Just a follow-up note from a "veteran" of xanax usage. I'm happy to say that I'm down from 4 mg to 3.5 mg of xanax daily now (reducing caffeine helps a lot - thanks, Leegh!), and have set my goal for 2 mg...but slowly. And then maybe lower - who knows.
I had an extremely stressful day a few days ago, and returned to 4 mg, but didn't have much discomfort returning to my current 3.5 mg.
I think Gingertea is correct about many who take xanax long-term. Many do not
build up tolerance under normal conditions. My escalation to 4 mg this last year was brought about by extreme stress, grief, and resulting insomnia.
But I had stayed at 2 mg daily or below (distributed thru the day and taken as needed) for many years
before with no need to increase my dosage. It stopped my panic attacks, quieted the constant "background" anxiety, and helped me stay asleep. It also lowered my BP, which tends to be a bit too high.
My doctor and psychiatrist independently said that xanax (or other benzos) for people with baseline (pre-treatment) anxiety and/or panic disorders seems to be about as significant as insulin for diabetes - particularly if the anxiety disorder is inherited and long-term (like mine). There's just something genetically awry in our nervous system (which is made even worse by stress) that seems to be "patched" by the xanax. One theory is that we have innately defective GABA receptors. Of course, I'm just expressing opinions, not hard facts.
Importantly, I have not lost mental acuity and do not feel "drugged" while taking xanax. At the very beginning, I used to feel an initial euphoric drowsiness after taking it, but that stopped happening fairly soon (kinda miss that, though - it was nice
). Now I actually feel more "normal" (emotionally balanced) with a bit of xanax in me.
Also, both my GP and my psych said independently that they personally have never known true anxiety/panic patients to abuse benzos such as xanax - we apparently seem to be too afraid of hurting ourselves or losing control of our functions. In fact, they said that we anxious folk are often guilty of underdosing and unintentionally inducing withdrawal.
I don't suspect either of my doctors of pushing "big pharma" because generic xanax is quite cheap now. (I've found Purepac and Greenstone to be the best quality.) I had awful experiences with several SSRIs, tricyclics, Wellbutrin, and other benzos, so xanax seems to be the right "key", for me personally at least.
I have wondered if xanax may have been "demonized" because there are many more expensive products out now that certain interests would like to profit from. I have heard too many stories of the agony of getting off of new SSRI's to believe that tapering off of xanax is any more difficult. Yes, it does take time and patience.
Before the advent of benzos, several members of my family treated their genetic anxiety/panic with alcohol, which ended up killing an aunt, an uncle, my brother and my mother (they all died of cirrhosis or strokes while intoxicated). Before xanax, alcohol was the only thing I could use that would stop painful anxiety or a panic attack - but with obvious risks to my physical health. Given the choice between constant anxiety and panic, alcohol, or xanax (which poses few dangers to one's health aside from "cold turkey" withdrawal), I have chosen xanax.
PS: Years of psychotherapy with different therapists (several of whom really disapproved of xanax therapy) never succeeded at reducing my anxiety. I feel now that it's something like trying to treat diabetes with psychotherapy. Given that I would wake up from a sound sleep and pleasant dreams in a sudden panic attack, I'm pretty much convinced that this is biochemical and not psychological.