Anxiety Meds before, during and After

[Don C 2]

I have had pretty bad panic/anxiety attacks since my 20s, so going on close to 30 years. I was diagnosed with panic disorder when I was about 29, I'm 50 now. I took xanax as needed when they figured it out. I still had attacks because I took it "as needed" and I wasn't good at knowing when they were coming on. Then Xanax XR- extended release came out. This is not a fave drug of psychiatrists but works for me- yes I have tried Pristique, Buspirol and all the others- they tend to be anxiety/depression meds and I am a rare zero depression type so when that phase of meds kicked in- I was SICK. So bottom line the Xanax XR works well for me. I am on 4 MG a day every morning. It is one that causes dependence- believe me I know if I forgot a dose within a few hours of my normal time of taking it. It also sits in the stomach from what I read and has a coating that makes it "gel" and stay there? dunno on that my psychiatrist is going to investigate absorption rates and things I was vaguely understanding from her.

I know I can't be the only one on a med like this that went for the surgery. If I was to "wean" off of this drug- you can't go cold turkey- seizures, convulsions, death, fun stuff like that, you can do a .5 mg reduction per week or two until you are off. So it is 'possible' to come off, eventually I want to be off of it anyway. But that means the debilitating attacks come back. I have read articles about moving from the immediate release- the kind "druggies" like to get their hands on to moving to extended release. But not the other way. My hope is to someday be off the constant XR and just take as needed especially since I will be retired and be able to deal with it, ride it out, take a break- etc- the things I can't do at work mid-meeting.

So I consult with my surgeon and he asks what is your biggest concern about having the surgery? And I tell him about this. He said "Nah don't worry bout it, how big are the pills? Bigger than an M&M?" Nope about that size actually. "Yeah just get up a few hours earlier, pop the pills, go back to bed, then come in for surgery- then when you wake up the next day just take them with a sip of Water, it will all be good. He's a very experienced, confident- almost cocky but not really guy" And I know all surgeons seem different on what to eat/drink, type, when, how fast etc. Even with me I will have the two week pre-op diet but he said I don't have to lose any weight for the surgery- both of my friends who did it had to drop 50 and 35 pounds respectively. So I am trying to trust my surgeon based on him knowing my needs. I should have asked- have you had any other patients who were on meds that they couldn't come off of easily?

So I know I am going to have some funky physical sensations with the surgery and healing- these physical sensations tend to trigger a panic attack for me so staying on my meds would be a good thing.

Have any of you out there have to deal with this? I also found out that I can't crush my Crestor or Actos- I didn't think they were extended release but I looked it up- I KNOW lots of us are on those meds for cholesterol or diabetes. My surgeon said "You aren't going to need those." Actos for pre-diabetes probably not, the Crestor I think I will as I needed it when i was skinny due to a genetic disorder making my cholesterol way out of whack. But I also thought- I may not need these in the future but immediately after surgery? It seems everyone with sleeve appears to drop about 35 pounds with immediate pre and post op diets but I wouldn't think that would change my numbers so much that I could come off those other meds. And I can be off them for a couple of weeks without more than a headache for just stopping.

So anyone have to face this or something close?

thanks in advance for any perspective you can share

Don

[mousecat88 2,281]

Okay, few things... I was on Xanax for 15 years (6mg a day) and I was able to just stop and start - no withdrawals symptoms. Some years I was on XR, some the instant release. Do you actually experience dangerous withdrawal symptoms or do you just think you will? Or do you just have increased anxiety?

I was switched to Valium because it lasts longer. I now take 30mg of valium a day (in 3 doses). I take as needed, however, so rarely 3 a day (typically one at night). They are small, like Xanax. Rather than going down in dose since surgery, I have needed an increased dose. I was only at 10mg a day, but another anxiety medication I was taking, Tenex, was causing me to blackout when standing so they had to stop me on that. I did have very severe rebound anxiety after the removal of the Tenex, which is when they increased the Valium.

Pill size only mattered if they were giant horse pills. I had to crush my Potassium pill for a month.

I was also on Ambien CR (the extended release). They told me to switch to instant after surgery, which doesn't help as much, but I did. HOWEVER, I have run out on occasion of the instant release and take a leftover extended release pill and it still works just as effectively. Every body is different, but the extended release may still work exactly the same for you, like the Ambien CR did for me. Can you switch to the instant release Xanax if you are concerned about it? Or switch to Valium because it is longer-acting than Xanax.

I don't think there is any shame on being on a benzodiazepine the rest of your life if it helps. I intend to be on either Xanax or Valium forever BECAUSE IT WORKS. No interest in not taking it and no shame in needing it.

Edited May 24, 2019 by mousecat88

[Don C 2]

Yes I do get rebound and withdrawal symptoms- first I get kinda fuzzy feeling, then nauseous. If I go longer I get the “electric shocks” feels like zapping in my head- pretty scary but I’m not actually having a panic attack it’s like I’m too sick to have one? I don’t know if that makes sense.

I was hoping my doc will tell me to come off the xr 4 mg and go to 4 mg throughout the day. I know my 4mg is only lasting 12 ish hours with xr so very rarely I’ll have an issue at night. But I’ve never been woken from sleep with an attack. I thought like you I probably wouldn’t take all 4 mg a day immediate release

also thanks for the support with taking it because it works. Taking those meds for panic attacks is not something I like discussing with people- anyone on that med doesn’t like too I’ve only become ok with it recently.

I have an apt with my psych before I have surgery so I can discuss options with her. She’s very good with me and my needs.

Thank you you for sharing I’ll share some of those options with her too and see what she thinks.

Thanks for sharing your experience