Xanax dependence (among other things)?

My past pdoc said I could take Xanax three times a day. So, I took her up on that advice because I was feeling anxious at that time in my life. This was around a month ago, maybe a little longer. Now, after switching pdocs, given that my old one was prescribing too much Zyprexa (15 mg) and my parents got all mad about it and were against my pdoc (I don't know why, because it seemed to be helping me)--that aside--I switched pdocs and the new one quickly titrated me down to 5 mg Zyprexa. Now, he raised my Zyprexa to 7.5 mg. But I still am not off of the Xanax, which worries me, because I don't think it really even has much of an effect anymore. My current pdoc said I could go down on Xanax by cutting the dose in quarters and for one week, I should take 3/4 of a pill, then after that, 1/2 of a pill for a week, and then after that, 1/4 of a pill for a week, then after that, nothing in terms of Xanax. I haven't felt confident enough in my decision-making lately to cut down on the Xanax in that way.

Anyway, I am just looking for some support on meds and what to do when your parents oppose your pdoc's decisions (my parents are 5,000 miles away and I'm 26 years old, for context). I don't know what to do because now I feel dependent on Xanax. Also, I could go back to the old pdoc, who I liked more because she was better, I felt, at her job and didn't make changes rapidly. The new pdoc also made other changes really quickly, like upping my Effexor XR from 300 mg to 450 mg instantaneously, and also upping my Abilify from 22.5 mg to 30 mg over the course of a couple weeks.

To top things off, when I ran out of Remeron one day and I forgot to refill the prescription, my new pdoc refused to give me the prescription that day (I live like four or five blocks from his office)--and said I'd be fine if I didn't take 45 mg Remeron one night, save for the fact that I can NEVER sleep without Remeron, a fact which I told him and he still couldn't give me the prescription.

Also the new pdoc charges significantly more. I know what I feel like doing, but I am afraid my parents will oppose it.

Hi, skibum. Are you financially dependent your parents? In the U.S., where I am, many, if most 26 year olds, don't tell their parents everything, especially about the psychiatrists they go to and the meds they take.

If they aren't paying your bills, then you don't have to do what they say. They will get mad and maybe even threaten you, but you have to take care of yourself. Is that what you wanted to hear?

I know some doctors are getting their patients off drugs like Xanax because they can affect memory and other such brain issues.

I was on Klonopin ( a much more powerful anxiety-reducing) drug and gradually weaned myself off of it--and now I take Xanax just occasionally. So, you can do it, I know. What does the new doc recommend for your anxiety?

Hi, I am financially dependent on my parents, so I think that's some (or all) of the problem. I haven't confided so much in my ability to hold down a job. The new doc still says to take Xanax, but that I can reduce it slowly if I want to.

I am living independently (though with my parents' support) abroad. So I think that if I can find a job, that would be ideal, and maybe it would lessen the burden I carry.

xanax can be difficult to reduce. some experts recommend a switch to Valium/diazepam (I think its xanax x 20= valium dosage) and then a slow taper off that, if possible.

sorry about your struggles.

Hi @skibum801

Quote:

Originally Posted by skibum801 My past pdoc said I could take Xanax three times a day. So, I took her up on that advice because I was feeling anxious at that time in my life. This was around a month ago, maybe a little longer. Now, after switching pdocs, given that my old one was prescribing too much Zyprexa (15 mg) and my parents got all mad about it and were against my pdoc (I don't know why, because it seemed to be helping me)--that aside--I switched pdocs and the new one quickly titrated me down to 5 mg Zyprexa. Now, he raised my Zyprexa to 7.5 mg. But I still am not off of the Xanax, which worries me, because I don't think it really even has much of an effect anymore. My current pdoc said I could go down on Xanax by cutting the dose in quarters and for one week, I should take 3/4 of a pill, then after that, 1/2 of a pill for a week, and then after that, 1/4 of a pill for a week, then after that, nothing in terms of Xanax. I haven't felt confident enough in my decision-making lately to cut down on the Xanax in that way.

Are you financially independent of your parents? Would they even know if you continued seeing your old p-doc?

