Alternatives To Xanax

[chemist]

and life-enders!!!

I guess you are talking about people trying to end their lives by ingesting large amounts of benzos. The thing is that the benzodiazepines replaced the old barbiturates virtually overnight in the sixties due to the fact that benzos have a very large therapeutic window and a wide safety margin (which the barbs don't have), that is, it is rather difficult to end one's life by overdosing on benzodiazepines alone. However, if you combine benzos with...Well, we are not supposed to talk about this on ThaiVisa.

Some of the worst offenders when it comes to "life-ending" are, by the way, the old tricyclic antidepressants and a few of the new antidepressants as well.

I am sorry for discussing this banned topic , but I figured that the quote above deserved a comment .

Best regards

It's hard to end your life with these drugs, as you say. My good friend was taking an average amount of diazepam daily for depression(prescribed in Thailand). He went back to the USA to come off these drugs in a treatment centre using phenol barbitol or something. He had a seizure and died during treatment. A coincedence?

Well, Neeranam. Here I am sitting in the middle of the night writing posts on ThaiVisa, while most other people are enjoying themselves, getting mao . No, seriously, I highly appreciate your input. After all, wouldn't it be boring if everyone had the same opinion about everything?

Ok, so your friend was taking diazepam for depression!? As you know, diazepam (and other benzos) are prescribed mostly for anxiety issues. Benzodiazepines can actually make depressions worse. This seems to be a fine example of a physician being not responsible (or even competent) when it comes to benzo prescribing. Maybe Thailand isn't the best place to start a professionally handled benzodiazepine treatment...

I guess you are talking about phenobarbital (a barbiturate) here? As I have said in a previous post, barbiturates were used mainly to treat anxiety disorders until the sixties, when the first (and much more safe) benzodiazepines turned up on the market.

Are you sure your friend was not suffering from some form of epilepsy to begin with? I ask this because I know that phenobarbital is still used in some countries to treat epilepsy disorders. I have no idea why this center in the US used phenobarbital to wean your friend off diazepam (which, by the way, also can be used to treat epilepsy). In fact, diazepam is often the benzo of choice (due to its long halflife) to make the discontinuation process smoother for some patients who have experienced too unpleasant withdrawal symptoms when they have tried to stop using shorter acting benzodiazepines like Xanax.

As for the coincidence question, I have no idea. But I can tell you this: If your friend was using phenobarbital at this center, and then decided to cut down on the dose (of this barbiturate) too quickly, he surely risked getting seizures. I am truly sorry about your friend.

When it comes to benzodiazepine use in general, I think I have stated my opinions pretty clearly in my former looooong post.

Best regards

[jumnien]

As Donald Rumsfeld would say, valium is non-addictive in every case where the patient isn't a drug addict (if he got addicted to it he's a drug addict. And valium is very safe though there may be some collateral loss of life upon occasion which is to be expected if we are going to win this war on anxiety.

Just anecdotally, I worked in a detox for two years and based on my experience I don't think it's fair to compare Valium with Heroin and other opiates. You can die during valium withdrawal whereas Heroin withdrawal is just a bit uncomfortable.

Edited July 14, 2007 by mdeland

[chemist]

As Donald Rumsfeld would say, valium is non-addictive in every case where the patient isn't a drug addict (if he got addicted to it he's a drug addict. And valium is very safe though there may be some collateral loss of life upon occasion which is to be expected if we are going to win this war on anxiety.

Just anecdotally, I worked in a detox for two years and based on my experience I don't think it's fair to compare Valium with Heroin and other opiates. You can die during valium withdrawal whereas Heroin withdrawal is just a bit uncomfortable.

International politics aside, I of course understand that the issue we are discussing here is sensitive and upsets many people. mdeland, I commend you for having worked in a detox clinic, as it must have been a very demanding task . But do you honestly believe that you will get a representative view of benzodiazepine treatments by working in a detox facility? Do you really think that the typical benzo prescribed patient has to go to a detox center when it is time to discontinue?

Quote: "You can die during valium withdrawal whereas Heroin withdrawal is just a bit uncomfortable." End of quote.

