Drug info - Alprazolam Help Please: Heavy drinker switching to Benzodiazepines for withdrawal

[bosch man]

(first off i do not need to use "swim" for the simple reason i am doing nothing wrong)

Hi i suffer from chronic anxiety virtually disabled by it,i have been self medicating with alchol for a few years only at night...does work BUT the new year is going to see me change...my doc has given me xanax to take a good while ago but cant face stopping the alcohol because for a breif spell it works.....i have taken half a .25 tab in the past (stopped alcohol would never mix) yes works ok...i am obviously not taking enough though as i still worry but can feel its goin to benefit me far more than acohol and of course will be safer.My questions to you bunch:

1.....i drink upto 12units of alcohol a night can i just switch to xanax without any alcohol withdrawel do you think?

2....i read up that you dont ever become tolerant to the anti anxiety properties of xanax but you will become tolerate to the other effects like using them for sleep or a buzz etc.Your thoughts?

3....i am advised to take .25mg 3 times a day,am i best having a day off or just say to hell with it and just do it for as long as i need?I really dont care about addiction as my life is hell...i want my life back and have been like this for 18years this xanax seems a miricle to me if it works and i have tried everything with my doctor and he agrees a drastic situation needs a drastic medication.


Thanks for your time.

[PsychoActivist]

I think you should read the rules here - that you agreed to - before you make anymore posts
Mainly the one about self incrimination. You can find them here :
http://www.drugs-forum.com/forum/misc.php?do=cfrules


Not trying to be a dick, but if you want your stay here to last long and especially if you have questions you would like answers to, then this is the first step you need to take.

[dark12]

It is good to see that SWIy will not mix alcohol and Xanax(alprazolam). This is definitely a deadly combo.

Alcohol withdrawal is nothing to mess around with. It can cause severe health problems especially when normally used in the amounts SWIy was taking.

SWIyour doctor prescribed it to SWIyou so SWIyou really should just follow his advice. Take it how he says, don't be too concerned with tolerance because this is something that doctors are taught to handle. As your body needs more and more alprazolam to reach the desired effect, your doctor will gradually increase your dosage.

SWIM took alprazolam for anxiety for a while and it definitely helped him. Please have SWIy let us know how it is working out for you.

[bosch man]

Hi my doctor says it wont be a problem stopping as xanax is used in withdrawal????

I must admit i am more worried than my doc in quitting from 12 units and that the small ammount of xanax i want to start off on might not be enuff.

I did read that serious withdrawel starts from 16 units a day...any thoughts on how true?

[dark12]

There is no way to predict how any individual will respond to quitting. If you plan to stop drinking and you have been drinking for years, or if you drink heavily when you do drink, or even if you drink moderately but frequently, you should consult a medical professional before going "cold turkey."

Severe symptoms:

• A state of confusion and hallucinations (visual) -- known as delirium tremens
• Agitation
• Fever
• Convulsions
• "Black outs" -- when the person forgets what happened during the drinking episode

SOURCE: http://alcoholism.about.com/cs/withdraw/a/aa030307a.htm

SWIM would say that 12 drinks a day is a significant amount to suddenly discontinue.

[panic82]

Swiy is coming off a lot of alcohol. Swim would suggest a dose of 1-2mg alprazolam every 4-6 hours for 3 days, then .5mg every 4-6 hours for 3 days, then .25mg every 4-6 hours thereafter. Has swiy thought of going on an SSRI, e.g. fluoxetine? SSRI's are a better way of treating anxiety in combination with the occasional use of alprazolam or lorazepam as needed. Alprazolam may work for a few months before efficacy notably declines. Adverse long term side effects of benzo use, e.g. depression, memory loss, are signs of decreased efficacy.

[Gradient]

bosch man,

On a general level, your primary concern is the fact that long-term alcohol exposure causes an up-regulation of glutamate (the brain's primary excitatory neurotransmitter) NMDA receptors coupled with a down-regulation of GABA (primary inhibitory neurotransmitter) receptors. Aside from the behavioral consequences of this provided by dark12, this neurological alteration will result in seizure activity due to over-excitation in the brain in the absence of ethanol. This is an extreme consequence, however, manifesting only in individuals characterized by long-term administration. You likely do not fall into this category yet. For your information/peace of mind, however:

Alprazolam is ideal in treating this state; as a GABAa agonist, alprazolam will simulate the inhibitory characteristics of the alcohol that will be absent. In addition, swim is of the opinion that the compound will be a far more effective anxiolytic for swiy - alcohol binds to a number of receptors that may be counterproductive to the goal of alleviating anxiety, including dopamine and NMDA, that may lead to intolerable emotional 'ups and downs'.

The only characteristic of ethanol that swiy may miss from switching to alprazolam is its dynamic with the hypothalamic-pituitary axis in theoretically reducing the release of corticotrophin releasing factor. This will reduce stress. However, I doubt that swiy would like to engage in long-term hormonal modifications to attenuate stress. Alprazolam should suffice in the short-term by allowing for perceptual shifts and the development of coping mechanisms, while under treatment, that may serve to attenuate stress responses after administration is terminated.

In terms of dosage for alprazolam, no one on this forum will be able to advise the perfect dose. Too many contributing factors are important to consider that no one else on the internet can be sensitive to, including body-weight, level of stress, and the level of elicited drowsiness/mental fogginess - all of which are subject to genetic polymorphisms that a doctor would be sensitive to by observation. panic82's suggestion would put me out for days, for example, but seems to be ideal for panic82. Generally speaking (again QUITE generally), daily administration of 1-6 mg of alprazolam shouldn't be too hard to wean off of. Weaning off of benzodiazepines is key, but much easier than ethanol due to the lack of reward activity.

Good luck with your treatment, bosch man.

[bosch man]

thanks for the replies,

Do you think I should wean off alcohol first like go down to 8 units, to be honest 12 is the max normally around 10, I read withdrawel starts at 15units aday and seizure is 30 units plus,my doc said just stop but I do worry.

I don't have shakey hands never drink before 8pm I go on till 10ish then dinner so I must be without alcohol most of the day in my system does this sound better?

[RaverHippie]

You can always give it an experiment and see how long it takes for any strange symptoms to show up by prolonging the alcohol use further and further, or skipping one night's amount of alcohol altogether if no symptoms arise. Experimentation can always prepare one for the real thing also!

[claroscura]

as previous posters have mentioned, benzodiazepines are often prescribed to an individual dealing with alcohol withdrawal. both substances affect GABA receptors in the brain. both relieve anxiety and promote sleep (in the case of alcohol, not usually quality sleep, but sleep nonetheless).

if one is going off alcohol but going on benzos, withdrawal symptoms should be minimal if present at all.

i'm on 1mg daily clonazepam (better known as klonipin) for sleeplessness/anxiety. be honest with your doctor about your drinking, and you should definitely be able to safely treat your anxiety and any withdrawal from alcohol. benzos are probably the right choice. i wonder if your recommended dose of xanax is high enough to begin with (as another poster mentioned, starting high and tapering might not be a bad idea). it depends, as i've said, on whether or not your doctor is aware of how much alcohol you're going off. but trust your doctor's judgment. if you feel serious withdrawal symptoms despite the benzos, call your prescriber and work out a different plan.

it's funny if you think about it. alcohol and benzos do roughly the same thing (hopefully you'll be more satisfied with benzos, though, as they generally last longer in your body), so your choice in self-medication was not far off.

good luck.

(on another note, one might argue there was nothing self-incriminating in this post, as long as the poster is of legal drinking age. it's not against the law to drink alcohol [with certain restrictions granted], and it's not against the law to take medication as it is prescribed to you.)