Quote:

Anyway, I am just looking for some support on meds and what to do when your parents oppose your pdoc's decisions (my parents are 5,000 miles away and I'm 26 years old, for context). I don't know what to do because now I feel dependent on Xanax. Also, I could go back to the old pdoc, who I liked more because she was better, I felt, at her job and didn't make changes rapidly. The new pdoc also made other changes really quickly, like upping my Effexor XR from 300 mg to 450 mg instantaneously, and also upping my Abilify from 22.5 mg to 30 mg over the course of a couple weeks.

I think you are old enough to do what you want about your own healthcare. I do not know if you are in the US but if you are we have HIPPA laws that prevent your medical info being discussed with anyone without permission. As long as you do not grant permission for your doc to talk to your parents they cant get any info about you from your doc.
Dependence and addiction are different things. Are you worried that you are addicted and abusing the xanax? Are you concerned that you are physically dependent on it? Or are you upset that you need it?

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To top things off, when I ran out of Remeron one day and I forgot to refill the prescription, my new pdoc refused to give me the prescription that day (I live like four or five blocks from his office)--and said I'd be fine if I didn't take 45 mg Remeron one night, save for the fact that I can NEVER sleep without Remeron, a fact which I told him and he still couldn't give me the prescription.

Aside from the other stuff this is plain negligence IMO.

I'm not worried that I'm addicted to the Xanax, though I am worried that I am physically dependent on it. I'm also somewhat upset that I need it.

Also, at times, I've had alcohol on Xanax, and I know that's a huge no-no.

I have quit alcohol since the last time I drank on Xanax, but the last time I did drink on Xanax, bad things happened (I got my phone stolen because I was so out of it). So that's worrying.

I have to say, the Xanax definitely helps with my anxiety though.

I feel like the stuff with my parents messed me up though--them trying to intervene in my mental healthcare from 5,000 miles away (or whatever it is).

I know that I should be less dependent on them, but I am not financially independent of my parents at this moment in time.

I do understand, however, that since I am the age I am, my parents don't need to worry about my mental health the way they do (it's mostly my mother).

Also, I agree that the psychiatrist's behavior was negligent. I have since scheduled an appointment with the psychiatrist I was seeing before. So, we'll see how that goes.

Thanks.

I saw you have a diagnosis of schizoaffective listed in your profile. Without knowing more about you, your mental health and medical history, it's hard to talk specifics, but what I can say is that 15mg of Zyprexa by itself is not a terribly high dose. I work on a unit for people with various psychotic disorders and i would say 10-20mg is pretty normal and I've also seen up to 40mg in more extreme cases, but only a handful of times

But like I said before, it also depends on what the Zyprexa is supposed to be treating, how it's working, and any side effects. There are a few common side effects of Zyprexa — increased appetite/weight gain, sedation, and metabolic syndrome (i.e. it can mess with your cholesterol, your triglycerides, blood sugar, etc.). That's why doctors generally only prescribe people as much as they need and not more; some doctors also prescribe a medicine (metformin) to help with the metabolic issues.

If you're still on high dose Abilify as well, that might be partly why your doctor wants to reduce the dose of the Zyprexa. They don't work identically, but Abilify and Zyprexa are both in the same class of meds and while not unheard of, depending on what country you live in and severity of symptoms, a lot of prescribers try to avoid putting people on > 1 antipsychotic.

** I re-read what you wrote and I'm more confident your doctor might be concerned about side effects with all these meds. Abilify, Remeron, and Zyprexa can all cause significant sedation and weight gain, even in already healthy or underweight people. (I've worked with patients who have gained 20-30lbs in two weeks just from Zyprexa.)

Also, if you feel like you need a benzo to help manage your anxiety, I'd recommend trying a different one. Xanax can be very habit forming, both due to how to works and its very short half-life, requiring you to take it 2-3 times a day. Depending on how high of a dose you get to too, it can be a pain to taper off of — more so than other benzos.

Klonopin is a pretty common alternative to Xanax. It's pretty much equal potency, but it's got a longer half-life, so you should only have to take it once or twice a day.