Yes, there are reports of people dying of seizures during (too rapid) benzodiazepine withdrawal, but these incidents are rare considering the number of people treated with benzos. (You of course have the right to refer to these cases as "some collateral loss of life in the war on anxiety" in some lame attempt to be "funny".)

As for heroin withdrawal being "just a bit uncomfortable", well...no comments needed there.

To put things in perspective:

1) A number of deaths during treatment with antidepressants (especially the SSRIs (the "happy pills") and bupropion (brand name: Wellbutrin in the US)) have been reported. These drugs lower the seizure threshold, and have provoked fatal seizures to a far from non-significant degree. Furthermore, antidepressants have been linked to discontinuation problems and highly unpleasant withdrawal symptoms in many cases (especially when it comes to venlafaxine (brand name in the US: Effexor) and paroxetine (brand name: Paxil in the US)).

So what do you think about this? Should these useful drugs be banned? Can we accept the "collateral loss of life" here?

(Granted, the benzos carry a greater risk than the antidepressants to induce unpleasant withdrawal effects, but where do you want to draw the line?)

2) In my home country Sweden (and I am sure the figure is similar in for example the US), the "blood thinning" drug warfarin accounts for more than 90 % of the drug treatment induced deaths (ALL drugs included). Still it is being used, because it SAVES so many more lives. But can we accept the "collateral loss of life in the war on cardiovascular diseases"?

3) ALL medications have side effects (and in most cases undesirable long-term issues) that in some instances are serious and even fatal. Even the OTC drug aspirine has caused a number of deaths related to acute gastric bleeding.

So hey, why don't we ban ALL drugs so that we can avoid the "collateral loss of life in the war on diseases"!?

As all medicines are potentially dangerous to some degree, there has to be a line drawn somewhere. Risk-benefit analyses have to be carried out for all medications, and then you decide that "this drug has an acceptable risk-benefit ratio, but that drug doesn't have it". That is what it all boils down to. When it comes to the benzodiazepines, the vast majority of countries (if not all of them) have apparently decided that the risk-benefit ratio is acceptable, because the benzos are still around. However, as I have stated one zillion times now, when it comes to benzodiazepine treatments (especially long-term ones) a risk-benefit analysis should be carried out in each individual case (and that approach is valid for many other drugs as well).

Anxiety disorders are highly disabling, carrying the risk of suicide and premature death due to disorder-induced (due to the accompanying excessive stress, for example) cardiovascular problems, strokes, cancer, etc. Furthermore (and obviously) the typical anxiety-ridden individual literally goes through he1l each and every day (I am talking about REAL anxiety here, and not some mild nervousness). For many of these persons, benzodiazepines are the only medications that work satisfactorily. Who are we to deny them the right to gain access to these effective medicines?

As stated before, the subject we discuss here is obviously a delicate one, and many people, including myself, have strong opinions about the matter. I don't claim to possess the only right answers or the only right views, and I highly respect the opinions of the other discussion participants out there (here's to you, Neeranam and mdeland for example: ). I also would like to apologize if my style of writing has been too provocative in the heat of the moment.

My wife has told me that I have spent way too much time in front of the computer lately, and since I am a door mat I tend to agree . I have said what I wanted to say on this matter, and it is unlikely (but you never know ) that I will write any more posts in this thread (at the moment I am exhausted).

Best regards

[Neeranam]

Chemist, thanks for taking the time to air your opinions.

Some things we will never agree on, however I respect your opinion.

I think what you wrote says it all really:-

Benzodiazepine treatment should be initiated, maintained and discontinued under a responsible physician's supervision. When it is time to stop the treatment, the patient should be informed that the taper should proceed slowly to avoid too unpleasant withdrawal effects. The key issues here are supervison and monitoring by a physician during the whole period of treatment.

I'm glad to hear that you're off 2mg Clomazepam - that's a lot - isn't that equivalent to 40mg diazepam? You're one of the lucky ones.

[Youbloodybeauty]

2) In my home country Sweden (and I am sure the figure is similar in for example the US), the "blood thinning" drug warfarin accounts for more than 90 % of the drug treatment induced deaths (ALL drugs included). Still it is being used, because it SAVES so many more lives. But can we accept the "collateral loss of life in the war on cardiovascular diseases"?

