Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Do we normally get prescribed Aplrazolam / Xanax?

Hi,

I went to my doctor to see if i should be taking my next shot of remicade. The blood work was not good, with elevated liver enzymes and ESR 26 and CRP 18.

She said i can do with a remicade shot now (based on whenever i am able to afford it) and then she prescribed me alprazolam 0.5 mg. Earlier she had prescribed me Trika. These, I understand, are anti-depressants and anti-anxiety medicines and they are meant to work as relaxants for us (that's what the doctor indicated). Did she precribe me this because i exhibited concern over the pain in my right hip??


I tried to read about it on the internet and was actually scared of the long term effects such as dependency, clumsiness, loss of sense of balance (esp. while driving), rage, impotency, suicidal or destructive urges.... Now these are long term effects; short term effects are constipation, lethargy etc. It takes so much effort to get out of bed...

I was driving yesterday back from a small getaway, and i did kind of sped a lot (even over bad roads) and then the after thought hit me. I know it helps me with the immediate tightness with the muscles esp. while sleeping but i am concerned as to how long i should use it...

What are your thoughts, has this been prescribed to you, what are your experiences? My hip has suddenly started to behave better since i visited the hospital, i don't know why and i am thinking of deferring the remicade shot more for financial reasons but I am not too comfortable in knowing that this drug could actually change my psychological responses.

-----------------------------------------------------


Indications
Xanax 2 mg tri-score tablets (AU)

The main medical uses for alprazolam include:
Panic disorder

Alprazolam is FDA-approved for the short-term treatment (up to 8 weeks) of panic disorder, with or without agoraphobia. Alprazolam is very effective in the short-term symptomatic relief of moderate to severe anxiety, essential tremor, and panic attacks. Physicians that elect to prescribe alprazolam for longer than 8 weeks should be aware that continued efficacy has not been systematically demonstrated beyond 8 weeks' use, as tolerance to alprazolam's effects may occur after 8 weeks and necessitate discontinuation or physician-directed dose escalation.[15] The physician should periodically reassess the usefulness of the drug for the individual patient.[16] Alprazolam is recommended for treatment resistant cases of panic disorder where there is no history of tolerance or dependence.[17]
[edit] Anxiety disorders

Alprazolam is indicated for the management of anxiety disorders (a condition corresponding most closely to the APA Diagnostic and Statistical Manual DSM-III-R diagnosis of generalized anxiety disorder) or the short-term relief of symptoms of anxiety.[16] Alprazolam is recommended for the short-term treatment (2–4 weeks) of severe acute anxiety.[18][19]

Alprazolam is sometimes prescribed for anxiety with associated depression. There is some evidence that it has antidepressant effects in treating clinical depression in outpatient settings; evidence for inpatients is lacking.[20] The antidepressant effects of alprazolam may be due to its effects on beta-adrenergic receptors.[21] Other benzodiazepines are not known to have antidepressant activity.[22][23] Studies show that any antidepressant action of alprazolam is questionable and generally weak in comparison to those of antidepressant medications.[24][25][26][27] In contrast, while alprazolam in acute or short-term treatment may have some antidepressant properties, there is evidence that up to a third of long-term users of alprazolam may develop depression.[28]

Side effects

Although the side-effect profile of alprazolam is, in general, benign, side-effects may occur in some patients and are more likely the higher the dosage taken. Some side-effects may disappear with continued treatment. If signs of an allergic reaction occur - such as hives; difficulty breathing; swelling of face, lips, tongue, or throat - medical attention should be sought immediately. Medical attention should also be sought immediately if signs of jaundice appear: yellowing of the skin or eyes. Other side-effects that may occur are as follows:

* drowsiness, dizziness, lightheadedness, fatigue, unsteadiness and impaired coordination, vertigo[29][30]
* skin rash, respiratory depression, constipation[29][30]
* disinhibition[31]
* suicidal ideation (rare)[32][33]
* urinary retention (infrequent)[34]
* hallucinations (rare)[35]
* ataxia, slurred speech[36]
* short-term memory loss and impairment of memory functions, particular the memory that the user experienced during the time of intoxication[37]
* anterograde amnesia[38] and concentration problems
* Change in libido[39]
* xerostomia (infrequent)[40]
* disorientation (when medicating in excess, such as to induce intoxication for recreational purposes)[41]
* increase in appetite[42]
* jaundice (very rare)[43]

Paradoxical reactions

Although unusual, if the following paradoxical reactions occur, the prescribing physician or other healthcare professional should be alerted and the medication gradually discontinued:

* Fasciculations and tremor[44]
* aggression[45]
* rage, hostility[31]
* mania, agitation, hyperactivity and restlessness[46]

My doctor prescribes clonezapam for me to stave off muscle spasms. I don't take it every day, and I've been taking it for 14 years and haven't become addicted. I personally have three rescue meds that I use depending upon the situation and severity of pain. But I'm super careful with them and never take more than is prescribed. Did your doc want you to take it every single day, or just for emergencies?

