![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by sukarno on July 1, 2010, at 18:54:29
I was having to use my light box 3 to 4 hours per day just to feel normal for a day, whereas in the past I could use just it for 1 or 2 hours and would be fine.
I quit Stablon on 28 April 2010 and Xanax around the same time. I went back to Valium and used light therapy, but the depression was becoming serious as was my mood (feeling like there was no way out of my situation).
I decided to give Xanax another try even though I know it lowers libido, increases appetite and has horrific withdrawal symptoms if you quit abruptly, unlike Valium.
I have been on 1mg alprazolam for 3 or 4 days and have not used my light box. My depression has not returned, even with the curtains closed (hence, dark).
This is very unusual. Usually my depression will hit hard if I skip one day of light therapy and I'll be crying and very emotional (full of frustration).
I am in a stressful situation.
However, I have noticed that the depression is in full remission as if I had taken an SSRI or something. This happened before in 2008 when I tried Xanax and the depression stayed away for 3 months. Depression returned only after moving to this house (which is very dark compared to my previous house).
I can only conclude that Xanax has an antidepressant effect. This is backed up by a psychiatrist in the US saying the same (but only in high doses and he wouldn't prescribe those doses) and a study in Japan in 2007 where they used Xanax as monotherapy in the treatment of Major Depressive Disorder. The majority responded and depression went into remission.
From what I've gathered, Xanax causes 5-HT (serotonin) release and also the release of noradrenaline. It also has another mode of action, but I can't remember off the top of my head what it was.
There is a possibility that Valium simply induces or exacerbates depression in its own right. I know that I feel depressed after taking Valium and with long term use (20 years) the depression seemed to be getting worse.
I noticed that I am much more patient now and my adverse situation no longer seems adverse anymore. Strange. I don't fly off the handle over small or big things anymore. I'm more rational. I feel like I've taken a mood stabilizer for the past few days.
I was to the point of considering using cannabis as an antidepressant despite serious legal consequences in the country where I reside.
Now that Xanax does the job (and as long as it keeps doing so), I'll just stick with that.
I know it will increase my appetite (already has), lower libido (probably due to 5-HT and NA release) and cause stronger physical dependence, but I feel the benefits are worth the risks.
Monotherapy on Xanax without light therapy and feeling happy... playing with my son a lot over the past few days. I feel like a new person. Happy, relaxed, but alert and emotionally stable. Quality of life is up 75% to 90% if I had to rate it. (previous psychiatrist asked me to rate things in percentages like that)
I hope this keeps up. I have more faith again in modern medicine and will stay away from the "herb" (grass). I haven't used it in 15 years.
:-)
Posted by Phillipa on July 1, 2010, at 23:38:02
In reply to Switch to Xanax; depression vanishes; QOL up, posted by sukarno on July 1, 2010, at 18:54:29
Xanax has slight antidepressant qualities and been on it with valium as well for years. Never increased my appetite though. That's strange. Glad it's working so well for you. Love Phillipa
Posted by fayeroe on July 1, 2010, at 23:59:55
In reply to Re: Switch to Xanax; depression vanishes; QOL up » sukarno, posted by Phillipa on July 1, 2010, at 23:38:02
> Xanax has slight antidepressant qualities and been on it with valium as well for years. Never increased my appetite though. That's strange. Glad it's working so well for you. Love Phillipa
i didn't know that. thanks for that information, Phillipa.
Faye
Posted by DocRon on July 2, 2010, at 8:02:35
In reply to Switch to Xanax; depression vanishes; QOL up, posted by sukarno on July 1, 2010, at 18:54:29
100% in agreed!! It makes my depression lift, my anxiety simply disappear, and has no real negative side effects when used long term (except for the addiction and TERRIBLE, life-threatening w/ds).
I have been taking 6mg/dy for 15 years and that dose is perfect--keeps the panic away while not gaining any more of a "tolerance" to it. I once took twice my daily dosage (12mg) by accident and never would have known it except for the pill count coming up short...that's how habituating it is.
One thing though is that it WORKS! End of story.
Posted by sukarno on July 2, 2010, at 13:35:14
In reply to Re: Switch to Xanax; depression vanishes; QOL up, posted by DocRon on July 2, 2010, at 8:02:35
I noticed the same thing if I forgot and accidentally took more. I wouldn't feel anything psychologically although I was a bit off balance as it affected my motor skills a bit heh.
I wish they could synthesize a drug with the same properties as Xanax, but with a half-life like that of diazepam (or even longer) to minimize the horrible withdrawals.
The triazolo ring in alprazolam causes it to be rapidly eliminated from the body.
I suppose there is no profit to be made in producing another controlled substance for anxiety for whatever reason? Too much liability perhaps?