Hi Chemist,

Thanks for your insight into these chemicals. I've an interest about your point above (a bit off topic) but why do you say warfrin accounts for 90% of deaths? What's the story there? Thanks.

[chemist]

Chemist, thanks for taking the time to air your opinions.

Some things we will never agree on, however I respect your opinion.

I think what you wrote says it all really:-

Benzodiazepine treatment should be initiated, maintained and discontinued under a responsible physician's supervision. When it is time to stop the treatment, the patient should be informed that the taper should proceed slowly to avoid too unpleasant withdrawal effects. The key issues here are supervison and monitoring by a physician during the whole period of treatment.

I'm glad to hear that you're off 2mg Clomazepam - that's a lot - isn't that equivalent to 40mg diazepam? You're one of the lucky ones.

Ok, I will break the promise I made in my previous post (I said I would not post on this thread anymore), and the reason for this is Neeranam's kind words above .

Neeranam: Yes, according to Ashton's equivalence chart 2 mg of clonazepam corresponds to 40 mg of diazepam, but I have seen other charts where for example 2 mg of clonazepam is "equal" to 20 mg of diazepam.

I think we will have to agree to disagree. Nothing wrong with that. On the contrary; wouldn't this world be a boring place if everyone had the same opinions about everything? I think it is always refreshing to get your own views challenged by other people, and in the process maybe learn something new. I have certainly been forced to scrutinize my own opinions during the debate here, although I basically still have the same views about benzos.

Thank you for your very valuable input Neeranam, and take care!

Best regards

chemist

[Youbloodybeauty]

I have certainly been forced to scrutinize my own opinions during the debate here, although I basically still have the same views about benzos.

Thank you for your very valuable input Neeranam, and take care!

Same here Neeranam

[Neeranam]

Enjoy the rest of the weekend!

[chemist]

2) In my home country Sweden (and I am sure the figure is similar in for example the US), the "blood thinning" drug warfarin accounts for more than 90 % of the drug treatment induced deaths (ALL drugs included). Still it is being used, because it SAVES so many more lives. But can we accept the "collateral loss of life in the war on cardiovascular diseases"?

Hi Chemist,

Thanks for your insight into these chemicals. I've an interest about your point above (a bit off topic) but why do you say warfrin accounts for 90% of deaths? What's the story there? Thanks.

Ok Ybb, I will write yet another post .

Maybe my statement above has the potential for misinterpretation (English is not my native language). Anyway, a number of people die as a direct result of drug treatment (due to side effects, overdosing, etc). Out of those medication-related deaths, warfarin is the guilty drug (the "killer") in more than 50 % of these unfortunate cases in Sweden (and, as I said above, I am sure the figure is similar in other countries). Please note that it should be 50 %, and not 90 % (sorry for that mistake). The figure is still astonishingly high, though.

If you want to know more about warfarin, I am sure there is more than enough information to find through Google, for example.

Regards

[Youbloodybeauty]

Ok Ybb, I will write yet another post .

Hi Chemist,

Top of my Google search was THIS.. Speaking directly is much more informative!

Thanks for the warning though, will look further...

Regards YBB

Edited July 15, 2007 by Youbloodybeauty

[chemist]

Ok Ybb, I will write yet another post .

Hi Chemist,

Top of my Google search was THIS.. Speaking directly is much more informative!

Thanks for the warning though, will look further...

Regards YBB

######. It seems I can't stay away from this topic .

Yeah, how many people know that the widely prescribed "blood thinner" warfarin is used as rat poison? Or the other way around, how many people know that the rat poison warfarin is used as a medicine for people with an increased risk of embolism, for example?

Well, new drugs that are supposed to replace warfarin are on the way. One example is AstraZeneca's ximelagatran (brand name: Exanta), which, unfortunately, has run into some problems (the drug is suspected to cause liver damage).

Cheers

[girlx]

hey sheryl, i am interested in this topic again, and was reading about buspirone, which is also non-addictive.... any comments on using it to treat general anxiety disorder? does it help depression?

