Switching From Xanax To Valium (Page 2)
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PLEASE HELP! For the past 7yrs I've been on 1mg Xanax (3x) per day for anxiety and panic attacks. I take my dosage of Xanax as prescribed by my Dr unless I have a severe panic attack, then I may take an additional (1-2) 1mg xanax when I'm actually having a severe full blown panic attack to stop it. I've been on other Benzos before but Xanax seems to be the only thing that stops the panic attacks when I'm having them. Recently my Dr decided to switch me from 1mg Xanax (3x) per day to 10mg of Valium (2x) per day because he says Valium is "stronger" and has a longer half life than Xanax. He says the Xanax isn't working for my anxiety anymore. From what I've read on the Internet about Xanax vs Valium is that Xanax works better than Valium for panic attacks. I like to mention I have a phobia of taking new medications. I stressed my concerns to my Dr that my anxiety isn't as much of issue for me as my Panic Attacks. He said not to worry cause the Valium is stronger. Then I asked him what if while I'm taking the Valium I suffer a sever panic attack? What do I do to stop the panic attack? His responce was that I could take a 1/2 of a 10mg Valium tablet to stop the panic attack. I wanted to tell him that from what I knew, Valium is slower acting and that I didn't agree 1/2 of a 10mg is going to stop my panic attacks but I didn't want to question his professional expertise over my Internet findings. I know he's the Dr and the Dr knows best right? So I guess to finally get to my point is I'm terrified to start the Valium because im afraid that when I have a panic attack and I say WHEN and not IF cause it's only a matter of when I will have a full blown sever panic attack what would I do to stop it? From reading up on Valium I know it wont help stop my panic attack like the Xanax will. I asked my Dr before I left his office that while I'm on the Valium and I have an attack could I take a Xanax to stop the attack? He said absolutely not! He said if I have a panic attack while on valium I can take a 1/2 of my 10mg Valium. I didnt say this to my Dr but I know from what I read about Valium is that it won't stop an attack as fast as Xanax will. I dont know what to do? Im so scared and I feel helpless cause I feel like my Dr isn't getting what im saying. My panic attacks can last as long as 2 hours or more. I know because my longest panic attack was while I was driving through the desert and realized I forgot to pack my Xanax. 2 hours in to my attack after trying breathing techniques and what not I had to taken to a hospital by ambulance cause my heart rate went up way to high and so did my blood pressure. My panic attacks can lead to an ambulance ride to the hospital. I feel like my Dr is focusing on treating my anxiety more than my panic attacks which are of greater concern to me at this time. I read on line that other people have been prescribed both Xanax and Valium to be taken as needed. Valium for anxiety and Xanax for panic attacked. I spoken to 3 pharmacists who tell me that I can take the Valium and if I should have a major panic attack I could take a Xanax no problem because they're both Benzos but only on the occassions when I'm having a bad panic attack. Why couldn't my Dr just say that? I know some of you may read this and say that I just have an addiction to Xanax. Honestly that would be further from the truth. If I knew that Valium would stop my sever panic attacks I would switch in a heart beat but from what I'm reading I know Valium won't help with an attack as fast as Xanax will. I'm not looking for the Xanax "kick" some people love to feel or to have a feeling of Ephoria. I just want a reliable medication to treat my disorder. I want to trust that my Dr knows what's best for me but only I know what my body and mind is going through and I somehow can't get him to understand! If anyone has had the same problem as me or can offer any support or advise I'd love to hear what you have to say. Has anyone ever taken both medications in the same manner im suggesting or together at the Sametime? How did it make you feel? We're you able to cope and how? Please anything will help. I know there has to be other people out there experiencing or have experienced the same thing. Thanks.

