Escitalopram and Xanax?

[Kiwigirl]

Hey all,

I'm taking Seroplex (same as Lexapro and Cipralex) for depression from anxiety (as a result of workplace bullying) and my doctor has just given me Xanax. She said that the xanax was to take when I felt upset/stressed/anxious. Can anyone explain how I'd take this? I just take a pill when I feel upset? Sorry to ask what may seem like a simple question, everything gets a bit lost in translation when I visit the Dr - I cannot explain myself well enough in French. Is it ok to take xanax with seroplex? I've read some horrible things about xanax being addictive? Is this true?

Thanks a lot,

Kiwigirl:)

[alias_kev]

Hi again. Somedays I feel like a stalker on here... sigh. Anyway Xanax = Alprazolam which is one of the (newer?) benzodiazepines. So I assume its broadly like diazepam, which you hear of a lot.

Good News:
Its not an SSRI and its not like Escitalopram - so no duplication or overlap.
All of the 'azepams are really good for anxiety as they give a fast high and don't stay active too long. So they tend to be a take it when you need it med.

Bad News: Most (all?) of the 'azepams are addictive both chemically and behavourally. Obviously if someone can pop a pill and feel better its very nice and easy. The danger is it can get too easy and people get dependent on both the drug and the ease of coping. In the 1970s the first 'azepams (eg. Vallium) were given out like smarties. These days the UK NHS doesn't like you to have them for more than a month on a tiny dose. Some of that's a knee jerk reaction, some of it as the NHS is nearly always terrible at managing withdrawal or tappering off a medication.

In terms of taking the any 'azepam the goal is to take a little as possible ONLY when you really really need the support. I've avoided asking for them and the GP's avoided talking about them. For me, I've had GAD build up over years (largely unnoticed - assumed to just be stress, etc), so it seems likely the recovery will also take sometime. So a medication one is discouraged from being on for any length of time didn't seem too useful to me. One good way to use the 'azepams is probably during the first weeks of an SSRI as it can do the job while your body/brain are still adapting, or while starting some therapy such as CBT.

A lot depends on how great your need is. Had mine been any worse I'd probably have tried it - but the NHS would have been fighting to get me off it almost before I started!

[Kiwigirl]

My prescription says xanax but i'm living in France so I guess things are different. The reason I ask is that in France you tend to be over-prescribed... you go in for a cold and come out with 12 boxes so I'm a bit scared to take things the Dr has prescribed. She has given me 2 months worth and another 2 months of Esc (I've taken 2.5 months worth already).

I guess for me I'm still pretty confused about whether I have anxiety or depression, and whether what I'm feeling is pretty normal given the situation - living in a different country far away (I'm in france, but am a NZer), PhD student at university, unhelpful/unsupportive/unrealistic (and demanding) supervisor, boyfriend living in Scotland... I just feel overwhelmed and I've gotten to the stage of avoiding work, university, friends, life just to chill out at home. I'd much rather stay in bed or on the couch or in my PJs rather than deal with everyday life. I've always had a lot of stress with university, study and work, and usually I've just sucked it up and got on with it because I liked my career choice and wanted to excell. Now I'm unmotivated and unwilling, and lazy!

I talk to a counsellor occasionally but this is not subsidised by the french healthcare system so I can't really afford it. She seems to think its my busy life thus far and the bullying of my supervisor. But I'm just so confused now!

Hmmmm anyway, off on a little tangent there! Now to face up to my supervisor....:unsure:

[alias_kev]

Hey Kiwigirl, The Xanax is just the (or one of many) brand name. The drug name is Alprazolam from the search I did. As I said its one of the benzodiazepines. I haven't read much on it in the past - if you are desperate I could do some looking up & summarising. The info I gave applies to most/all of the 'azepines, based mainly on diazepam one of the most commonly used.

France sounds great if you need or like pills. The NHS is desparate in the UK to keep/get you off even stuff you need, and usually abrupt when it comes to stopping. Traditionally its not uncommon to give a fast (and hopefully briefly used) medication like diazepam and a slower active mediation, usually an SSRI to carry the load longterm. In that context the 'azepan can also help deal with the early side effects of the SSRI and any paradoxical anxiety (ie. temporary increase) that kicks in.

Your description of your behavour does sound like its in the spectrum of depression/anxiety. Only you can know if its appropriate to your circumstances. In my view illness occurs at the point where the behavour and feelings are disproportionate, long lasting or prevent you actually dealing with your problems. To some extent it sounds like this has occured for you. I also think that for most people there is eventually a mixture of anxiety & depression & life (one following from another) but the hard bit is deciding WHICH is the DOMINANT or ORIGINAL/ROOT aspect. Drs have a habit of treating the most obvious or picking one at random, some patients will tell the Dr only some of their situation leading to an edited view & treatment.

There are levels of anxiety and depression and a few flavours. I would suggest reading the information pages here on NMP (over on the left) and also those at anxietycare.org.uk. Between them you should get a feeling of what is affecting you. (That's how I discovered GAD and that I had it!).

The Escitalopram is very good against the depression (in my experience) but less good against severe long term GAD. It might do better against shorter term or milder GAD. YMMV. The 'azepine should be good against the anxiety but most are hard to escape in the long term. Its probably best to use it sparingly and just until the Esc' kicks in but only you know your circumstances.

Take Care.

[Kiwigirl]

Thanks so much for answering that for me Kevin. It definitely helps out a lot. When I went to get my prescription filled the pharmacist said they didn't sell Xanax but a generic brand of Alprazolam. I'm certainly glad to have financial help with this, I'd hate to think how much all the meds and Drs visits would cost me in NZ!

I'll do a little more research into the symptoms. Thanks once again :D