How to avoid negative effects of Xanax?

[Nubbly]

So my doctor recently prescribed me some Xanax for my panic attacks (I already have huge anxiety issues just being outside, and sometimes out of nowhere my heart beat goes absolutely crazy even if I'm not in a social situation), and I'm wondering how to minimize any long-term negative effects of taking them. The pills I received were 1mg, but I started by splitting one in half, they definitely took the edge off. A day later I took an full pill before a meeting with some friends at a party and I was finally able to be my self. Despite the positive effect its had on my life I've been worried about using them as a solution to dealing with stress.

I've read a decent amount of information and it all seems to point towards benzo's increasing the risk of dementia/brain damage later in life; that really scared the crap out of me. So, is there a set of rules I should follow to avoid those risks? I've already decided to put myself on a 3-4 day hiatus between taking them, but I don't know if that's enough to avoid any sort of long-term damage.

I don't plan on taking these permanently, but I want to know if there's a hard limit where I should just completely cut them out of my life. If possible I'd like to be able to use them on occasion in high-stress situations, but if that means raising my chances for developing dementia in my later years I'd rather just cut them out entirely.

Sorry for the disorganized question, and thank you to anyone willing to impart some insight.

 

[Keif' Richards]

Please be aware that there is no direct link established between Benzodiazepine use and neurotoxicity. I've heard theory bandied about, but as of right now, Benzodiazepines are still considered to be very safe and effective medications with a wide therapeutic index. I would stop worrying about the dementia.

The more serious danger with using Benzodiazepines for these purposes is developing addiction/dependence. It's difficult when you have problems in your life that are "solved" by consuming a small pill. Anxiety really sucks and with access to an antidote, it can be very hard to say no.

The best way to use them is as you are. Take as small a dose as possible. I would save their usage for special occasions where you feel there is to be a heightened level of stress, like say, the company Christmas party or something. You don't want to be taking Benzodiazepines just to deal with an average day of work and interaction with people. It's not sustainable.

Benzodiazepine dependence is well-known for being a nightmare experience. I'm not trying to scare you, but some people who aren't very experienced with drugs have the tendency to interpret Benzodiazepines as subtle or mild. They are capable of wreaking havoc.

 

[Burnt Offerings]

It's a cost benefit analysis: do the benefits of the drug in your life outweigh the (potential) costs/risks of using the drug

Probably only something you can answer because I don't think there is a set limit of tranquilizers one can take before they experience cognition issues

 

[d1nach]

According to someone everything causes dementia. The biggest factor in you developing dementia is what genes your parents happened to give you when they did it. If you are worried about dementia the best thing you can do is eat healthy, exercise, and engage in regular challenging mental activities like going to school, work, doing taxes, you know regular stuff. To my knowledge the issue with benzos like antipsychotics when they are used to overmedicate sickly or elderly into a passive stupor for long peroids of time due to places being understaffed underresourced. And with too many patients to give them a enriched environment and exercise needed for mental longevity

 

[Ilove2nod]

Benzos totally saved me from being a totally, secluded social idiot.. They took away all of my anxiety, both general and social, and let me be the person, I really should be! I was a very shy, very introverted person before being put on clonazepam, 5 years ago.. and I couldn't deal with it hindering my life anymore.. it got so bad, that if I did actually go out to a party with friends and people I didn't know, I would just stand near the only people that I actually knew at the party, instead of actually partying, and socializing with new people! I became more and more shy, and had this weird thing where I was terrified to talk to people I didn't know! and just terrified about life in general as well, every little thing, would just worry me to death, for no reason.. I would think up things that weren't even there, and worry about them!

5 years later, after being on klonopin most of them, with a couple other benzos in between and now currently back on klonopin, I feel perfect! As long as I am responsible with my meds, I feel I am fine.. and have no issue and have accepted that I will most likely need to take some sort of benzo to live my life, the way it should be lived! Taking them, is like turning on a light in a dark room for me! Truly, very therapeutic if used in low to moderate doses for some people, like myself! For others, its a nightmare waiting to happen when they take that first benzo, whatever it may be... they become madly addicted, rather than just to take the same dose daily, and get prescribed them taking as prescribed in a responsible manner, then buy more and more, usually Xanax, and act entirely crazy on it.. If your not careful, Xanax especially, I have found to make me "fearless" and do things I normally wouldn't do, when I used to take it, in just a slightly higher dose than my normal 1-3mg, as soon as I tried benzos, unprescribed in my teens/early 20s.. But once I got scripted klonopin, I pretty much liked it way better, and it seemed to be much more subtle in terms of being "fearless" while still taking away all of my issues with anxiety, and anxiety induced panic attacks(which I sometimes would get!) and also lack of sleep, or insomnia, stemmed from anxiety as well.