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107

Since my post Matilda & Rusty S. have both posted rather interesting views. Now as you know, or those who see me regularly on questions concerning anxiolysis, panic, OCD, related conditions, & my other great affliction of chronic pain do - I never write anything which is beyond either my knowledge or my personal experience (which on this platform is probably the most important as we are giving opinions which could influence peoples' medicine choice remembering that the PIL must ALWAYS be referred to for cautions, interactions and contraindications) & neither do I ever speak "with forked tongue" to any writer - in my case with the exception of Verwon, who riles me regularly by his US-Centric comments on many things which he often uses badly, forgetting that the US pharma industry is the most corrupt and self serving in the world, charging huge prices for cheap substances, and even self regulating to the extent where the FDA actually permits a variation in API content of pills from the original patented brand, I have heard of 10% & 20% from different sources; the precise same tablet being sold with different imprints at wildly differing prices (Watson are most guilty, Norco and '853' being identical as are Fioricet brand and their 'generic' acetaminophen/butalbital/caffeine tablets; in ANY other country that would be so illegal that the resultant fines could probably put companies of that size out of business! And do not forget that the ONLY generic alprazolam in the USA which would be acceptable in Europe, Greenstone, as well as their triazolam, are identical to branded Xanax/Xanor/Tafil and Halcion respectively; I found out that not only do Pfizer OWN Greenstone, they actually make both in the same factory, and reading the PIL contain exactly the same proportions of excipients, suggesting that they break that same 'identical tablet, different imprint, far higher price' nonsense as Watson! Every other generic alprazolam made there would n3ver make it to a European pharmacy due to the absolutely dreadful quality and the variations in strength - Sandoz GG2499, the largest selling alp in the US, would never get a licence here because of its awful quality and low potency, meaning that the majority of Americans using generic alprazolam would never know what hit them if they were dispensed U94 Xanax/Xanor, Egis Frontin or even the EuroGenerics (EG) generic... Verwon tends to insist that US meds are the best but jote that almost every one of his posts are direct quotations from manufacturer or FDA (that should have been NOTE!) papers or US Industry approved websites which customarily hide their racketeering self regulatory and price fixing policies...

The ONLY benefit I can see of diazepam over alprazolam is indeed half life. Its active metabolites are nordazepam and oxazepam, both available as drugs in their own right, the former having a half life of well over 100 hours, whereas alprazolam is somewhere between 6 and 12 hours dependent on one's metabolism and benzodiazepine tolerance. Now I MUST stress that I have never said diazepam is no good, in fact as a substitute for others when reducing dosage or quitting, it is second only to medazepam (Rudotel, Nobrium) as the best to use due to that half life. However there is absolutely no doubt that the dosages prescribed to the OP are silly and that the doc concerned has blatantly lied about potency and efficacy in panic disorder. Diazepam is primarily a sedative BZD which is, when compared with alprazolam, virtually useless for acute panic. There is also a huge mistake - the onset of action of diazepam is in fact faster. Witha slower curve up to peak plasma level, but alprazolam takes only 15-20 mins longer to begin working. It is however far faster in reaching its peak level and the plateau longer. Just because half life is so much shorter does NOT mean duration of action is. The usefulness of diazepam, as long as you are dispensed Valium or a very good make, is certainly NOT in the field of panic disorder control. It is an ancient BZD which unlike the later triazolo-BZDs does not target GABAa receptors specifically but all GABA receptors more or less equally. Medazepam has an almost identical profile but is considerably less sedative, allowing the patient to live bormally while taking it. The big problem with diazepam is that sedation which can be disabling enough at a medium dosage of 20-25mg to prevent the user from working, and causing ataxia which is not the case with alprazolam in a dosage equivalent in potency to twice that of the diazepam!