[zorro1]

i have generalized anxiety disorder and was prescribed xanax about 5 years ago by my doctor at home. i rarely use it unless i am really stressed out, and still have a couple pills left from that time (which probably have expired now). recently i have been under more stress than usual and have been thinking of ways to treat it. i tried to get a new prescription of xanax from a clinic near me but they treated me like a drug addict, and i doubt i will find the real version at an pharmacy outside of the hospital. so i have been looking at alternatives... thus far i have tried passion flower capsules, which a pharmacist in malaysia recommended to me. it actually worked pretty well to calm me down but i bought a small bottle and haven't been able to find more around here. i have tried valerian as well (another herb) but that didn't really work at all. i have also tried yoga (been doing it for a year) and that works really well, when i have time to do it (which is rarely these days as i am overwhelmed by work and personal crises). any other suggestions? thanks for any help.

nah you can get them and there the real thing. go to the larger of the 2 chemists cnr soi 3 and sukhumvit Nana BKK. just say you want xanax for sleep but say it confidently. Be carful they are double strength though 1mg and i think 1000bht for for a single foil maybe 12 tablets?

Edited December 5, 2007 by zorro1

[girlx]

i am not interested in getting xanax, if you read the thread. if i were, i would go get legitimate xanax from a hospital.

[Neeranam]

i have generalized anxiety disorder and was prescribed xanax about 5 years ago by my doctor at home. i rarely use it unless i am really stressed out, and still have a couple pills left from that time (which probably have expired now). recently i have been under more stress than usual and have been thinking of ways to treat it. i tried to get a new prescription of xanax from a clinic near me but they treated me like a drug addict, and i doubt i will find the real version at an pharmacy outside of the hospital. so i have been looking at alternatives... thus far i have tried passion flower capsules, which a pharmacist in malaysia recommended to me. it actually worked pretty well to calm me down but i bought a small bottle and haven't been able to find more around here. i have tried valerian as well (another herb) but that didn't really work at all. i have also tried yoga (been doing it for a year) and that works really well, when i have time to do it (which is rarely these days as i am overwhelmed by work and personal crises). any other suggestions? thanks for any help.

nah you can get them and there the real thing. go to the larger of the 2 chemists cnr soi 3 and sukhumvit Nana BKK. just say you want xanax for sleep but say it confidently. Be carful they are double strength though 1mg and i think 1000bht for for a single foil maybe 12 tablets?

What a ripoff - you must be an addict to pay that price.

[zorro1]

i am not interested in getting xanax, if you read the thread. if i were, i would go get legitimate xanax from a hospital.

. i rarely use it unless i am really stressed out, and still have a couple pills left from that time (which probably have expired now). recently i have been under more stress than usual and have been thinking of ways to treat it. i tried to get a new prescription of xanax from a clinic near me but they treated me like a drug addict, and i doubt i will find the real version at an pharmacy outside of the hospital. so i have been looking at alternatives

Read your own post lady. Says you doubt you will find the real version at a pharmacy outside hospital so you looking for alternatives. Im simply telling you that you can

i have generalized anxiety disorder and was prescribed xanax about 5 years ago by my doctor at home. i rarely use it unless i am really stressed out, and still have a couple pills left from that time (which probably have expired now). recently i have been under more stress than usual and have been thinking of ways to treat it. i tried to get a new prescription of xanax from a clinic near me but they treated me like a drug addict, and i doubt i will find the real version at an pharmacy outside of the hospital. so i have been looking at alternatives... thus far i have tried passion flower capsules, which a pharmacist in malaysia recommended to me. it actually worked pretty well to calm me down but i bought a small bottle and haven't been able to find more around here. i have tried valerian as well (another herb) but that didn't really work at all. i have also tried yoga (been doing it for a year) and that works really well, when i have time to do it (which is rarely these days as i am overwhelmed by work and personal crises). any other suggestions? thanks for any help.

nah you can get them and there the real thing. go to the larger of the 2 chemists cnr soi 3 and sukhumvit Nana BKK. just say you want xanax for sleep but say it confidently. Be carful they are double strength though 1mg and i think 1000bht for for a single foil maybe 12 tablets?

What a ripoff - you must be an addict to pay that price.

You sir are a total f--kwit for making that assumption. I have a serious sleep disorder which left me no alternative at the time. 1 foil is 24 normal strength tabs which is around what you would pay back home. Of course they cost a bit more its like airport food, what choice do you have?

[Sheryl]

Ok guys, enough with the name calling.

