Does Xanax work for all panic attacks?

July 15, 2005 8:31 AM

Xanax and anxiety have been discussed here before, but I've recently been prescribed Xanax to be taken on an as-needed (during an attack) basis and am too scared to take it.

My specific attacks are more of the derealization/woozy/can't swallow/numb variety, rather than the chest pain/sweaty/hyperventilating stereotype. Will Xanax take those feelings away, or just leave me feeling even more out of it?

posted by juniper to health & fitness (21 answers total)

Although I don't know much abour Xanax, may I suggest something? I think you should take one when you aren't having an attack. That way you'll get to become familiar with the effects without the added burden of the anxiety.
posted by Specklet at 8:44 AM on July 15, 2005

My experience with Xanax wasn't great. Lots of memory loss, "out of it" feelings. You could always try scoring the tablet in half... but the most important thing to do would be to tell your doc that you are really uncomfortable with this drug and want to know what your options are. I was given Xanax for suspected anxiety attacks and a sleep disorder, but further testing showed that I was having genuine heart trouble and not a classic panic atack. There are a variety of therapies, like CBT, that do help with panic attacks... if possible, think about a therapeutic treatment as opposed to a pharma one. My old doc tried to treat a phobia with drugs and it didn't work, only desensitization worked. Anyway, best of luck, and you're welcome to contact me if you want more discussion!
posted by moonbird at 8:48 AM on July 15, 2005

Xanax is a good drug at what it does, but it is also very addicting. Very addicting. I would not be afraid to use it, I would caution you that if you use it too much it can begin to cause anxiety when you are in withdrawal from it. This can lead to a bad cycle, in which you are no longer taking the drug to counter anxiety that you had before, but a new iatrogenic anxiety. In order to counter that it might be best to think of it as something very temporary that will help you learn how to handle your anxiety in other ways.

Do not mix it with alcohol. But don't be afraid of it. Email in profile if you want to discuss it more.
posted by OmieWise at 9:09 AM on July 15, 2005

I was prescribed Xanax for anxiety while studying for my PhD oral exam.

Duing my first attempt at the exam, I had the classic chest pain/sweaty/hyperventilating anxiety attack, and failed the exam. I was told I'd have one more chance to pass the exam. Every time I tried to study for the re-test, I had the derealization/woozy variety of attack. I literally couldn't study without falling asleep at my desk. The Xanax took away the sleepiness, allowing me to study pretty intensely.

I then took my exams, under the influence of both Xanax and Inderal. I passed, and have never had to take either drug again.
posted by MrMoonPie at 10:21 AM on July 15, 2005

I took xanax and while it helped my panic attacks, I didn't like the fact that I felt totally hung over the next day (headache, lethargy, dead heart).

So when I'd have a panic attack I got to the point where I'd weigh how much I needed immediate relief vs. how much I want to feel crappy the next day. I ended up learning meditation to get over them.
posted by superkim at 10:55 AM on July 15, 2005

I don't like taking medications unless it is really necessary and get a bit anxious about taking anything new. I've come to the conclusion that I won't know until I've tried and I can always stop once I know and whatever feelings/effects I may have from taking a drug won't last forever.

You could try taking half of what was prescribed (if it isn't the extended release xanax xr) if your worried it might make you higher than a kite, but it prolly wont, if anything it might make you feel drowsy. Try taking it when you don't have to preform (work/school) and have someone around just in case. I got a bit sleepy when I took it but it was better than being anxious and not being able to think right. Of course YMMV since we all react differently to medications.
posted by squeak at 11:24 AM on July 15, 2005

How did your prescribing doctor answer your question?
posted by mischief at 11:37 AM on July 15, 2005

I take Klonopin which is a similar compound to Xanax but, I was told, with a longer half-life so addiction and hangover problems are lessened. I only take a .5 mg dose and it just takes the edge off but doesn't put me out of it. After 5 years of use I rarely have to take it at all, except when flying. I think the fact that I know I have it available, I always carry a pill in my wallet, acts as a security blanket and has had more of an effect on reducing attacks than the medicine itself.
posted by white_devil at 11:57 AM on July 15, 2005

After taking Xanax for a while, the memory lapses can get so bad that it will seem to you as if someone's trying to drive you crazy. Memory loss is a hallmark of all the members of the Valium family -- Xanax, Klonopin, Restoril, Ativan, etc.

That said, it's effective if it's used correctly. If you use it as prescribed, without using it when you don't need to do so, the likelihood of addiction is small.

Xanax is safe and has been around for many years. If it works, go ahead and use it, because it would be a shame for you to suffer needlessly.
posted by lambchop1 at 12:46 PM on July 15, 2005

Prescribing doctor didn't say so much. "It'll take the edge off." And he did say I should try it at home one night with my husband around. Thanks for all the answers. Part of me still feels like, if my anxiety is marked by drunky loopy unsteady feelings, a tranquilizer may not be the best treatment.
posted by juniper at 12:51 PM on July 15, 2005

Thing is, if your prescription is for using it on an "as needed" basis as opposed to taking it twice a day, every day, the addiction factor isn't really a problem. If you take it once a week or whatever you aren't going to get physically addicted.