I agree that diazepam may be used in lower dose for keeping GAD in check but must repeat that for acute panic attacks, it is useless and 5mg is hardly enough to stop a panicking MOUSE! I repeat that a far better combination would be clonazepam 2mg tds with alprazolam always there for the worse times and in sufficient dosage for acute panic attack. My attacks are thanatophobic, meaning that I am sure I am in the process of dying, taking my last breath, my heart not beating properly, and it does not matter that anyone reassures me or not I am 100% convinced that I AM dying, until the alprazolam fixes that. As I said, a large dosage of Lysanxia (prazepam) or Lexilium/Lexotan (bromazepam, which is the benzodiazepine I find "chills one out" better than any other) must in my case follow along with an e tra Rivotril (clonazepam), & I return to normal within around 45-60 minutes. My attacks can last anything from 10 mins to an hour or more so ensure I ALWAYS carry at least half a dozen 2mg clonazepam, 10mg alprazolam and a strip at least of ten x 6 or 12mg Lexilium/Lexotan in my pocket at all times. I am terrified every time I leave home that I will have an episode. It rarely occurs since I started clonazepam but I MUST carry those with me as well as my oxycodone and other opioids like dipipanone and dextromoramide. Auralis brand freeze dried 100 or 500mg diamorphine powder vials are great for instant analgesia when insufflated in the dose to which one is accustomed, as I will not use needles. My doctor knows I insufflate it so prescribes 3 x dosage for inj. I believe they don't prescribe heroin hydrochloride at all in America, saying that this essential drug has "no clinical use" - something which we here simply can not understand as it is probably the drug which is clinically the best by far for severe pain and especially heart attacks, as it is about the only opiate which does not interfere with the electrocardio system - proof is easily found in the statistics showing that where diamorphine is first line treatment death rates from a myocardial infarction are much lower than where they do not give it.

Anyway I wanted to say that even though I disagree with a couple of your points such as the 'fact' diazepam is a good drug for acute panic, you both do make some interesting and valid points. Just remember that US made generics are not absolutely equivalent in potency to brand name, so unlike in Europe, the patient dose depends not only on the doctor's opinion but on the make disoensed - or your income! What a shame Obama's attempt to make your healthcare more like Europe failed miserably, showing the power lies not in the Oval Office but in Boardrooms, which in medicine can be dangerous. Not to say financially bad for the vast majority of patients no matter what is wrong with them... And Verwon, please stop simply quoting from American literature funded by these thieves who run your healthcare. I have a letter to write to Sylvia Burwell, Health Secy in the Cabinet, which I promise will include a plea to make it easier for the ordinary American to get the same level of treatment as those who can afford the best. It simply does not work that way anywhere else in the world and I feel so soory for US citizens who fall ill or have conditions like anxiety and severe panic disorder.

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106

Take the five Valium half a Valium keep a blood pressure machine around check your heart rate if it's your heart rate going fast then you need to take a Valiumalso get you something to pulse also get you pulse oximetr you put it on your index finger and it tells you what your heart rate is and what your oxygen level is whenever you can get enough oxygen to your heart that's when your heart*squirrel fast you have an attack OK so heart rate is over 100 you need to value more even close to hundred I don't wait until it's 100 enough you still having Zaidi knows your heart rate is OK but you have air anxious then you take the Xanax I know because I've had it for years

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105

I recommend valium for Panic Attacs!
I take both I check my blood pressure if I feel like I'm getting Anxietyi I take Xanax I feel like my heart is pounding I take valium I am where it all depends on your symptoms and I've taken go to the same time but I took a very low dose half a Xanax it's a 2.5 or five and I've taken a half a Valium like a five or 2.5 even it will stop and you can have it under your tongue and it does Work faster believe me that valium
am works faster! Takes 45 minutes for Xanax to work it takes 20 minutes for valiant to work again for having a real bad attack I take half of one and half of the other five Valium and a half of the five Xanax and an aspirin

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104

I recommend valium for Panic Attacs!
I take both I check my blood pressure if I feel like I'm getting Zaidi I take Xanax I feel like my heart is pounding I take that I am where it all depends on your symptoms and I've taken go to the same time but I took a very low dose half a Xanax it's a 2.5 or five and I've taken a half a Valium like a five or 2.5 even it will stop and you can have it under your tongue and it does Work faster believe me that valium
am works faster! Takes 45 minutes for Xanax to work it takes 20 minutes for valiant to work again for having a real bad attack I take half of one and half of the other five Valium and a half of the five Xanax and an aspirin

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103

Xanax is ten times stronger than Valium. 10 mg. Valium did help provide relief when I was withdrawing from Xanax. Try the Valium, but I don't think the dosage the doctor is offering you is going to help because 1 Xanax equals 10 mg. of Valium.

