at all.
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