Addiction - Tolerance to Xanax (Alprazolam)

[Rottenfruit]

In my latest chapter in my epic fictinoal novel about the life of the non existent swimmy he has created massive tolerance to xanax.

Swimmy took around 10mg of xanax and felt almost nothing!

Swimmy can take 50-80mg of diazapum without a thing..

my poor charachter in my book is all worried and he wonders how can he reduce this massive tolerance

[Cryptic Concoction]

Given the precipitous doses your character is taking, it would certainly be unwise to entirely abstain from benzodiazepines (i.e. cold turkey), as serious and agonizing withdrawals will likely ensue.

It appears to me that your character's most sage recourse is to gradually taper down on his dosage. This may entail more mild withdrawal symptoms, depending on the degree of reduction and frequency. A slower reduction will not only result in mitigated withdrawal symptoms, but may decrease the risk of protracted withdrawal syndrome.

Given that diazepam has a much longer half-life than alprazolam, it will likely prove more efficacious in your character's pursuit. I must also state that I strongly discourage your character using alcohol during his tapering period or any other GABA agonists, as it shares a similar mechanism of action with benzodiazepines and will disrupt the reduction process.

If your character cannot procure diazepam, in order to prevent disruption of his tapering schedule and process, he should consult this benzodiazepine equivalency table: http://en.wikipedia.org/wiki/List_of_benzodiazepines

I must caution that I am not a professional in managing benzodiazepine withdrawal, and that benzodiazepine withdrawal can be not only tormenting but potentially fatal. Given the precarious nature of benzodiazepine withdrawal, your character may find that it is best that he seek professional help.

Again, I am not a professional, but it appears to me that the only means through which he may reduce his tolerance in the safest manner possible is to gradually reduce his dosage. Please keep in mind that a slower reduction will not only increase the likelihood of success compared to a quicker reduction in dosage, but it may decrease the likelihood of more severe withdrawal symptoms.

I recommend that your character peruse articles regarding benzodiazepine withdrawal management, as well as the potential risks involved with benzodiazepine withdrawal if he intends to fly solo.

*********Do not go "cold turkey."*********

[Rottenfruit]

Swimmy has done it before , such as with clonzapam and many others...

Cold Turkey works fine for swimmy

[Cryptic Concoction]

SWIY's available options are to either reduce his dosage or terminate administration entirely. It seems that he has already chosen to go "cold turkey," and I will not attempt to dictate how he governs his mind and body.

However, in the interest of harm reduction, and potential future readers of this thread, I feel it is necessary to delineate the effects of benzodiazepine withdrawal as a result of compensatory mechanisms (experienced as tolerance). Because SWIY seems comfortable with going "cold turkey," I write this chiefly for those who may read this thread and assume that it is harmless to take this course.

GABA (the principal inhibitory neurotransmitter in the central nervous system) provides inhibitory synaptic connections with copious systems in the central nervous system, regulating their activity and suppressing the firing of neurons. As benzodiazepines are administered frequently and in increasing doses, the central nervous system employs adaptive measures in order to restore a state of equilibrium. This entails desensitization to GABA and other mechanisms serving to reduce GABAergic activity. Given that benzodiazepines act on GABA receptors, they provide inhibition to neurons innervated and modulated by GABA secreting neurons.

When benzodiazepines are removed, the central nervous system's compensatory mechanisms remain. The dramatic reduction in GABAergic activity, as a direct result of compensatory measures in the brain (experienced as tolerance), results in potentially extreme hyperactivity of the systems that GABA normally inhibits. This pronounced hyperactivity of systems in the central nervous system can be manifested in seizures, psychosis, delusions, catatonia, convulsions, and other serious withdrawal symptoms--including potential death.

Massive tolerance to benzodiazepines is indicative of pronounced compensation by the central nervous system in an attempt to reduce the inhibition that GABA agonists exert. Without GABA agonists to nullify this compensation, the central nervous system is thrust into hyperdrive.

But, again, it is SWIY's mind, SWIY's body, and SWIY's life. My intent is not to direct how SWIY manages his own life, but to provide information. After that, it is SWIY's choice whether or not he heeds it or behaves in the manner he feels is most appropriate for himself. While I would not advise that SWIY go "cold turkey," if it appears to work for him, it is his choice.

Please do not interpret my post as an attempt to force my almighty creed upon yourself and the world. I mean only to make information available that may be valuable to some and drivel to others. I believe in freedom of mind and freedom of body, and will not preach to SWIY regarding his behavior. I hope he is successful in whichever path he elects to follow.

Reputation Comments on this post:

	Very good information and advice in this post
	Fantastic post: Harm Reduction AND Science!
	extremely informative post, great job

[phatassone]

With high doses of benzos "cold turkey" is definately NOT recomended, it can cause seizures and death... the best thing to do is convert your benzo to valium and diminish 10% per week example if you're taking 2mg of alprazolam per day, switch to 20 or 30mg of diazepam and diminish by 2 or 3 mg per week, this is the most painless way to get through benzo withdrawl...

[waiting281]

Just out of curiosity, would phenobarbital hypothetically help someone during such a tapering period? I seem to remember reading another thread on here about a swimmer who used such measures

and good luck to the OP, I hope he is still with us, and cryptic concoction is definitely one of this sites most useful members, such good, detailed information!!