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102

I need help. I've been on xanax for years and due to all the opiate od's in my hometown the drs are not prescribing any types of narcotics. I've been to 5 drs in 4 months trying to get my meds and people who need them cannot get them. ANY HELP

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To Chrissy who thinks she's an expert on all the reasons for panic attacks and anxiety: My daughter had pancreatitis which was misdiagnosed as "just anxiety" (because apparently some docs think that severe abdominal pain, a high white blood cell count and other symptoms of pancreatitis are actually symptoms of anxiety if you're a 26 year old female.) They sent her to a therapist who overdosed her on Cymbalta and told her she just needed a boyfriend--no, I'm not kidding. When she had the 2nd attack of pancreatitis 2 weeks later, she insisted they do some blood work which is when they discovered she actually had pancreatitis for no apparent reason (she's not a drinker.) When finally treated appropriately, the pancreatitis went away. But the damage from giving her far above the maximum acceptable dose of Cymbalta was done; she was subsequently diagnosed with PTSD by three separate psychiatrists. Essentially, she had brain damage from being overdosed on Cymbalta; the damage was permanent and she has struggled with terrible anxiety because of it for the last 9 years. It has nothing to do with being unmarried, overweight, having financial problems or any of the other causes you ignorantly claim are the reason for anxiety you say one can cure by just learning to "cope". Your ignorance is strongly evident; stop pretending to be an expert on this topic when you obviously know so little about it.

To New Day: Valium does not have a longer SHELF life than Xanax. I believe you meant it has a longer HALF life which means it continues to work longer. "Shelf life" refers to how long a product remains fresh before it becomes outdated and, in the case of medications, becomes ineffective or at least LESS effective.

To Berry: There are no "seratonins;" there's just "serotonin." It's a single chemical-- there aren't several kinds of serotonin!

To All Those Arguing about Xanax vs. Valium vs. other anti-anxiety meds: My daughter suffers from PTSD and SEVERE anxiety. Valium has absolutely NO effect on her, Xanax helps her somewhat but only in high doses which she can't get outside of being hospitalized and all the other anti-anxiety meds (e.g., Klonopin, Buspar, Paxil, etc.) give her either severe serotonin syndrome or seizures.

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100

It seems U worry about full blown Panic Attacks worse than every day Anxiety. By taking the Valium U will receive good consistent treatment. And Valium WILL stop Panic Attacks. I was rescued 25 years ago from Xannax transferred over to Valium & have been on them ever since then. Panic Attacks will not occur as often when on Valium. Try it out with good intentions & U may find it works out. All the Best.

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99

Here goes honest answer. I was prescribes Xanax when it first came out early 1980s for panic attacks. I had been addicted for Valium and didn't want to go near another Benzo. Once again not enough research had been done to safely give me or anyone that drug with a history of addiction m. It worked for about a yr. it gradually creeps up on you because it's fast and short term acting. I think your doc sees a need at in crease as. Bad sign you are building up a tolerance not good.

It was hell detoxing from Xanax. Valium has a much longer shelf life almost 24 hrs if I recall. You don't get the pop like Xanax but it's working.they are both bad but I think Valium is a lesser of evils our bodies chew through Xanax like candy in 4-6 hrs it's gone, huge rate of addiction. Hope this helped good luck.

