Anxiety Support

Afraid to Take Xanax

Hi all, okay, so went to Urgent Care today with a massive head, nose and chest cold and congestion that made me panic all night because I felt like I couldn't breathe. Even through my mouth. I was given Maalox that took the heavy, constrictive feelings from my chest away (the PA suspected it was acid reflux, and she may have been right), and I was told to take Zyrtec for my allergies, a saline nasal spray for my nasal congestion, and a Zantac every day to prevent acid reflux and heartburn. I was also prescribed Xanax for my anxiety. I explained to the PA about my breathing problems, what I suspect is chronic hyperventilation syndrome (more about it in this link: emedicine.medscape.com/arti... ). I read there that certain anti-anxiety meds like Xanax can help with hyperventilation if it is caused by anxiety or a panic attack. From that link:

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"Anxiolytics, Benzodiazepines

Class Summary

Benzodiazepines are useful in the treatment of hyperventilation resulting from anxiety and panic attacks. By binding to specific receptor sites, these agents appear to potentiate the effects of gamma-aminobutyric acid (GABA) and to facilitate inhibitory GABA neurotransmission and the actions of other inhibitory transmitters.

Alprazolam (Xanax, Niravam)

View full drug information

Alprazolam is indicated for treatment of anxiety and management of panic attacks.

Lorazepam (Ativan, Lorazepam Intensol)

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Lorazepam is a sedative-hypnotic of the benzodiazepine class that has a short time to onset of effect and a relatively long half-life. By enhancing the action of GABA, a major inhibitory neurotransmitter, it may depress all levels of the CNS, including the limbic area and reticular formation.

Diazepam (Valium, Diastat)

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Diazepam depresses all levels of the CNS (eg, limbic and reticular formation), possibly by increasing the activity of GABA. It is considered second-line therapy for seizures.

Next: Antidepressants, SSRIs

Antidepressants, SSRIs

Class Summary

SSRIs are useful in treating hyperventilation associated with anxiety.

Paroxetine (Paxil, Pexeva)

View full drug information

Paroxetine is the alternative drug of choice for HVS. It is a potent selective inhibitor of neuronal reuptake of serotonin and has a weak effect on neuronal reuptake of norepinephrine and dopamine."

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So as it states above, Xanax may help with HVS (hyperventilation syndrome) if it is caused by anxiety or panic disorder. However, one of the many possible side effects of Xanax is trouble breathing, plus I have not gotten much sleep at all so I already feel drowsy and sedated, making me scared that the Xanax could just magnify that and possibly kill me (by sedating me too much.) The PA that prescribe it suggested I only take one a day and at bedtime, and it is okay for me to try with only half a pill. Am I overreacting in being concerned about taking one or half of one Xanax at bedtime if I am already tired and if I have hyperventilation syndrome? I really want to get over this and get back to the confident, outgoing, worry-free man I was just a month ago before the hyperventilation and panic attacks befell me. I now I'll need therapy too, and I was referred to a psychiatrist, but until I see one, should I try the Xanax? None of my doctors or pharmacists seem concerned about the possible side effects I worry about. Thank you.

-Chris

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Chris. I don’t have hyperventilation syndrome, but suffer from generalized anxiety and panic attack disorder. Xanax has been a godsend and extremely helpful in calming me down. I’ve never had any problem breathing with xanax though. I can relate to fear of a pill though. I was once prescribed a beta blocker which helps slow your heart rate to calm you down. Mentally though, the thought of that just didn’t jive with my anxiety. Taking it just made me more anxious so I decided it wasn’t for me. If you’re afraid of taking it, you may not feel the effects since taking it will cause you stress. If you’re already drowsy and sleepy from other meds, ask yourself... do you really need it? I can, however, assure you that they’ve prescribed you a pretty baby amount of Xanax that will in no way kill you. I once had to take up to 5 10mg during a bad panic attack and was fine. I’d say only take it if you feel your anxiety is getting the better of you... it really does make you go from “oh my god im going to lose my mind” to “I feel pretty fucking fine right now” in a short period of time. That said, coming from my experience with beta blockers, sometimes there’s just you just don’t want to take something no matter how illogical or unfounded your fear is (mine definitely was... my cousin is a heart doctor and told me multiple times I had nothing to worry about with the beta blocker... nonetheless, i just struggled to trust that and move past it so I decided not to take it).

Also, sounds like this is a big 180 for you. After my first panic attack, my life kind of changed over night. Had never been to therapy, had no idea what was happening to me. Felt like, who the fuck am I? Recently wrote about it in a reflection of my life since then... maybe it will help and provide some insight: medium.com/@defoxington/how...

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Hi, defx, thanks for the response. I am not drowsy from other meds. I am drowsy and overly exhausted from not getting any sleep because my panic attacks are worse at night, even when I think I am calm and relaxed. I am also tired because I was diagnosed years ago with CFS (Chronic Fatigue Syndrome), that is that no matter how much sleep I used to get (before my anxiety), I was always overly exhausted. I may also have sleep apnea that runs through my family and that my father has, also contributing to my daily fatigue. I am just afraid that since I am so drowsy already-from not sleeping due to anxiety, from fatigue due to CFS or Sleep Apnea- that the Xanax, being a sedative, could exasperate that and kill me by sedating me too much? Yet, as you pointed out, I was prescribed a "baby" portion so it shouldn't bother me at all. As you know, our anxiety makes every little thing seem 10 times worse than it really is (like this head and chest cold I have right now.) I am going to try it this weekend when I have no plans in case I get any bad side effects. I see my PCP (primary care physician) this Tuesday again and I will talk with him about it and about other anti-anxiety meds or anti-depressants. I was also referred to a psychiatric clinic that I plan on calling to see how much a session is and if my insurance will pay for any of it. Thank you again.

-Chris

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Sounds like a good plan man. Sorry you've had to shoulder chronic fatigue on top of the anxiety - that's something I have less familiarity with! I can imagine it isn't fun...

I will say, it's a little easier to find that balance between "gonna knock me out" and "gonna level my anxiety out" with something like Xanax - could take some trying to find that balance, but starting with a small dose (you can even break the pill in half and take a really minimal amount) will likely not exasperate or overly sedate you. It's faster acting and less powerful of a sedative than something like Valium (which can feel like what I imagine being shot with a tranquilizer dart is like). If it's expressly used for calming panic, something I am well versed in, xanax really can be an effective medication to have by your side. That said, totally understand your hesitation and wanting to be sure - anxiety does make things seem 10 times worse - the last thing a new medication should do is to cause you more anxiety in the long run. So if it's something you just mentally don't feel comfortable with, I wouldn't burden yourself with taking it. Good luck with the insurance - always a crap shoot on that - got lucky that mine will cover up to 65% per session following deductible. Still expensive, but my health is worth the cost if within reach of my budget.

Take Care,

Daniel

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Yes its alright to take the xanax but half will probably not work as good I take 1 in the morning and 1 at night I suffer from severe anxiety and if I hadn't got them id go mad it really helps so hopefully it will work for you too

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