Consider yourselves even and drop it.

Girlx, Buspirone does treat anxiety, and yes, it is non-addictive but it has quite an impressive array of side effects and has to be taken regularly for a week or two before you see the results.

It can trigger an episode of depression, sometimes quite serious depression.

I don't think it is advisable to take except under medical supervision.

I think the best thing for you would be to get into therapy and work on resolving the underlying cause of the anxiety. There is an notice pinned on this forum that lists a number of places with western therapists.

If in addition you need something to take the edge of the anxiety, the safest thing would be atarax 50 mg (it comes in both 10mg and 25 mg strengths in Thailand, the 10mg strength is for use as an antihistamine, for anxiety the dose is 50 mg). But that should be only very temporary, and it will make your mouth dry and may make you sleepy, don't drive a car or moto after taking it.

Some antidepressents are also sometimes helpful in generalized anxiety disorder but they need to be chosen and used with care, as there's a risk of worsening the anxiety.

Really, you should get professional care. Most therapists have a psychiatrist they refer to for prescribing meds where needed. A therapist who knows you can much better assess whether you need meds and if so what type might be best.

A course of Vipassana meditation would also be extremely helpful.

Good luck

[george]

I use Atarax when I have problems with sleep. Works wonder and is not addictive.

[stevenjm]

I'd totally stay away from any benzo's. have had addictions to xanax and rohypnol before without even realising it. addiction to xanax, in my opinion, comes faster than any other benzo i know - only takes a week or two and your addicted - stop and you get no sleep and massive migrain headaches for 5 days. rohypnol addiction is even worse - you get the no sleep, migraine headaches and vomiting thats so bad that your stomache muscles won't stop vomiting and you can barely breathe.

I'd never go near benzo's again and as for the antidepressants they don't work but when you try to stop them you get totally depressed and your heart does really weird things - ive been trying to stop the dam_n things for 3 months and am on a miniscule dose but just can't get past it (lexapro)

The only thing i have found that works without effecting your brain function and is absolutey great for GAD is a new drug called Lyrica - its been aproved for treating GAD in several countries and has had great results, much more effective than antidepressants. The down side is that its very expensive and, for me, it seems to make my eyes get a little bloodshot sometimes. Its related to neurontin and its a drug for neuropathic pain but i'd really recomend it for anybody with GAD and beleive me i'm an expert on just about every drug known to mankind in trying to find an answer to GAD including the illicits.

[Sheryl]

Thanks for that Steve, I had totally forgotten Lyrica since it is so new. But it does indeed seem to offer new hope for people with hard to treat GAD and panic disorders.

Girlx, your problem will be getting this as it will only be obtainable through a one of the international hospitals and only psychiatrists who are very up to date on the literature will know about it. Both of which spell B-A-N-G-K-O-K, but might be worth a trip. I would suggest you try this doctor at Samitivej Hosp Western trained with special interest in this field:

http://www.samitivejhospitals.com/samitive...11190&Img=1

or if you prefer, this one at Bangkok Hospital:

http://www.bangkokhospital.com/App/doctorp...&Lang=en-US

Be sure to mention your history of addiction and ask specifically about Lyrica.

[Dakhar]

I had a doctor in the US Rx Ambien, I believe 10mg. He said he knew people got addicted to the stuff, but he didn't think addiction was a bad thing...?!

Well. it was a horible experience, tha anxiety, dry eyes, etc.

The the ultimate was this:

I woke up in the morning naked, my wife naked, and she had a "love bite" or hickey as some folks call them. I usually am not one to do that. I asked her what happened. She said I bassically attacked her, and yes we had sex...

I have absolutley NO MEMORY of that event... Nada...

After that I swore off Ambien, and getting off of it wasn't too easy. But I did.

[pete66]

I had a doctor in the US Rx Ambien, I believe 10mg. He said he knew people got addicted to the stuff, but he didn't think addiction was a bad thing...?!

Well. it was a horible experience, tha anxiety, dry eyes, etc.

The the ultimate was this:

I woke up in the morning naked, my wife naked, and she had a "love bite" or hickey as some folks call them. I usually am not one to do that. I asked her what happened. She said I bassically attacked her, and yes we had sex...