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I also was diagnosed for depression from the start when I first went to the Dr to address my issues that had been plaguing me since I was 13 years old. At 18 they started me on pail, tried it for a year or so, it gave me weird feelings but was better then my normal. When it quit working I was given every type of antidepressant there is. Eventually it hit me or more so them that I actually had some extreme anxiety that started around adolescence. It did so happen that my family has some major anxiety issues going bk to my great uncle whom couldn't leave his home for 3 yrs. He eventually got prescribed valium and he was able to go about life again normally. I think valium really can work for major anxiety. Perhaps adding an antidepressant could help. I have also been down the Xanax road and as it can work well it's cons seem to really outweigh its pros. I switched from xanax to valium about 5 months ago and my anxiety is gone. I do need to address some other issues, thinking about which antidepressant would work the best for me. You made a good point when you mentioned how it seemed once you became more knowledgeable about certain medications and what works best for you, your doctor seemed to be weary of you. I've experienced that and it stands in my way often from getting better. They don't understand that maybe what we're going thru is so overwhelming/& stands in the way of our lives that we are desperate to find an answer so we do the responsible thing and we eeducate ourselves in hopes of helping the Dr find the right treatment for us. And yet so often all they see is a drug seeker. Its hard to find a good doctor that will listen and not write you off. Best of Luck to you.

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I'm sorry U have so many panic attacks. Your Dr probably changed over to Valium due to U reporting still having panic attacks. If U have the amount of panic attacks U R saying then I think it is appropriate to try Valium. True Valium works slower but actually quite effective. It also works for much longer than Xannax. It will give U all the help U need. All the Best.. Solidmike

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96

Exactly. This person was given about 1/7th the equivilent in valium on their switch from xanax to valium, they experienced withdrawal. Just like they would if they took literally half a pill of their original xanax RX and split it into smaller pieces through the day. Valium is better, lasts longer, builds in system, prevents panic/anxiety. Withdrawal is one thing, a medication that actually makes someone a functioning human being is another thing, their doctor failed at the dosage for the transition and i guess klonopin is okay, but i've been on all three and valium by far is the best, you can wake up and literally do something without having to pop a pill first thing in the morning, it does build it does last and it does work, the dosages are hugely misunderstood by many doctors though.

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Let me first say this. Valium is by far the best. No, it will not make you feel as clear and lucid as quickly as xanax will, it actually is one of the older benzo's, and got the bad rap for benzos started many many years ago, and now we have the three most common ones, Xanax, Klonopin, and Ativan, all of which are much MUCH more dangerous than valium. I was prescribed 1mg Xanax 3x daily for about 4 years, then switched to 1mg xanax 3-4x daily as needed for roughly five years. It helped me work, and hold jobs. It helped me be social. It also made me wake up with rage and fear, and about 6 months in, the medicine would only last a couple hours, then full fledge panic worse than before i started (and before i started it was so severe i would wait till night time to take the trash out or get the mail, and trust me, im not a lazy person.) I got into a legal issue, at a 'party', punched a car window out and ended up getting about 30 stitches and a LOT of glass pulled out of my arm. The hospital kept me, made me cold turkey. I convulsed one time, dont remember it, they just said i did, i have no recollection. They kept me until my arm was healed, and stitches were out. Then kept me longer because my vitals, ie bloodpressure and temp etc, were still not on track. I can tell you what benzo withdrawal feels like. But i wont, because you should never EVER have to experience the kind of hell it was. After x amount of time, i got out of hospital. My withdrawals lasted for many years. Yes, my body adjusted after about 5 months, possibly less, but the mind did not. It was like a one year + acid trip followed by another 2 years of anxiety so excrutiating and painful i would literally put my ear to bedroom door to listen if it was not busy outside bedroom, so i could use bathroom or get glass of water. Then finally, after being stubborn, got klonopin. the klonopin was much better, .5 mg 3x daily. it took a while to kick in however, about an hour to an hour and half, but i would still wake up with panic and aggitation, even though it helped me function in society. After doing that for a couple years, i did my research, Xanax cold turkey, literally froze the receptors into a numb state as far as GABA is concerened, they had no chance to re-adjust. Klonopin did last longer, and did make me feel functional, however i wanted to get off of benzos, which i am trying now. I have been on valium instead of klonopin for 1 month, 5mg 3x daily. The first 2 weeks were terrible. The equivilent dose of valium for a 1mg KLNPIN or 1MG XNX is roughly 20 MG. so i basically underwent a half-way detox, going from halfmg kpin to 5mg val. I have adjusted, and something i notice, this is not a medication for people looking to feel happy and silly. It does take time, you do adjust, i do not wake up in anxiety or aggitated states anymore, the half life is 200 hours instead of 50 (kpin) or 14 (xanax). It works, it helps you function, it maintains y our sobriety, and it will build in your system over time. But for a doctor to bring you from x amount of benzo to x amount of valium, it will NOT work unless they know, or you understand even if they dont, the equivilent dose. If they dont know, but you understand, that is what i did, and now have finally started feeling level, yes, i still have klonopin withdrawal, but its mostly physical. Gastrointestinal tbh. But i will say this. Valium is for adults, people who want to function, who have panic attacks or severe anxiety in general. And it is MUCH better of an option than the mainstream benzos docs are handing out at the drop of a hat these days. I will say, while i am sitting here with klonopin withdrawal, and have done severe xanax withdrawal, that Valium does work, and if you can switch, do it. It might save your life. In fact there is a very good chance it will. Also i reccomend looking up the Ashton Manual. .

