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Old 06-11-2010, 01:38 PM   #1 (permalink)
 
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Default Xanax - how often is safe?

I've been on a very high dose for a long time(2mg x3), so I cannot take them as needed any more. If I don't take it for more than 6 hours since it wears off, I get super anxious without being around anyone and start to twitch like crazy. AFAIK Xanax lasts about 6 hours, but I don't feel the effects until 1 hour or longer after intake, so I take another after 5 hours. Is this too close? Am I having those withdrawal effects because I take one too early before another wears off?
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Old 06-11-2010, 01:39 PM   #2 (permalink)
 
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I use my Xanax 1-2 times max. I use it every night for sleep and maybe once during the day if I got something causing me anxiety/paranoia.
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Old 06-13-2010, 08:12 PM   #3 (permalink)
 
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That is not what I asked in the post. Sorry the title was a bit misleading.
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Old 06-13-2010, 08:23 PM   #4 (permalink)
 
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Sounds like inter-dose withdrawal.
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Old 06-13-2010, 08:31 PM   #5 (permalink)
 
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Quote:
Originally Posted by akstylish View Post
That is not what I asked in the post. Sorry the title was a bit misleading.
sorry bout that, I dont actually read every post. As for your situation I would suggest you take a longer acting benzo like Valium if you just take your Xanax every day at the same time multiple times a day. That should stop you going through as the other poster said "inter dose withdrawal". I personally don't believe benzos are a good choice for GAD. For GAD you should be on an anti-depressant cause there is no point of dosing PRN if you are anxious ALL the time.
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Old 06-14-2010, 01:22 AM   #6 (permalink)
 
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I think generally 4-6 hours seems about right, but I don't know. I do know that on .25-.50MG, I feel it in my body the WHOLE DAY and crash (sleep) pretty well..
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Old 06-14-2010, 07:47 AM   #7 (permalink)
 
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Quote:
Originally Posted by akstylish View Post
I've been on a very high dose for a long time(2mg x3), so I cannot take them as needed any more. If I don't take it for more than 6 hours since it wears off, I get super anxious without being around anyone and start to twitch like crazy. AFAIK Xanax lasts about 6 hours, but I don't feel the effects until 1 hour or longer after intake, so I take another after 5 hours. Is this too close? Am I having those withdrawal effects because I take one too early before another wears off?
6Mgs a day is not safe if done on a consistant basis. You just set yourself up for addiction (which has already taken place)

I used to be addicted pretty bad to Xanax and had to used less powerful Benzos to ease off the Xanax. As far as danger....well not really as long as you keep taking it, but any cold turkey discontinuation at that dosage can cause sezures.
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Old 06-14-2010, 08:17 AM   #8 (permalink)
 
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The dosing schedule itself is safe and reasonable, but especially considering the whole concept of half-life and all that, and since you're constantly using the drug, you end up with a baseline concentration of Xanax that has more or less built up and is constantly floating around your blood. So with that, and the fact that a simple overdose is actually quite a challenging thing to do with benzos, the more relevant question would probably be "how much can I safely take on a daily basis?"

And you've more than likely crossed that threshold. Xanax has a half-life of about 11 hours so it means that after 11 hours, half of the drug is still remaining. After 22 hours, a quarter of the dose still remains, after 33 hours an eighth still remains, etc. As you can probably guess from this information, for a person dependent on Xanax, what you experience 5-6 hours after dosing is just the tip of the iceberg. If you stopped using the drug completely for a few days, it's possible you'd be encountering seizures, which is why I say that your overall daily intake has probably put you somewhere into "unsafe" territory.

As for the logic you use to justify 5 hours, it's a bit flawed. Xanax, like any other drug, especially when swallowed, takes a bit of time to get into your system because, among other things, your stomach needs to break the pill down, absorb the medicine into your bloodstream, etc. For all intents and purposes, the time in between swallowing and when the drug has kicked in doesn't count as part of the duration.

I can see how you might make the mistake between the first and second dose of the day, but since you're taking it 3 times a day, it should be easier to explain. You allow only 10 hours to pass between your first and third dose of the day - that's 10 hours. So even if you could cancel out the first hour where you're getting no effect using the flawed logic, that would amount to 11 hours. An average of 5.5 hours total. Obviously that doesn't line up with the 6 hour duration you think you're taking it for. If you took a 4th dose 5 hours later, that would amount to 16 hours when including that initial hour, giving you an average of 5.3 hours.