I have absolutley NO MEMORY of that event... Nada...

After that I swore off Ambien, and getting off of it wasn't too easy. But I did.

I'm really curious - does anyone have a succinct answer for the question "why do anti-depressants take so long to work" - they are often quoted as a "month or two" before working. What is going on in the meantime? Is it chemical, psychological, combination, something else entirely?

[mrtoad]

I'm really curious - does anyone have a succinct answer for the question "why do anti-depressants take so long to work" - they are often quoted as a "month or two" before working. What is going on in the meantime? Is it chemical, psychological, combination, something else entirely?

Hmm, well it is a little difficult to actually categorise all under the same header. For example there are different types of Anti=depressants - monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), Noradrenergic and specific serotonergic antidepressants (NaSSAs),Norepinephrine (noradrenaline) reuptake inhibitors (NRIs),Norepinephrine-dopamine reuptake inhibitors (NDRIs), Selective serotonin reuptake enhancers (SSREs), tetracyclic antidepressants (TeCAs), selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs).

These days the more common prescribed antidepressants come from the SSRI group, along with the SNRI's - mainly you will find that the side effects are supposidly less, and the fact that they are quicker acting. Clinical trials have shown that SSRI's and SNRI's can often start to show some results within the first week of actually taking the medication. To be honest, if there had been no evidence of the prescribed medication working after 8 weeks, most Doctors would be looking to change the anti-depressant or possibly add an augmenter drug. To be honest, there are a number of ways at looking at how these drugs work - but in the end no one is absolutley certain (of course research has shown that there is a chemical element to this) - from my experience though whilst there is most certainly a chemical element involved, there is also the "placebo" effect from taking the medication as well (in effect Psychological). If we look at the chemical effect, then we have to understand that in basic terms the medication is altering the chemical balances, and therefore this can be very different from patient to patient - hence there is no "set amount of days" for evident results, and in some cases if any. In the end most cases of "genuine depression" need to be treated with a combination of an anti-depressant along with Cognitive Behaviour Therapy approach form the therapist/Nurse. Patienets who respond well to treatment generally engage in changing lifestyle, diet and exercise along with the talking therapies.

A significant amount of people who are prescribed Anti-depressants have been mis diagnosed due to laziness on the doctors behalf, and do not fit the correct criteria for prescribing.

Sorry, that I can't give you an exact answer.

[indoroids]

xanax is the best

why search for alternative? herbal is useless

[mrtoad]

xanax is the best

why search for alternative? herbal is useless

I would strongly recommend that you do not take Xanax over a long period. It is fine for short term interventions, and occasional use. Ultimately many people would benefit from making some lifestyle changes, and improving their sleep hygiene if they are having sleep problems.

[indoroids]

valium or ativan are good alternative

[Sheryl]

valium or ativan are good alternative

Same disadvantages as xanax:

- controlled substances, illegal to purc hase OTC or posess in Thailabnd without a prescription

-- addictive

etc etc

[Chivas]

xanax is the best

why search for alternative? herbal is useless

I would strongly recommend that you do not take Xanax over a long period. It is fine for short term interventions, and occasional use. Ultimately many people would benefit from making some lifestyle changes, and improving their sleep hygiene if they are having sleep problems.

So easy to say but so hard to implement for some....

I haven't slept for 20 years nearly, meaning I'm awake 2 nights completely, and on third night I will sleep through exhaustion but still I have arsehol_e doctors telling me they know better, and refusing sleeping tablets.

Edit-I didnt spell my description of doctors that way...

Edited August 16, 2011 by Chivas

[Sheryl]

Have you been checked for sleep apnea in a sleep lab?

[houseinbkk]

Ive not slept in the evening since coming to Thailand 8 days ago, and its starting to do my head in so ive gone and bought some Diazepam to get me too sleep and help me relax..

The ones ive got are DAZ (diazepam) 10mg made by SAFE pharmaceuticals, from Pakistan it comes in a blister packet of 10, from a certain Chemist in Soi 22.

Now are these the real thing as i opened one blister and it crumbled out into 2 pieces. Also is about 1/3 of these the right amount to take to get me too sleep, ive taken Diazepam in the UK stolen from my mother and i believe these were only 2mg (the yellow ones)