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94

OK, Verwon, please read a little more carefully what the original poster (Syrus) actually said. He (or she) does take the Xanax regularly for anxiety as prescribed by the doctor. But when they feel a true panic attack coming, they take a little bit extra to stave off a full-blown attack. I'm not sure where you're getting the idea that they take the Xanax ONLY when they are getting a panic attack since the contributor never states this. They're NOT just "using Xanax to stop them." In fact, they state very specifically that they take 1 mg. of Xanax 3x per day to treat their anxiety. Also, according to the writer, the Xanax is still working just fine so they're wondering, legitimately so, why the doctor claims it's not working and is switching them to Valium. (Perhaps another case of deciding to "fix what ain't broke"? Who knows?!) I do agree that the patient should give the Valium a try. They may discover that it works as well or better than the Xanax. If they use it for a couple weeks and find that it's not as helpful as the Xanax, then they should return to their doctor and let them know that the Valium isn't working as well for them. In my own experience with pain medications, I've certainly learned that people can respond very differently to the same medication. Also, it's important to not assume from what's written on the internet that someone else's response will also be yours. Obviously, just the idea of changing meds is a difficult thing for this particular patient who says they have a "phobia for taking new medicines" so they need to push through that and remember that internet sources aren't always reliable! Unfortunately, doctors aren't always reliable either, particularly in their knowledge of medications. I've talked about this issue with my doc and he absolutely agrees that pharmacists are the true experts when it comes to medications and their use. That's their specialty! A doctor needs to know a lot of things and specific knowledge of specific medications and their interactions and usage is simply not an area of expertise for them. If the Valium doesn't work for this patient's panic attacks, it might be helpful to have their pharmacist communicate with their doctor about the co-use of Valium and Xanax. Since the original posting about this topic was over 3 years ago, I'd love to hear what happened and how the Valium vs. Xanax battle worked out!

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93

she's been prescribed 10mg Valium /3 daily. So she's not w/out proper medication. I just hope she is taking the valium bc it WILL work. I really believe that it will work much much better! I think her doctor made the right call. I know how she feels but I also know how much better she will feel when the xanax leaves her body and she gives the valium a chance.