To make it even more clear, imagine the extreme example of a drug having a duration of 1 hour, and taking 1 hour to kick in. With the logic you're using, counting that initial hour, you'd end up taking an infinite-sized dose because it would never actually start working! Or if that's too abstract, imagine a drug that somehow has an EXACT duration of 1 hour and 1 minute, and takes an hour to kick in. With a duration of 1 hour and 1 minute, you could expect that if you didn't sleep at all, that'd be about 24 doses in the day. But by reasoning that since it takes an hour to kick in, you should be subtracting that hour from your dosing schedule, you would be taking another dose every single minute. Instead of about 24 doses throughout the day, you're now taking 1,440 = hopefully you can see by now that it doesn't make any sense.

Since the time it takes to kick in should be consistent, if the drug really has an effective duration of 6 hours for you at that dose, it would make sense to take the pills 6 hours apart. So do you take the dose every 5 hours because you start feeling like you need it, or because your math said so? If waiting any longer to dose will send you into withdrawals (though according to your post, if happens when you wait more than SIX hours to dose), then it's reasonable, although still unfortunate that you've gotten yourself dependent on that much Xanax per day. If the reason you're taking it every 5 hours is strictly because you've calculated it out that way, well as I've shown, it wasn't accurate, but even if it was, everybody processes these drugs differently, so even "accurate" math wouldn't be the appropriate way of going about it either. Maybe with a heart medication or something else that's being treated where the symptoms aren't immediately noticeable, but if you're treating anxiety, it's something inherently noticeable and is why you're treating it in the first place (anything else would be as useless as giving somebody painkillers for pain when they don't feel pain), so also since benzos work with just a single dose, rather than trying to reason out how long you should wait to take the next dose, the best way is really just to do it by feeling, even though for many other medications (ie SSRIS) this would be terrible advice. If you only need to take it every 6 hours to avoid significant withdrawals, then you really only need to take it every 6 hours.
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Old 06-14-2010, 01:46 PM   #9 (permalink)
 
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Quote:
Originally Posted by Dr House
As for your situation I would suggest you take a longer acting benzo like Valium if you just take your Xanax every day at the same time multiple times a day.
I would've done that, but Xanax is the only med that is even remotely effective for my anxiety.

Quote:
Originally Posted by meyaj
As for the logic you use to justify 5 hours, it's a bit flawed. Xanax, like any other drug, especially when swallowed, takes a bit of time to get into your system because, among other things, your stomach needs to break the pill down, absorb the medicine into your bloodstream, etc. For all intents and purposes, the time in between swallowing and when the drug has kicked in doesn't count as part of the duration.
I see what you are saying. I indeed counted the time for the drug to enter the bloodstream as part of the duration. I can't believe I missed that.

Quote:
So do you take the dose every 5 hours because you start feeling like you need it, or because your math said so?
Both. It just doesn't feel like it lasts 6 hours to me.

Since this is related, I might as well ask this question here: As I increased the dose, the twitches had gone, but after a while, they came back and eventually got worse. After 1mg x 3, increment didn't help anymore, so I stopped at 2mg x 3, which is what I'm taking now. They get uncontrollable when I don't take it for 12+ hours, but they are pretty bad even when I take it. It looks likely that Xanax is the culprit, but is it really a known side effect that happens DURING it's taking effect? I wanted to figure this out on my own by quitting it very slowly, but as of now I haven't found a medication that can replace it.
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Old 06-15-2010, 10:58 AM   #10 (permalink)
 
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yes, many of the side effects of benzo withdrawal can actually occur while still on benzos. this is because your body becomes so tolerant to benzos, and you have to raise the dose as you did to make these effects go away. but then they come back again as you build tolerance to your new dose.

the only solution, is to get off benzos completely. i'm sorry to be the bringer of bad news, but it sounds as if you've gotten yourself in pretty deep. i was there myself with xanax and getting off it has been the most difficult thing i have ever undertaken. but it's the only sensible option. if you want help coming up with a taper plan, you can ask me. you should definitely read the ashton manual though, if you haven't already (google it) and you may want to consider her suggestion of switching to a longer acting benzo for the purposes of tapering.
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Old 06-15-2010, 12:55 PM   #11 (permalink)
 
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Im surprised no one mention Xanax XR. Its extended release so it continues to release medicine for quite some time.

Anyways, 6mg per day of Xanax is pretty hardcore dependence. I imagine you get the 2mg bars of xanax. What you could do is cut the bars in half and take half pills for awhile.

You might go through some withdrawal but you could dose 1mg 6x daily and I suspect this would keep you a bit more "even". For instance 1mg when you wake up, and then 1mg every 2-3 hours or so. You would probably need to take some melatonin or benedryl in order to sleep however.

I am curious if the Xanax is still effective for SA given the inter-dose withdrawal symptom. I would imagine it would have lose most of its anxiolytic effect.
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