So if you are responsible with your script, you should be okay, and if you don't feel like you have 11/10 on the anxiety scale everyday, like me.. then you should be able to get away with taking them, on an as needed basis every so often, instead of taking them as a daily regimen like I feel as I need to. Klonopin, truly was/is like some sort of magic pill, that just makes life so much easier for me... not having to worry about talking with another person, who I don't know... I can walk up to anyone and strike up a conversation with them, it totally changed me for the better. Like I said, everyone is different, so just be careful with these.. benzos are no joke, if you get tolerant to them, and start taking more and more, on a frequent basis, until your up to taking 10mg+ a day... be safe OP.

Sorry for the long post lol, I tend to go a bit overboard now and then with my posts. and turn what was supposed to be a paragraph, into a 5 paragraph essay!

 

[d1nach]

Basically I think like with anything if used in really high dose itll prpb cause brain issues later on. For example if you drink a huge amount of alcohol your motor skills could deteriorate. If you eat nothing but tuna abnormal ampunts of mercury might build up over the years. If you spray paint all day everyday you might end up with organic solvent brain damage. If you take huge amounts of food you might increase the risk of your brain having a stroke. If you consume massive amounts of lithium you might cause perminate damage. If you take huge doses of antipsychotics you might get tremors later on.

If benzos cause dementia ask questions how much benzos? Was there a control group? Was this replicated? Does this source have a conflict of interest ie selling safety supplements for anxiety. How do they define dementia? How do they measure dementia?

 

[cduggles]

d1nach: Benzodiazepines are frequently studied in patients with dementia because they are used to treat them, but no causal link has been established.
However, amnesia induced by benzodiazepines has been reported in animal and human experiments.
In animals, both neurochemical and behavioral studies have shown administration of benzodiazepines disrupt memory.
In humans, anterograde amnesia has been both reported by subjects in a controlled setting and subjects being observed. Anterograde amnesia means the ability to form memories after ingesting drug or recalling events just before ingestion.
Amnesia in this context has no correlation with dementia.
In these studies the effects were dosage-dependent (higher=worse), the addition of alcohol and other drugs (in non-forensic setting) decreased ability to judge impairment and memory of behavior, including violent behavior.
Data on retrograde memory (already formed memories) is less available but suggests that when benzodiazepines are administered, long-term memory might also be impaired while drug is metabolized.
For a number of reasons, including ethics, long-term studies aren't feasible. Retrospective studies (based on medical histories) are almost impossible due to incomplete records, questions about causality, etc.
Benzodiazepines have been around a long time. But taking bars with alcohol, overprescribing, other pharmacological interactions with newer drugs (both legal and illegal) have opened the field for studying potential brain or other organ damage, particularly in brains that aren't fully developed.
The reversibility or permanence of retrograde amnesia effects (not dementia!) and possible permanent effects on anterograde memory formation (which then leads to the formation of permanent memories) are being studied.
Basically, use longer-acting benzodiazepines if indicated (xanax is indicated for panic attacks) & don't use recreationally in combination with other drugs (or minimize it).

 

[lylastar]

This thread brings up lots of small and one or two large questions. I share in having had "panic disorder without agoraphobia" (DMS-4) since 1990, initially treated with clonazepam 1mg tid (3X/day) & changed to alprazolam 1mg tid in 1990. I'll list the discussed stuff above according to observations in my own life. I cannot guarantee applicability for other persons, since some of this involves subjective introspection, and drug-wise, some fine tuning:

1. Clonazepam is the right idea in principle but for myself fails over time in practice. The long-acting nature of this drug results in essentially constant blood levels which the brain will nullify and overcome in approx. 6 months. The rapid blood level onset-escalation of a short-acting sedative such as diazepam (Valium®) or alprazolam (Xanax®) was required to ensure continued effectiveness when the drug was to be used day after day on a chronic basis. Long-acting clonazepam over enough time simply results in complete CNS tolerance and thus loss of effect without a doubling and ultimately redoubling of each dose, until the drug plateaus off and becomes indefinitely without effect, other than having a huge risk should the regimen become interrupted. Alprazolam at 1mg three times per day over (at this point) 16 yrs is still sedative and fully effective. Only someone with panic disorder themselves would uncover this paradoxical discovery.