Just make sure you don't take it more than a couple days in a row.
posted by Justinian at 12:59 PM on July 15, 2005

Memory loss was noticeable for me. I was taking it during a week long vacation in Germany. I remember very little of that trip. Good thing I took pictures.
posted by punkfloyd at 1:01 PM on July 15, 2005

juniper, I had that fear, as well, but it had precisely the opposite effect. Since the anxiety was making me feel drowsy, removing the anxiety via Xanax actually gave me much more energy. My mind was sharp enough to make it through a three-hour PhD oral exam.
posted by MrMoonPie at 2:16 PM on July 15, 2005

My sister came off xanax abruptly because of an emergency surgery. She was so psychotic because of this they put her in icu. She was hallucinating big time. It was one of the scariest/funniest things I have ever been through. She would tell me these long involved stories about how the nurses had kidnapped her the night before and taken her to the roof, tied her to a chair and proceeded to give her a haircut.

ymmv.
posted by vronsky at 2:39 PM on July 15, 2005

Many friends have taken xanax on a non-prescription basis to deal with anxiety. They almost always take half. YMMV, but I don't think there's much harm in taking one when you're not having an attack, just to give it a spin.

FYI: Erowid.
posted by mai at 3:24 PM on July 15, 2005

It's a dangerous drug. It's is very addictive because it has such a quick-acting, yet short-lived effect. People feel better immediately, but then it doesn't last very long.

Years ago, I was given a sample pack in case of another dark PMS-depression. I took one and fell asleep for 36 hours. I never took any more!
posted by abbyladybug at 3:49 PM on July 15, 2005

I've had all sorts of different panic symptoms on airplanes - I really do not like airplanes - and I can tell you that this doc never flies without his bottle of Xanax in hand. It's great to remove all the sorts of feelings you mention and you should definitely use it once to see how it works for you. If you can be in a safe environment with your spouse around the first time, that will be good to let you know that someone's there in the event that the effect is unpleasant.

But my guess is that it'll be good. People get hooked on this stuff for a reason - it feels nice to have anxiety suddenly dissolved and removed. However, you will probably be like most people who are prescribed Xanax, in that you will use it as prescribed, not abuse it, and not become addicted.
posted by ikkyu2 at 6:07 PM on July 15, 2005

I take Xanax when I fly. I take one pill a few minutes before boarding and I'm asleep before the plane leaves the ground. I only noticed a hangover effect, rather somewhat blurry thought when I take it for short flights under three hours. I summize that the effects of the drug must last 4 - 6 hours total. Since I take it specifically to sleep on planes, I don't have a problem with memory loss.
posted by Juicylicious at 6:51 PM on July 15, 2005

What dosage? When I got anxiety attacks, I told my doctor that I would like an anti-anxiety pill, but was very frank about the idea that they scared the hell out of me.

She gave me the lowest dosage (25 mg?) available.

I didn't even notice that they did anything. So that's one approach. But the few times I used them, I didn't get an anxiety attack, so maybe they worked.

I actually really like the idea mentioned up-thread: try one when you are not in the grips of an anxiety attack. I found that, when I was freaking out, anything could make it worse. I could have probably convinced myself that water would make me die in that state. So that's a good idea.

But the best thing for me was behavioral therapy (in the form of The Anxiety & Phobia Workbook, by E. Bourne) and figuring out the root cause of the problem (depression). After that, I did not need the pills, and most of the bottle I was given went unused.
posted by teece at 9:20 PM on July 15, 2005

juniper, unless you react really differently to benzodiazepenes than most people [or unless you take large doses / combine them with alcohol], drunken loopy feelings shouldn't be a problem. Drowsiness is a possibility. Mostly when taking related medication [diazepam, i.e. valium], I find that my anxiety and anger and depression slowly lose their edge. It feels like calming down, not going numb or getting drunk or loopy or whatever. Since I generally take it before bed, due to anxiety-related insomia, I do get drowsy, but I'm not sure whether that's necessarily the drug, since I am taking it at bedtime and trying to sleep. I haven't had problems with drowsiness the few times I've taken it during the day, though. Some people complain about hangover-like effects, but I've never noticed those.

I'd talk to your doctor about your concerns. It's his/her job to give you answers and advice on this kind of stuff. Start with the smallest dose - if your doctor or psychiatrist says it's OK, you might even want to only take half of a tablet. Like several other people have said, take it once or twice when not in an anxiety attack, so that you can figure out what it feels like and not have concern about the drug adding to your panic. If you're taking small doses on an infrequent as-needed basis, you're unlikely to have to deal with either dependence or unpleasant side-effects. It certainly won't hurt you to try it once or twice - if you can't stand it, you can always decide not to take any more, but if you don't try it, you may be avoiding something that could help you a lot.
posted by ubersturm at 9:49 PM on July 15, 2005

ikkyu - I just joined the ranks of 'fliers-on-benzos'. .5 of klonopin prior to a cc flight. It was sublime. No sedation, but no more "white-knuckle" syndrome. Having kids did it to me, I guess.

I would just add another rec for cognitive therapy. Panic and anxiety seem to respond very well to behavioral and feedback techniques, and are a useful tool long after medication may or may not be in the picture. The most important thing I can usually do in a first contact with someone with a new-onset panic issue is try to normalize it and put in a contextually less worrisome realm. They are common, and no one ever really declines in the way that the panic seems to make them think they will. Few things are as frightening, though.
posted by docpops at 8:02 AM on July 16, 2005