Hello All.....I have a strange question. I have both Generalized Anxiety Disorder AND severe depression. Now, I am quite familiar with what a panic attack feels like, which I had been handling with Rivotril/Klonopin. However, I felt that maybe Xanax might be a better choice, and have changed to using that benzo in order to sleep and (barely) function during the day. However, it makes me so very tired and I have virtually no appetite. (Now it could be my imagination, but the Xanax seems to have also increased my depression, but then I have also had some very bad things happen to me lately.) ANYWAY, I was wondering if any of you have ever experienced, for lack of a better term, a "depression attack". The best way I can describe it is this immense feeling of hopelessness (no sweating, racing heart, like with a panic attack). Has anyone experienced this "flip side" of a panic attack, or have I just lost some more of my marbles? Thank you so much for your help!.......Kim

I have tried xanax and it makes me so tired and washed out.I went to my mental health providerand they prescribed Clonopin which I like better but makes me tired to.Both are very addictive.

Xanax and other benzos are known for sometimes causing anxiety and depression. Also, they can make you very tired. Usually the side affects go away after you have taken the medicine after a while. Don't worry you are not crazy.

Sometimes an option would be to cut your medication in half to allow your body to get used to the medication. Sometimes worth thinking about.

Xanax is rarely a better choice. Believe it or not, Ativan used to be prescribed in the UK for depression associated with anxiety - that indication soon disappeared. Diazepam is an all-round better choice.

I take effexor XR 75mg and Diazepam has interactions. I take Xanax and you do build a tolerance to it quickly. Then I cut way down and my tolerance goes way down too. I wish though, I could take a valium every now and then but I'm not allowed...(miss em too)

That's an unfortunate interaction in your case since it generally doesn't occur, though has been tested for:

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=7650232&dopt=Abstract

Very unfortunate is exactly what I say. Valium helps me more than Xanax.

This has been an ongoing debate, I have shared this before and will again. The source, while just an opinion, is the opinion of my brother. He graduated second in his class from Boston University School of Medicine, did a 4 year residency in psychiatry and a fifth year fellowship in child/adolescent psychiatry.

I am quite proud of him and trust his judgement implicitly, he is the second smartest doctor I know, second only to my dad who is an internist.

Regarding benzos and anxiety, he has told me that the short acting ones, especially Ativan (lorazepam) and to a similar extent Xanax (alprazolam) are medications that he rarely if ever will consider prescribing.

He prefers, when needed to prescribe one of the good ole 3. Valium (diazepam), Librium (chlordiazepoxide) and Klonopin (clonazepam).

His rationale for opting for the longer acting ones rather than the shorter acting ones is thus. One has an anxiety reaction, one feels an attack coming on and one takes, for instance a 1mg dose of Ativan or Xanax. 4-8 hours later, the active blood levels of the medication drops off, rather quickly in fact, and one can often feel "rebound anxiety". This rebound anxiety, which can occur often when the short acting benzos wear off, can actually be worse in intensity than the original anxiety. So what does the patient do then? Well usually they wind up having to take another pill, an so on.

When one uses a longer acting benzo like valium for instance, its half life is so long, that it eliminates very slowly from the body and has active metabolites, so after its first pass through the liver it produces oxazepam which also acts as an anxiolytic, so as it slowly decreases in active blood level from the body, it is much less likely to cause "rebound" anxiety.

Anyway, it makes sense, and that has been my brother's experience treating many patients, young and old alike.

So I agree with Nephro on this one, valium, librium and klonopin are better choices for most folks.

Every one is different and your mileage may vary.

wishing all as pain free (physically and pschologically) a weekend as possible

JimmyK and the rest are right. I was prescribed xanax years ago and tolerance builds up quickly. Getting off of it is sheer hell. Klonopin works extremely well for phobias and anxiety disorders.

Good luck.

[quote=Adena]Xanax and other benzos are known for sometimes causing anxiety and depression.
[/quote

Dear friend, Adena, this is in no way a bashing of your opinion, or ideas. that disclaimer made, let me be clear... I have no MD to qualify me, but I've had 35 years, of experience, (more actually). Now, while it IS definately a problematic issue while one tapers, (or titrates DOWN) an increase in anxiety CAN, and often DOES present problems for patients who wish to come off benzo's. HOWEVER, Never in my reading, or experience, have I ran into information that INCREASING dosage can cause this effect. if you stay dose consistent, one may occasionally become tolerant to that dose, and THEN, yes, those symptoms can increase in severity. please, don't take this as me hammering you. your opinion is just as valid as mine, I'm only sharing my (informal, but extensive) education, and my experience with you, and the questioner who began the conversation.

2) Benzo's will/can cause problems with fatigue for as long as one takes them. I've been on them (& off) for many years. I've always had a problem with fatigue, but usually I first get a burst of energy, THEN, that will subside, and THEN I get tired. just my experience.

one last thing: I find that benzo's will actually HELP RELIEVE depression. I have had a long painful fight for life, (no exaggeration) with depression, as well as anxiety... but, for what it's worth, in my case, xanax makes me feel happy, but... be careful because if you can feel it, and especially if ya feel good you're probably raising your tolerance too much. perhaps WAY too much. just be careful, and good luck.

to all -- may the universe look after you, and may you find the peace you deserve...

Agreed... absolutely, agreed. but, detox not only CAN BE hell, IT IS hell. However... one thing that will be a huge benefit is a VERY slow taper. so slow, you can't feel the decrease. if ya feel a decrease, IMO you're moving too fast. I've had to kick... (NO, I won't go into detail) several addictive drugs simultaneously. it was 8 days of very real dangers, in fact terrifying to me, literal hallucinations, both audio as well as visual... never would I wish this on anyone. the point here is that you NEVER should detox, or even titrate DOWN without going VERY slowly. not only will your success be more likely, you'll feel 100% better.

anyway, klonopin, valium, Xanax, or whatever benzo, it really doesn't matter, except that Klonopin's detox will last longer, (for the exact reason it's a preferable med for some prescribers, longer 1/2 life). My own opinion differs, but whatever. that's not pertinent to this discussion. I just wanted to say, they will bother be terrifically painful to get off unless you go VERY, VERY VERY SLOWLY. PLEASE read that again. then once more, if you are going to come off a benzo.

While that may have been your personal experience with benzodiazepines, it is definitely not always the norm.
Medical research is replete with reported negative side effects from long-term benzo use including agitation, depressed mood, insomnia, cutting and even suicidal ideation.
Steady dosing, increased dosing, tapered dosing, doesn't matter. I'd say you have been very lucky if you've been taking these drugs for more than 35 years and have not encountered any of these problems.
The monograph for Xanax even warns that patients should be careful to discuss any history of depression with their doctor before taking the drug.