Occasional Xanax Use For Sleep

• Updated treatment guidelines from the American Academy of Sleep Medicine published in 2018 don’t recommend trazodone for chronic insomnia because there's so little data to support its use.
• Xanax occasional use A 31-year-old female asked: i have prescription for.25mg of xanax (alprazolam) i use occasionally, like 2-4 times a month.
• Re: Low dose Xanax at bedtime for anxiety/sleep I also have been taking it when i need it, it does work if you take it on an empty stomach it hits me real hard and you get drowsy but when i take it at night i feel great and makes me eel so happy! Its hard not gettig adicted to them.
• Sleep disorders are not uncommon among individuals suffering from anxiety or depression, and the use of a drug such as Xanax can help the patient to relax so that it becomes easier to fall asleep and stay sleeping. This drug is not prescribed to people who occasionally struggle to be able to fall asleep.

Hi, @bruce0712 – Since you've now stopped taking zolpidem (Ambien), I'd like to request @sndishpr @contentandwell @kenny52 @rachel123 return to this discussion to offer any tips they may have on getting to sleep on occasional nights when you cannot sleep for whatever reason.

Asked

28 Nov 2009 by Anonymous

Updated

15 February 2019

Topics

xanax, anxiety, generalized anxiety disorder

I am prescribed .25mg (very low dose) of xanax (alprozolam) for anxiety. From many of the posts I have read, it has been said that xanax is a terrible long term drug. I only take .25mg of the drug maybe twice a week at the most sometimes going for months without it because i only take it as needed. at this rate will my body build a tolerance to the drug? I really want to continue to use the drug as needed in the long term (years), considering how little I take xanax is this okay to use for many years to come or should I look into switching medications?

Hi
i have been off and on xanax for twenty years I never got above 10mg a day and that when i choose to abuse it. I take it for panic attacks and i take 1mg to 4mg a day and i am ok with that because i dealt with alot of trauma and i can go outside and live. I think the dose your on is fine and at that level and in frequency it sounds like you have a good handle on it. Xanax is a tough drug because it does work so well for anxiety and panic attacks. You are one of the only person I have ever heard of at that dose. Dont sweat it you are doing well. I set a guldeline for my self I dont go above 4mg a day and I only get weekly prescriptions and I see a dr and therapist weekly. We are looking into alternatives but at 42 i am ok if i have to take a couple of pills to make the panic go away and i live a productive life, I dont buy them off the street, i dont run out of them, i dont sell them. So you are doing very well. If you notice you are going up talk to someone and see what is going on in your life. Good luck and you are fine.

if your only using it that often i dont think it should build up a tolerance since xan clears your system (but if you start taking more often this is one of the most addictive benzos) within the day but in my opinion valium is overall better for most people. it lasts 100+ hours in the system before termination and since you dont need to take them very often less chance to build a tolerance. this also makes it easier to taper off of if you do start building anything. i havnt been on any benzo prescrips but i have been on them and i would have to say the xan are much more addictive.

I have panic attacks. I have been on .5 mg for about 7 years and a VA doctor just told me I won't get any more, that I was 'addicted'. I took 1mg mg to sleep every night and 0 to 1mg per day for anxiety and it was fine. Now I take Ambien to sleep, so don't need as much Xanax, but need some during the day for anxiety in order to live a full life. I know when I am addicted. I am not. It works and that is why it was developed. The doctors are CYA rather arbitrarily. M.D.'s or not, they are wrong on this one. I am sick and tired of doctors paranoid over controlled drugs because some people abuse them. I don't. Doctors need to treat people like we have some intelligence but they too often take the route of medication with more side effects, etc., because it is safer for them, but ineffective or worse for the patient.

I couldn't agree more with you about some doctors and their CYA attitudes, especially the one I recently encountered at my local VA clinic. I think they must all have got that way because they are constantly being sued and abused. My son is a surgeon and I do have some sympathy and understanding regarding their struggle to satisfy unreasonable patients and still help them. The PA at my VA clinic categorically refused to prescribe .5 mg alprazolam, and would only give me a limited amount of 5mg zolpidem. My problem is insomnia and other doctors have been prescribing .5 mg of alprazolam and 10 mg of zolpidem. I then cut those pills in half, and I have been doing this almost 20 years now. I recently moved and have a new doctor. I could go to the VA, but since they won't prescribe these things for me, I had to get a Medicare Advantage plan. My new doctor is OK about prescribing these sleep meds for me. But he warned me about dependency.

My thinking is that it is fine to be dependent on them, the way I am dependent on food and oxygen. But I did decide to try to research the topic and that is how I ended up here. Last night I did not take my alprazolam or zolpidem and had one of those horrible, sleepless nights that I remember from 20 years ago. I am 74 yrs old and in excellent health, very active, no depression or anxiety. I think I am just going to get dependent or remain dependent on these sleep meds and not suffer these horrendous sleepless nights anymore and not fret about the dependency. As long as my doctor will keep on prescribing them and they remain affordable through insurance, or on my own nickel, if necessary.

I know this is an old post but it's handy info I was on Xanax 0.25 X 3 times a day for 18 years for panic disorder weened off them over 6 mths and I'm fine. All the best

I need some advice concerning this 2 yrs ago I was diagnosed with pulmonary HP Iwas put om losartan/hct 100/25 1 x a day I was also diagnosed with Dysthymia Disorder. I at 1st was prescribed Wellbutrin 150mil 2x a day about a yr later I was prescribed Xanax 0.25 mil as needed it was later boosted to 2x day I felt a lot better mood/anger depression ect basically gone you are all going to have a few bad day its life.Sometime during Aug of this yr I noticed a changed lil more bummed out and mood swing Irritated anger went back to the doctor in Sept she changed the Xanax to 0.5mil 2x a day it works for the most part but I am still sort of bummed out any idea why? I been on the wellbutrin for 2yrs now at 300 mil a day

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As an academic psychiatrist who treats people with anxiety and trauma, I often hear questions about a specific class of medications called benzodiazepines. I also often receive referrals for patients who are on these medications and reluctant to discontinue them.