2. At the above dose I do not experience self-detectable diminishing of cognition. However, at higher doses, benzodiazepine sedation can do many adverse things. Easiest to uncover is suppression of anterograde long-term memory or a lack of remembering the fine details of yesterday's experiences. Common is the onset of temporary (fast to happen and fast to be able to reduce) tolerance necessitating increasing the daily dose to experience the same level of effect. If the drug "runs away with you" the treatment is to simply impose the now-not-working original dose level until it starts to work again, for me would become restored in an avg. of 4 days. A self-undetectable mild impairment of judgement, performance, and verbal communications can occur, all the time with the person thinking they are functioning fully normally. By its nature this can be insidious and is often best demonstrated by watching a videotaping of oneself plus heeding the comments of close friends and your significant other or mate. The cure is either dosage reduction, taking each dose at an adjusted daily schedule, or something like (supposing your daily dose is 1mg X 3 doses per day) taking 1mg upon starting the day and 2mg 30min. before bedtime [adjustments of this type are person-&-situation specific and must be evaluated by the patient with all possible inputs from others in one's presence who can see and feel how you act]. Structural, or functional brain or CNS damage is not known to occur with benzodiazepines directly. However, they are known to possibly impair performance, opening the door for secondary damage: such as a car accident, getting fired from your job, failing a college course, doing poorly on a first date, failing an important test, oversleeping, etc. It is urged to nip this type of syndrome early and to be diligent so that destructive patterns don't fester.

3. Flunitrazepam is the generic name for 1mg tablets of the hypnotic benzodiazepine indicated for insomnia and sleep induction, having originally the brand name Rohypnol® ("rupies"). While flunitrazepam is potent and effective, and has become an urban legend when someone secretly adulterates a woman's drink to ensure amnesia and sleep in advance of involuntary acts of sex, there is nothing special about this agent that equivalent doses of several other benzodiazepines could satisfactorily substitute for. Because of its bad name it is illegal to use in the U.S., banned by its placement into Schedule I of the CSA.

4. "Use it or lose it" is the best way, within a person's voluntary control, to push back against a person's chance of Alzheimer's Disease, meaning to not stop learning, and to encourage the brain's development of new neuronal connectomes through its plasticity, by giving yourself difficult mental challenges. An example would be to learn a foreign language, or to teach yourself to play a new musical instrument, or discover more advanced mathematics and physics, and the equivalent according to your likes and desires. Taking vitamins C, D, & E are known to help. If type II diabetic or pre-diabetic, then slowing down this condition helps immensely, since a great deal of research implicates nerve cells in relation to insulin. "Use it or lose it" seems to slow aging no matter what systems of the body one focuses on. As for benzodiazepines, there is not any known direct relationship between them and Alz, to my knowledge.
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[cduggles]

lylastar, a lot of insight, not so much on the science. A lot of what you state as true or untrue or unproven is inaccurate in all your points. I'm not trying to be aggressive and you did qualify your post, but putting inaccurate information out there is irresponsible.

 

[lylastar]

cduggles, thank you for your comment. The very last thing I am about is stating untrue information in any postings. Ar the top of my post I attempted to inform that the body of my message was "what I had found out that was true in my own life experience" (only). should I approach all information-containing material as if I were writing a scientific paper to pharmacologists? I would be happy to document every statement, but I felt yesterday that were I to have done that I would violate the level of sophistication, technically, that this forum specifically was about. And it would render my posting basically not worth reading for the majority of persons on this forum.

Since I am brand new to bluelight I still have everything to learn about it. If I made factual errors I am really sorry and would immensely be grateful if each of them could be pointed out to me. I have no wish to spread crap around or propaganda. that is not the kind of person I am. I apologize if I offended you.
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[cduggles]

lylastar, sorry that post came off harsh. It was written in haste. I did point out your qualifier... and welcome! I'm relatively new as well.
I'm not going to pick through everything, because it would be a lot of work. Feel free to pick through mine though.
Instead of picking apart your points, I'm going to try to be constructive.
First, don't assume anything about the level of sophistication here. Many users understand which receptors are affected by different meds/drugs and contraindications, side effects, etc.
Take a look at the post above mine (first one) by d1nach. He asks exactly what should be asked about studies. People write informally here but that doesn't mean that they don't know what they are talking about.
Second, for someone trying not to sound like someone writing a paper to pharmacologists, you do.
And your language is the biggest problem I have with your post. You go from empirical n=1 to factual seamlessly and incorrectly. Or you have one great paper titled "Effective Long-Term Treatment of Panic Disorder without Agoraphobia for Everyone Everywhere". (Note that in the US, ICD-9 codes are often used with or instead of DSM-5 [2013] because the latter is regarded as subjective and otherwise problematic.)
I've got to go to point 4. Great generic life advice. But you can't cite one peer-reviewed reference that categorically proves causality of prevention of Alzheimer's through one "use it or lose it" tip.
Yes neuronal plasticity occurs much later in life to a greater extent than previously believed in certain areas of the brain. And yes learning new things creates new synaptic connections. Neither of which has been proven to prevent the pathology of Alzheimer's. It's great general advice that has nothing to do with Alzheimer's prevention, which is how you present it.

I get that you're new here and you do have personal knowledge to share. You're willing to and that's great. It really is. Just try to remember that different people have had different experiences than you with benzos, with anxiety with life in general and you'll be fine.
You can message me if you want, because this is off-thread at this point.

Back to OPs question...