Severe rebound anxiety

[hadini]

So a couple years ago I was prescribed xanax 1mg and told by my awesome doctor "take when anxious". That was it. No warning about addiction or tolerance or withdrawal, and my only drug experiences beforehand had been with heavy cannabis use (a remarkably forgiving drug). I'm always anxious, so I started always taking it. Quickly climbed up to an abuse level 2-4mg a day... that went on for six months or so... then I suffered a detox and horrible withdrawal.

After I cleaned out my system for months, I still had xanax around but would use only .25 sparingly for interviews, dates and the like. Still, I found, it gave me bad anxiety the 1st, 2nd day after use. So after about a year-ish of using maybe 1mg a month I decided the rebound wasn't worth it and stopped completely. Benzos are no longer a problem for me, so please dont warn me about falling back into addiction, etc...

I've been having extreme trouble sleeping, and was just prescribed Halcion .25 and I took it last night as prescribed. Blacked out; luckily woke up on my bed fully clothed (i think I just ate a lot). I have been INSANELY anxious all day... it feels like it is getting better. I am confused because ambien and sonata (short half life drugs) made sleep very easy and didn't have nearly the same or any rebound.

Is there some difference in the way my body is adjusted to benzo dependence vs. z-drugs to cause this difference or is it psychological?

 

[BlueStar13]

I don't think it's a difference in half-lives, as triazolam(halcion) has a pretty short half life, and I don't think that it's purely psychological. I do have a theory, and numerous anecdotal reports as well as some literature on how the neurons in our brain develop up-regulate and down-regulate the amounts of receports present in their synapses in response to pharmaceutical agents, supports it. Seeing as you have already been dependent upon benzodiazepines, your brain has, on a subconscious or perhaps even non-conscious level, "remembered" its increases in tolerance to benzodiazepines. Now, whenever you take a benzodiazepine your neurons rapidly up-regulate the amount of GABA receptors present, causing you to gain tolerance and thus dependence much faster than before. Hence, the rebound anxiety on the following day. This is just my theory, but it sounds pretty reasonable to me, and I doubt there are any other justifiable explanations.

 

[hadini]

Am I wrong or are do z-drugs and benzos act on the same receptor site, with z-drugs targeting a specific sedation related GABA site versus the benzos targeting all/more of them?

Assuming this is true, which it may not be, but I would think z-drugs would have a much more noticeable rebound. Perhaps, understandably, not as anxiety-inducing as a full benzo but still some sort of 'sick'. But there is none...

 

[BlueStar13]

That's a oversimplification but the basic principle of your statement is true. Benzodiazepines target both GABA-A receptors and GABA-B receptors, while z-drugs target just GABA-A. Hence, the reason why benzodiazepines are subjectively more "euphoric" than are z-drugs, as the A Subtype receptor appears to primarily be responsible for sedation. In your case, the rebound anxiety following benzodiazepine usages appears to stem from your GABA-B receptors "remembering" how to rapidly up-regulate(increase their amount) due to your previous benzodiazepine dependency.