There has been increasing attention into long-term risks of benzodiazepines, including potential for addiction, overdose, and cognitive impairment. The overdose death rate among patients receiving both benzodiazepines and opioids is 10 times higher than those only receiving opioids, and benzo misuse is a serious concern.

What are benzodiazepines?

Benzodiazepines are a class of anti-anxiety medications, or anxiolytics, that increase the activity of the gamma-aminobutyric acid receptors in the brain. GABA is a neurotransmitter, a molecule that helps brain cells, or neurons, communicate with each other. GABA receptors are widely available across the brain, and benzodiazepines work to reduce anxiety by enhancing GABA inhibitory function.

The benzo family includes diazepam, or Valium; clonazepam, or Klonopin; lorazepam, or Ativan; chlordiazepoxide, or Librium; and the one most commonly known to the pop culture, alprazolan, or Xanax, among others.

Different benzos have similar effects, but they differ in strength, how long it takes for them to work and half-life, a measure of how long the drug stays in your system. For example, while diazepam has a half-life of up to 48 hours, the half-life of alprazolam can be as short as six hours. This is important, as a shorter half-life is linked with higher potential for addiction and dependence. That is one reason physicians typically are not excited about prescribing Xanax for long periods of time.

When are they used?

When benzos were introduced to the market in the 1950s, there was excitement as they were considered safer compared to barbiturates, which had been used to treat anxiety. By the 1970s, benzos made it to the list of the most highly prescribed medications.

Occasional Xanax Use For Sleep Apnea

Benzos are mainly used to treat anxiety disorders, such as phobias, panic disorder and generalized anxiety disorder. They are mostly used for a short period at the beginning of the treatment. That is because it may take a few weeks for the main pharmacological treatment for anxiety, antidepressants, to kick in. During that time, if anxiety is severe and debilitating, benzodiazepines may be prescribed for temporary use.

Occasional Xanax Use For Sleep Anxiety

Benzos are also prescribed for occasional situations of high anxiety, such as that caused by phobias. The main treatment of phobias, such as excessive fear of animals, places, and social interactions, is psychotherapy. Sometimes, however, phobias can interfere with one’s functioning just sporadically, and the person may not be interested in investing in therapy. For example, a person with fear of flying who may fly on a plane once or twice a year may choose to take a benzo before flying. However, for a businessman or woman who flies several times a months, psychotherapy is recommended.

Benzos may also be used for situations of short-term stress, such as a stressful job interview.

Benzos are also used for other medical conditions, such as treatment of seizures or alcohol withdrawal in the hospital. There is no good evidence for use of benzos in post-traumatic stress disorder.

So why the worry?

Now we get to the part about why I and other doctors are not eager to prescribe benzodiazepines for long-term use: We have a Hippocratic oath to “first do not harm.” I sometimes tell patients who insist on getting benzos: “I am not paid differently based on the medication I prescribe, and my life would be much easier not arguing with you about this medication. I do this because I care about you.”

A major risk of long-term use of benzos is addiction. That means you may become dependent on these meds and that you have to keep increasing the dose to get the same effect. Actually benzos, especially Xanax, have street value because of the pleasant feeling they induce. In 2017, there were more than 11,000 deaths involving benzos alone or with other drugs, and in 2015, a fifth of those who died of opioid overdose also had benzos in their blood.

Benzos to anxiety can be seen like opioids to pain. They both are mostly for short use, have a potential for addiction and are not a cure. Benzo overdose, especially when mixed with alcohol or opioids, may lead to slowing of breathing and potentially death. Benzo misuse can also lead to lack of restraint of aggressive or impulsive behavior.

As benzos are sedating medications, they also increase the risk of accidents and falls, especially in the elderly. This is worse when they are mixed with other central nervous system suppressants like alcohol or opioids.

Recently, we have been learning more about the potential cognitive, memory, and psychomotor impairment in long-term use of benzodiazepines, especially in older adults. Cognitive functions impacted may include processing speed and learning, among others. Such effects may persist even after discontinuation of long-term use of the benzos.

Stopping benzos abruptly, especially if high dose, can cause withdrawal symptoms, such as restlessness, irritability, insomnia, muscle tension, blurred vision, and racing heart. Withdrawal from high doses of benzos, especially those that are shorter acting, may be dangerous, leading to seizure, and getting off of these medications should be done under supervision of a physician.

Safer options abound

There are safer effective treatments for anxiety, but they require patience to work. A first line of treatment for anxiety disorders is psychotherapy, mainly cognitive behavioral therapy. During therapy, the person learns more adaptive coping skills and corrects cognitive distortions to reduce stress.

Exposure therapy is an effective treatment for phobias, social phobia, obsessive compulsive disorder, and PTSD. During exposure therapy, the person is gradually exposed to the feared situation under the guidance of the therapist until the situation does not create anxiety anymore. Importantly, the skills earned during therapy can always be used, allowing better long-term outcome compared to medications.

Medications are also used for treatment of anxiety disorders. The main group of such medications is selective serotonin reuptake inhibitors, commonly known as antidepressants. Examples of such medications are fluoxetine, sertraline, and citalopram. Especially when combined with psychotherapy, these medications are effective and are safer options than the benzos, and without a risk of addiction.

This article was originally published on The Conversation by Arash Javanbakht. Read the original article here.