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don't take it as an insult when someone suggests ur abusing it. Bc it's hard for a lot of people, non addicts/recovering addicts/and people that have nvr touched another drug in their life, to take that poison benzo and not have some issues w it. For those that can and do you're fortunate you don't. I had to switch after 6months of attempts to take it exactly as directed and every time I believed I could then finally I had to face that I can't and I told my doctor to switch me to valium and if I ever tell him I think it'd work better now and I wouldn't have any issues w it and to switch me no to xanax to tell me NO! Its too strong, that's the problem and it leaves it system quicker then any other benzo. So coming off of it w/out the valium u have now would be a nightmare! Your valium will work. He prescribed you valium bc it has the longest half life, it stays in ur body for abt 22 days. And it works. There's nvr going to be enough xanax that ur doctor can legally prescribe that's going to do u any better. Of course ur probably upset & offended now, many people have been there. You'll get over the xanax and you'll be happier w the valium in the near future. Btw valium is going to build up in ur body and stays there much longer so ur worry about needing that quick acting xanax in the middle of a panic attack won't be needed bc you'll have a build up if valium keeping the panic attacks at bay. that should help that problem. And u might ask ur Dr for an antidepressant that works great for panic attacks. A lot of them do. I find it odd that he didn't prescribe u one at that visit. Post updates on how ur doing! I will say the first few days will be just a little icky,maybe not, but that xanax will leave quick. once it does you'll figure out how the Valium is working for you...especially after a week-or 2 when it's really built up. Just don't give yourself a panic attack worrying abt the loss of ur xanax! You'll be okay.I have a feeling a month or two from now you'll be glad you were switched. Bc running out or low on xanax will give u a panic attack and can certainly land u in the ER desperate! That rollercoaster is over now. If you want to email personally just inquire abt my email and I'll give it to you.

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91

OK - firstly, let me admit I have NOT read any ptevious answers, as I am replying directly from a daily Medschat newsletter link.
I live in the UK where Xanax prescriptions are quite rare for two reasons; the 1 & 2mg strengths have been unavailable for over 15 years, and the cost of 500mcg tabs is about the highest I know of. Also there are no generic alprazolams whatsoever, so it's expensive original brand or nothing. The cost to me every month (2mg tds) was so much I had to change, not to Valium (which was withdrawn here in 1994 - only a few generic diazepams are dispensed, notably Actavis, but none of which are of the quality of Valium - which incidentally I am VERY surprised you get as Roche's US prices are ridiculously and criminally - in a price-fixing way - high...) but to lorazepam 2.5mg qds, a little weaker over 24 hrs. I tend to often get original ex-Wyeth Temesta/Ativan/Tavor (country-dependent brand name) as there are so few top class original patent brands left on our NHS due to a policy of dispensing the cheapest generic. More of which to follow in my advice.

Xanax is even worse in cost than here & one thing I DO know is that, should you ever go for generic alprazolam there is really only ONE SINGLE MAKE in America which even comes close to European (or Xanax) quality, which is that by Greenstone. US-made generic diazepam is similarly poor, Watson's DAN tabs having the best reputation and Mylan's green 10mg the very worst - you would be better off with the cheapest crap Indian brand than touching anything by Mylan USA - though here the old Merck Generics are now under Mylan name and retain the excellent quality of that German company.

