Xanax: Interdose Withdrawal and Tolerance

[Rebel Maven]

I need your ideas and suggestions for my Xanax interdosing schedule change please as it is not going well.

I was on 2.5mg SID at bedtime for sleep with the occasional 0.5mg-1mg for situational anxiety. My symptoms appeared to be tolerance and interdose withdrawal. So as advised I began splitting the dose up multiple times a day two weeks ago.

I am dosing TID. In the morning I take 0.25mg. In the afternoon/evening I take 0.25mg. At night I take the balance of the dose which is 2.0mg.

After a few days of doing this I started to feel stoned all day and it is getting worse every day, lol!

So does this mean I have not reached tolerance?

Am I not in interdose withdrawal from the Xanax? I can hardly stay awake on 0.25mg which is crazy because I used to not even be able to sleep on 4mg and I have been taking it for over 20 years.

Could taking it more frequently even though I am not increasing the daily dose make me this stoned even though I am taking only 0.25mg q8h twice a day in the daytime?

I don't think that I have moved in the last week or so. I just want to drop.

What's up with this?

Thanks

 

[Groundhogdayagain]

Honestly, your dilemma has me stumped. After 20 years, you shouldn't be getting that effect. Especially after a few days of getting used to daytime benzos. Any other meds in the mix that you take that could potentiate the daytime Xanax? Do you take anything OTC for acid reflux/ gastro issues?

 

[Rebel Maven]

Honestly, your dilemma has me stumped. After 20 years, you shouldn't be getting that effect. Especially after a few days of getting used to daytime benzos. Any other meds in the mix that you take that could potentiate the daytime Xanax? Do you take anything OTC for acid reflux/ gastro issues?

I am stumped also.

*The Prozac is making me manic so that should not be it. I am cutting the Prozac which could potentiate it but I am making a small cut and it has only been a week so I did not think that was it.
*The trazodone makes me hung over for a short while in the morning but not like this and not all day long. So it is questionable but the grogginess did not start until a week ago and I started splitting up the anax doses 16 days ago.
*The drug interaction between the Prozac and the trazodone is adding to the mania so that is not likely it.
*The omeprazole screws everything up so who knows.

Hmmmm....look what I just bolded....

Could a 4mg reduction in Prozac in just a few days effect the potentiation of the Xanax already? That would be pretty fast.

I started reducing my blue light exposure with f.lux three days ago so I am getting less stimulation from that.

I also started magnesium 250mg SID two days ago to calm my neuropsychological reactions and the physical symptoms I am having.

I would have to be extremely hypersensitized if a one week 4mg reduction in Prozac, the reduction in blue light three days ago, and two days of magnesium were enough to make me from manic to stoned.

IDK. What do you think now that I've mentioned the other factors?

Thanks

 

[Groundhogdayagain]

Fluoxetine—Coadministration of fluoxetine with alprazolam increased the maximum plasma concentration of alprazolam by 46%, decreased clearance by 21%, increased half-life by 17%, and decreased measured psychomotor performance.

According to the above, which I think comes with your prescription, the Prozac will potentiate the Xanax. See how it also impacts the clearance and half-life. So it appears to potentiate and turn Xanax into a medium half life benzo.

However, it sounds like you have been on Prozac for a while too. Which brings me to the trazadone, which is known to interact with Xanax via increased dizziness, drowsiness and ability to concentrate.

If that sounds like the stoned you have been experiencing, I would lean toward the trazadone and Xanax interaction.

 

[Groundhogdayagain]

Forgot to mention, Prozac and Trazadone are not typically prescribed together. You get these two from same doctor?

 

[Rebel Maven]

Fluoxetine—Coadministration of fluoxetine with alprazolam increased the maximum plasma concentration of alprazolam by 46%, decreased clearance by 21%, increased half-life by 17%, and decreased measured psychomotor performance.

According to the above, which I think comes with your prescription, the Prozac will potentiate the Xanax. See how it also impacts the clearance and half-life. So it appears to potentiate and turn Xanax into a medium half life benzo.

I am having a paradpxical reaction to the Prozac which is causing neuropsychological overstimulation manifesting in the form of mania. So cutting the Prozac may potentiate the Xanax.

However, it sounds like you have been on Prozac for a while too. Which brings me to the trazadone, which is known to interact with Xanax via increased dizziness, drowsiness and ability to concentrate.

That is true but before I started splitting up the Xanax dose I had gotten over 90% of the trazadone hang over by morning. I only take it SID at bedtime for sleep and based on its half-life and the way the duration of affect has been on me this is a totally new thing with the Xanax dosing change.

If that sounds like the stoned you have been experiencing, I would lean toward the trazadone and Xanax interaction.

I have been on them both together but was taking all of my doses of each one only at night. This has never happened before. Only since the Xanax dosing change along with the decrease in Prozac, the reduction in blue light, and the addition of magnesium.

It is bizzare that 0.25mg of Xanax could make me so stoned after 20+ years on such a higher amount.

Perhaps it is just a combination of the reduction in the Prozac, the reduction of blue light, and the magnesium. All this was done in an attempt to calm my neuropsychological symptoms down after flipping from major depression in to hypomania that was triggered by what we suspect was the ingestion of caffeine which I had not had for over a year.

Thanks for responding and I look forward to your thoughts.

 

[Rebel Maven]

Yes and the severe drug interaction between these two is widely known regarding how risky and stupid this is. Unfortunately at the time I was some what of a depressed, suicidal, insomniac, vegetable and let her do it.

 

[Groundhogdayagain]

Interesting. Quick question what was your starting dose on the Prozac? Based upon the fact that you didn't experience this until you cut your Prozac (along with bl reduction and magnesium). You have a couple of complicating factors at play, your paradoxical reaction to Prozac, recent cycling and potentiation. Perhaps your next cut is of Prozac and keep the Xanax and all others constant. If your theory is correct you will probably get even more stoned. I don't want to advise you to do that, as I am unsure as to what commitments you have. Aside from having the patadoxical effect, do you think you are ultra sensitive to the Prozac? Lastly, I wanted to inquire as to the origins of the cycle from depression to mania, Prozac or caffeine?

 

[Rebel Maven]

Interesting. Quick question what was your starting dose on the Prozac?

20mg then up to 40mg after three weeks.

Based upon the fact that you didn't experience this until you cut your Prozac (along with bl reduction and magnesium). You have a couple of complicating factors at play, your paradoxical reaction to Prozac, recent cycling and potentiation. Perhaps your next cut is of Prozac and keep the Xanax and all others constant. If your theory is correct you will probably get even more stoned. I don't want to advise you to do that, as I am unsure as to what commitments you have.

I am only cutting the Prozac at this time. I am doing a 10% taper and holding for a month. All other drugs will remain consistent.

Aside from having the paradoxical effect, do you think you are ultra sensitive to the Prozac?

I an hypresensitized now to everything - drugs, food, drinks, touch, smell, sight, etc..

Lastly, I wanted to inquire as to the origins of the cycle from depression to mania, Prozac or caffeine?

The origin of my cycling is due to rapid tapers off multiple neuropsychological drugs. I took Prozac for years with caffeine and it never bothered me. But since my last two times of radical withdrawals I have become hypersensitized. The cycles get worse in intensity each time. This time I was in major depression and totally dysfunctional until I drank that one Coke and had not had caffeine in over a year and flipped from that depression to hypomanic in approximately one hour. It has continued to escalate and that was approximately a month ago.

Thank you so much for your reply.