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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Taking Xanax Long-term. Have GAD. Need Alternative For Xanax

I have taken Xanax for close to 10 years, and were told long ago that I have GAD and recently that the medication may no longer be as effective as it once was, BUT that there's "no alternative".. My anxiety is clearly hereditary, and it's obvious that I need an alternative. I'm also pursuing other non-medical alternatives. Is there an option for me?
Mon, 22 Apr 2013
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General & Family Physician 's  Response
Hello, and thank you for using Healthcare Magic!



Generalized anxiety disorder (GAD) can be treated with a variety of drugs. Benzodiazepines, which includes medications such as Valium, Klonopin, Ativan and Xanax are very effective for treating this disorder. However, in recent years they have fallen out of favor due to the fact that they are highly habit forming, and can be life threatening if taken in very high doses. Finally, if a patient takes them regularly for a long time, the withdrawal symptoms which occur if the drug is stopped suddenly can be very severe, sometimes life threatening. There are many other drugs which are also very effective and have less dangerous side effects.



A class of medicines that are primarily used for depression (selective serotonin reuptake inhibitors, or SSRIs) have also been shown to work very well for GAD, and now are recommended to be used as the first choice in treating anxiety. One of the reasons they are thought to work so well for anxiety is that frequently patients who have GAD also have depression (and treating the depression makes the anxiety less severe). These medicines do have side effects, certainly, but they are much less severe than with benzodiazepines. Also, SSRIs are not habit-forming and do not cause withdrawal symptoms when stopped. Examples of these medicines include Prozac, Zoloft, Paxil, Celexa and others.



It is VERY important that you not stop taking Xanax all at once after taking it for years. You need to be slowly tapered off of it, under the close supervision of a doctor. This will ensure that you do not experience the serious problems that benzo withdrawal can cause.



Here is some excellent information for patients with anxiety: http://www.emedicinehealth.com/anxiety/article_em.htm





I hope I have provided you with helpful information, and I wish you the best of health.



Sincerely,



Dr. Kinney
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Taking Xanax Long-term. Have GAD. Need Alternative For Xanax

Hello, and thank you for using Healthcare Magic! Generalized anxiety disorder (GAD) can be treated with a variety of drugs. Benzodiazepines, which includes medications such as Valium, Klonopin, Ativan and Xanax are very effective for treating this disorder. However, in recent years they have fallen out of favor due to the fact that they are highly habit forming, and can be life threatening if taken in very high doses. Finally, if a patient takes them regularly for a long time, the withdrawal symptoms which occur if the drug is stopped suddenly can be very severe, sometimes life threatening. There are many other drugs which are also very effective and have less dangerous side effects. A class of medicines that are primarily used for depression (selective serotonin reuptake inhibitors, or SSRIs) have also been shown to work very well for GAD, and now are recommended to be used as the first choice in treating anxiety. One of the reasons they are thought to work so well for anxiety is that frequently patients who have GAD also have depression (and treating the depression makes the anxiety less severe). These medicines do have side effects, certainly, but they are much less severe than with benzodiazepines. Also, SSRIs are not habit-forming and do not cause withdrawal symptoms when stopped. Examples of these medicines include Prozac, Zoloft, Paxil, Celexa and others. It is VERY important that you not stop taking Xanax all at once after taking it for years. You need to be slowly tapered off of it, under the close supervision of a doctor. This will ensure that you do not experience the serious problems that benzo withdrawal can cause. Here is some excellent information for patients with anxiety: http://www.emedicinehealth.com/anxiety/article_em.htm I hope I have provided you with helpful information, and I wish you the best of health. Sincerely, Dr. Kinney