To the facts. Diazepam is a LOT weaker than alprazolam so your doc is either ignorant or lying to you. 5mg for an acute panic attack Don't make me laugh. Diazepam is more useful as a sedative than an anxiolytic and 5mg is equivalent to only a white oval Xanax 'UPJOHN 29' 250mcg tablet - one quarter the strength of a 1mg! I find Xanax much better for anxiety and most certainly as yourself in higher than usual dosage (5mg in my case) for acute attacks. I then use Lysanxia or Lexotan to chill afyer the shock of an attack. However the information you should get over to your ptesumably undereducated or benzophobic doctor is that the anticonvulsant benzo CLONAZEPAM also acts not just as a prophylactic for seizure, but for panic; and it is VERY effective. Since starting (was on 2mg qds now reduced to tds) I have gone from two or three panic episodes per month to only one or two ANNUALLY over the past 8 years. I saud I would say more about generics - Roche withdrew the superb RIVOTRIL (except in one country where it is branded 'Klonopin' & also made in the very strange 1mg strength, whereas worldwide Rivotril is in only 500mcg & 2mg) last year because of that lowest price policy of the NHS - previously I was prescribed by brand - so when able to afford it I get the Roche Switzerland product, which of course is Roche's very best, or the top class Roche-licenced (& far cheaper) Rivotril by Galenika of Serbia rather than the now-ubiauitous Auden McKenzie generic, which has serious bioavailability issues probably caused by excipients used, & the characteristic minty taste can not even be tasted. I need back to 8mg or even 10mg daily when using those.

Personally I would go back to your doctor and explain just how wrong s/he is, how alprazolam & diazepam differ subjectively, and give him/her absolute PELTERS for suggesting a fully blown panic attack can possibly be tackled by such a puny dose of such a puny benzo comparatively. Your daily dosage of benzodiazepine is now precisely one third of what it was when using the Pfizer drug. Stronger my bony ass. Demand a return to Xanax 1mg tds but also an off-label usage of clonazepam (Roche - I know of only one decent generic & that is dispersible CLONOTRIL only found (Torrent Labs) in India) original Rivotril brand, as its efficacy as a preventative for panic attack is wonderful. Use diazepam ONLY as a sedative, dosage required being 20-30mg, not that idiotic 5mg; and for acute panic episodes, which I guarantee will be rare once clonazepam is part of your regimen, consider LORAZEPAM (I prefer Pfizer ex-Wyeth original brand TEMESTA) 2.5mg x 2 or x 3. It is faster acting than either alprazolam or diazepam. I also know of a friend who keeps flunitrazepam (1mg Roche ROHYPNOL & 2mg HYPNOCALM) and finds 3mg sorts out panic attacks very fast indeed - onset twice as quick as lorazepam, which is what hospitals give IV in 4/5mg dose when patients are in full panic mode. Rohypnol is licensed to be prescribed only for sleep so it may be difficult to get a doc to write up 3mg doses when 2mg is the maximum recommended in ANY country, but some decent doctors WILL prescribe on the basis of a patient's previous subjective experience.

The most important thing that comes out of your questioning post is that you are with a doctor who is either uneducated and ignorant, or is blatantly lying to you, & that is a situation demanding complaint to superiors. The wo/man is a fool and unfit to practice if issuing such nonsensical things and suggesting a completely ineffective solution to acute panic, which I have suffered now for 39 years so should know a little of what I'm talking about! Best of luck my friend.

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True colors came out after poor syrus poored his compassion to you Tiffany! As needed ?six times maybe a day?I read your last post crystal clear! Your abusing Xanax! Its not fun suffering panic attacks! I am greatful for valuim 3x daily.your going to be out and really have withdrals.

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Well there you go. Your education in mental health field you say? Those other meds help seratonins in your brain with panic attacks. Be careful filling a script u confidently have. Your med Dr. just tried helping. People do abuse Xanax! Not good to change a med Dr. My opinion, your upset with the antidepressants assuming it's for Bi polar. I agree with mirtazapine, and Dr.s usually listen to concerns. Remember seeing a new Med Dr. in psychiatry, kinda looks bad, but you must know they went to school for 15yrs and will let you know one of his concerns, your concern's, and what you've taken. I suffer from panic attacks, and I need my paxil, buspar, and valuim. help! Not cure, help with therapy.

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You can't have both.wouldn't we all love to have both for panic attacks, however from someone who takes valuim for panic attacks ,asked if I could try xanex and I did,and I went back to valuim.you asked 3pharmacists?wouldn't one be acceptable? You can't have both.

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