Well, seems like its for a month and then follow up...

if it were me, i'd prefer to be prescribed exactly what i was prescribed, a muscle relaxant to address the tight muscles directly. i've been on zanaflex, 2 mg, at bedtime since 2001 or so. i also take it as needed, but the bedtime dose loosens my tight muscles a bit, helps me to fall asleep, stay asleep, and not have muscle tighten too much over the next about 6 hours (its very short acting, perfect for a night's sleep).

when i first developed the gatritis, was given the prescription for the acid blocker and another for xanax. i took the xanax for about a week and realized it wasn't doing anything for me and didn't like the idea of being on it long term, so went off it with no consequences. i've been on the acid blocker for the last 17 years.

i tend to like to use the drug that affects exactly what we're trying to affect, no more, no less. not always possible, but its what i strive for.

interestingly, i do think sometimes we can come across anxious, even if we're not. i'm not exactly sure why some doctors tend to put it into my report; i think they mistake intense for anxious. after dealing with the symptoms for over a decade and going to 5 different rheumies and a slew of other doctors, yeh, when i go in, i'm all business. if they want to see me relaxed, being casual, having a good time, i can invite them over for dinner some time!

Rightly said Sue... The first time i met my doctor, i was literally limping, with a lot of pain in the right hip and this time too i was concerned about my right hip. She told me that i have put on weight (which is a fact) but it seems to me that she has taken that impression of me too. Like you when I go to see a doctor i want him / her to be very specific and I have seen some doctors trying to change the subject or move on when i try to discuss the topic in detail. Then i will get compliments (or so one would think) that "you know you should have been a doctor". Its as if you are not supposed to know well about your disease. Also, there are others who tend to advice you not to read too much about your disease over the internet, as if we can't take it.

Hi Anky..
I have been on both. I am glad I am not on them now. Cause I was really confused and dull.. Cymbalta is my main med. but that is my story. I sure hope osmethign works for you. Let me know what helps, ok?

Your friend
Lon

all sounds familiar, but i can also say it really depends so much on the doctor i am talking to. a few sort of "opposite" cases:

recently saw a new doctor, a naturopath. she complimented me on what a good organized patient i was. said she wished all her patients were so proactive and on top of things.

saw my podiatrist after not seeing her for two years. saw her because the new rheumy had scheduled xrays of my feet. semi-apologized for being there though my feet were pretty good and i was managing ok with the tips she had given me n the past. i have had doctors act like i was wasting their time under similar circumstances like "if you're not sick, then why are you here?" instead she was so positive! so thrilled that i was doing so well. thanked me for coming in, keeping her in the loop regarding the feet, the xrays, etc. was thrilled that she had been able to help. and was glad i had figured out the mysterious edema i had in them, those two years ago....was due to a statin i had taken. when i left there, she had me feeling (emotionally) like a superstar. it was so nice to have such a positive interaction. made me realize, not so very hard to make a person feel good about themselves instead of bad.

many of my doctors: my gastroenterologist, my endocrinologist, my physiatrist, tell me to my face and i see it in the reports that they write, that they see me as a good organized, proactive, educated patient, and are happy about that. just wish everyone saw me and treated me that way. and it was pretty much from the beginning, not after they got to know me better. so i just think it comes down to personalities, theirs and mine, and how we interact.

i think what disappoints me the most some times is when i think i have this great relationship, then read in the notes something different than what i thought. i shouldn't care so much, i know that, but still do.

Sue,
Your reply to Anky.. is very right on!
Your deep caring endears you to all of us.
Lin had me take out a section in our Christmas letter this year because she thought I had said it all last year. I have a need to express my anger at not feeling fell every stinking day.
Anky, Sue, we love you guys.

we love you too lon and glad to see you back here once again!

I personally can't do any of those mood altering drugs (antidepressants) - succumbed to citalopram last year mostly because several docs were pushing it and I hadn't been on anything like that for a while. Took it for six months - it flattened my mood, made me more apathetic and lethargic, got me thinking some weird thoughts (like while driving on several occasions I considered how easy it would be to put my foot down and veer onto the wrong side of the road into oncoming traffic), and didn't do anything for pain levels, neuropathic or otherwise. When I finally came off the stuff I couldn't believe the difference - I felt human again and in touch with the world. And thats apart from the physical side effects I also suffered.

Yes, I know for some people antidepressants used for pain, etc, can have amazing effects, but its not for everyone. I personally would rather take drugs that are much more targetted - if I want a muscle relaxant, then I take a muscle relaxant.