Hi Moe. My GI suggested the Xanax .05mg. That was 16 years ago. I have never had to increase the strength or frequency. I have had zero side effects from the xanax. I am exquisitely chemical sensitive. Many many drugs I cannot tolerate. I thankfully do not suffer from anxiety or depression.
My esophageal spasms are a result of nerve damage. I can only imagine how awful it must be to have this problem and then have it compounded with anxiety disorder.
My spasms are very much like yours. Thank God they do not happen every day. In the past the Xanax would relax the esophageal muscle, and that would stop the pain. Think of it like a severe spasm in your calf muscle, ya know. Then it all makes sense. Once you stop the spasm....the pain goes away. However....I have evidently taken a downward step. Most esophageal spasms are due to either acid reflux, and/or damage to the nerve endings in the esophagus. I have both.
None of my Dr's have suggested use of AD's, since I don't suffer depression. The CNS (xanax) as I have said, took care of the problem for 16 years. Evidently the nerve damage has gotten worse, so now I'm going to occasionally need a narcotic along with it to handle the severe pain that now is going to accompany the worst of the attacks.
Over the years as they have been approved, my GI has tried me on many PPI's. Everyone has caused awful side effects. So I basically did a total lifestyle dietary change. No citrus, tomato based foods, greasy foods, spicey foods, no caffeine. It really was not hard to do.....because as you well know.....the attacks are so horrible, it was actually easy to eliminate them from my diet.
...anyway, I hope they find something if the xanax is wearing off.. have they suggested another benzo maybe? Klonopin or Activan? Or something like 
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