I'm just glad it works. Why abuse something that gives you your life back and never results in tolerance to the anxiolytic effect? That's the way I see it. From the reports I've read, panic disorder patients are the least likely to abuse Xanax.
I have a feeling we will never produce a psychiatric drug that is free of the risks of dependence and withdrawal.
This is the last medication I can tolerate that actually works. I couldn't imagine growing up in a world without these medications. Imagine panic attacks happening several times a day (big ones) and there being nothing you can do about it, except for CBT (unfortunately that didn't stop my attacks.. it only helped me somewhat with agoraphobia). Just my personal experience with CBT. Everyone is different though.
It is heartening to hear that another person has done well with Xanax, even after years of use at the same dosage. It has been my experience too that BZDs taken at the same dosage for years maintain their efficacy against the panic attacks.
Posted by europerep on July 2, 2010, at 14:47:59
In reply to Re: Switch to Xanax; depression vanishes; QOL up, posted by DocRon on July 2, 2010, at 8:02:35
> (it) has no real negative side effects when used long term (except for ... TERRIBLE, life-threatening w/ds).
>
it's not funny, but it still made me laugh.. I guess that shows how the end of the "really bad sh*t"-scale gets pushed way beyond a normal person's scale, as soon as mental illness appears... "it has no negative side effects worth mentioning, except for the permanent, searing pain throughout the body that feels like dozens of burning daggers stabbing me every second"..;-)glad to hear xanax might be considered an option, it scares me much much more than other "problematic" drugs though, like opioids for example.. I guess I'll have to see whether some other stuff will work or not..
P.S.: this board is "peeping" out "dirty words"? sorry, but that's sooo American... ;-).. great board though!
Posted by sukarno on July 2, 2010, at 15:46:18
In reply to Re: Switch to Xanax; depression vanishes; QOL up, posted by europerep on July 2, 2010, at 14:47:59
Xanax is one of those medications you have to take extra precautions with. Never let yourself run out (always keep a back-up supply in a separate bottle in case you lose or misplace your medication), take it on time and never taper faster than 0.5mg every three days.
Never, no matter what anyone tells you, quit abruptly ("cold turkey") or quickly.
Slow, long tapers are better. You can get 0.25mg tablets and taper by 0.125mg if you have to. That way you will avoid severe withdrawal symptoms.
I suppose Xanax is like the "Paxil" of the SSRIs or oxycodone of the opioids in terms of withdrawal reactions. You can quit (if you need to, but if you are doing fine on it there is really no need to stop), but always quit slowly over a period of months and you shouldn't have problems, but YMMV. Often times panic disorder is chronic and lifelong, so anxiety upon completion of a slow taper should be expected.
Medication doesn't cure an underlying condition unfortunately. Years ago it was thought that a 6 month course of tricyclic antidepressants or even Xanax could somehow "cure" panic disorder. That's wishful thinking and I used to believe it, but it just doesn't make sense unless one believes that medications can rewire the brain permanently so it will produce appropriate amounts of neurotransmitters when the medication is withdrawn.
I think the brain will always try to maintain homeostasis (pre-drug state), even if that homeostatis is "wrong" or "defective".
There was a study that said that people with panic disorder produce "20% less GABA" or have "20% less GABA activity" than controls. This was in those who had never received medication as far as I can remember.
My psychiatrist in 1997 told me to allow 6 to 18 months for a taper off benzodiazepines as I had been on them for 7 years continuously. Now it is 20 years.
Posted by Phillipa on July 2, 2010, at 19:42:42
In reply to Re: Switch to Xanax; depression vanishes; QOL up, posted by sukarno on July 2, 2010, at 15:46:18
Got you beat with the 40 years. But seriously when life events were going well I could stop the low doses and not have any withdrawal. Switched from benzo to benzo throughout the years no problems ever. In the beginning was also on with valium 15 TID mephrobamate 400mg I think and life was good so just stopped it no withdrawal at all didn't know squat about meds then so didn't expect anything adverse maybe that is why? Anyway can you get and maybe try the sustained release xanax? Didn't like it myself as only use the benzos at night for sleep. Phillipa
Posted by sukarno on July 2, 2010, at 20:00:46
In reply to Re: Switch to Xanax; depression vanishes; QOL up » sukarno, posted by Phillipa on July 2, 2010, at 19:42:42
"But seriously when life events were going well I could stop the low doses and not have any withdrawal."
Same here. I found it very easy to taper Tranxene from 7.5mg QID to only BID in a matter of weeks without any withdrawal symptoms that I could remember (in 1996) when life was going really well for me.
I took a trip to Mexico with my friend and we had a great time. No anxiety...no need to increase the dose back to the previous one until winter came around. Winter always made me feel more anxious, perhaps because of cloudy, short days which worsened depression and thus anxiety.
With Xanax though it is pretty hard for me to reduce the dose. In 2004 I tried reducing the dose by only 0.25mg and didn't expect anything bad to happen, but woke up in the middle of the night sweating, breathless and nervous. It wasn't severe, but was unnerving. :-(
Life wasn't that great then though either. Lots of background stress. I suppose if things were as good as they were back in '96, I would be able to taper off much more easily or at least I wouldn't need this high of a dose.
Posted by Phillipa on July 2, 2010, at 21:37:36
In reply to Re: Switch to Xanax; depression vanishes; QOL up » Phillipa, posted by sukarno on July 2, 2010, at 20:00:46
I only take it at night as I don't want to be tired. Strange? Think will cut down more tonight to see???? Phillipa
Posted by bleauberry on July 3, 2010, at 5:00:02
In reply to Switch to Xanax; depression vanishes; QOL up, posted by sukarno on July 1, 2010, at 18:54:29
I remember reading an an old small study on pubmed where xanax was tested as an antidepressant. I think the doses were around 3mg? The results were impressive and the authors concluded there was a GABA theory of depression. Of course we all know it aint that simple. But if it works, it works. That's all that matters.
The only caution I see here is...xanax is sold as a street drug for a reason. People like the way it makes them feel. Maybe relaxed, maybe euphoric. These effects usually develop tolerance requiring higher and higher doses to get the same initial effect. And then of course, the person is addicted at that point and cannot easily get out of the situation. Maybe could work longterm and maybe not, who knows. But for now, if you are getting a vacation from depression, I would give two thumbs up on that.
Posted by sukarno on July 3, 2010, at 17:11:34
In reply to Re: Switch to Xanax; depression vanishes; QOL up, posted by bleauberry on July 3, 2010, at 5:00:02
Tolerance to the intoxicating effects desired by drug seekers develops quite readily with nearly all psychotropic medications requiring ever escalating doses to keep achieving a state of intoxication or "deep relaxation" (sedation).
People often confuse this sedation or subjective sense of intoxication with anxiolysis and mistakenly believe they must feel heavily sedated in order to be free of anxiety (or else the drug must have stopped working).
Tolerance to the sedative effect (which causes a "buzz" in some people or sense of deep relaxation) readily develops but tolerance to the anxiolytic effect does not occur.
That is, tolerance to the anti-panic effect does not occur. If it does it is very rare.
Nearly all drug abusers find that Xanax "does nothing" after a few days of use at the same dosage. It will keep blocking panic attacks and anxiety though, although it won't make them feel "high" or deeply relaxed.
A ten year study also proved this. One could see Xanax as they see pain medication. Taken at the same doses for the long term, pain is kept at bay, although there is no euphoria/"buzz" or relaxation anymore at those doses.
Highly addictive stimulant drugs in Schedule II such as methylphenidate (Ritalin) or amphetamine work to help alleviate ADD/ADHD even in the long term at the same doses.
I'm not sure why tolerance to the anxiolytic effect does not develop, but that is a good thing for those with panic disorder. They won't need to keep increasing the dose to reap the benefits.
The sad thing is the unscientific view taken in the UK among physicians who think that any benefit obtained from long term benzodiazepine therapy is merely psychological (i.e. a placebo effect), but that is not true.
I feel this is another benefit of Xanax: the ability to feel little or no sedation with long term use and still have no panic attacks or anxiety. :-)
Posted by sukarno on July 3, 2010, at 17:22:38
In reply to Re: Switch to Xanax; depression vanishes; QOL up, posted by sukarno on July 3, 2010, at 17:11:34
I should also note that tolerance to the myorelaxant (muscle relaxant) effects of benzodiazepines never develops. For those on diazepam, a dosage of 40mg/day should not be exceeded to avoid respiratory depression, especially in those with sleep apnea. They won't develop a tolerance to this effect.
Muscle relaxation is currently believed to occur by action of BZDs on the spinal cord instead of by action on GABA alone.
Posted by jade k on July 3, 2010, at 18:59:22
In reply to Re: Switch to Xanax; depression vanishes; QOL up, posted by sukarno on July 3, 2010, at 17:22:38
How refreshing to read a positive thread that provides its readers with so much relative information and honest detailed experience about a specific medication. Whether I am interested in this med right now or in the future, I don't feel "thrown around" by hysterical responses. I have a lot of what I would need to make a sound rational choice. Any concerns, problems, etc. (that I saw) were presented calmly and honestly.
Well done (imho)
~Jade
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.