Dependence can begin after 3-4 weeks if BZDs are taken *regularly, just as you have a dependency to fluoxetine. Dependence isn't addiction. What's the difference, well, not many taking BZDs would behave as the subjects in this study about a common pain killer did: Hirschowitz BI, 1998 Abstract | Full text
* 'regularly' doesn't necessarily mean daily. Because alprazolam has a short half-life you would need to take it daily for a while for dependence to develop, however, with longer half-life BZDs even taking them only 2-3 times a week may be enough to trigger it as these meds remain in the system for over a week.
BTW-you are already dependent on BZDs. Natural BZDs1 which include diazepam (Valium) and its metabolites and lorazepam (Ativan) are found naturally in almost all foods. Sprouted grains and seeds, especially wheat, and potato are particularly rich in them. While the quantities are small, levels can reach pharmaceutical levels in patients with some liver diseases2.These may become so high that medical intervention3 is necessary. We are so adapted to these natural BZDs that we could not survive without them.
To limit dependency onset try and have regular wash out periods. It takes up to 55 hours for alprazolam to be completely metabolized and eliminated, so, if possible, some occasional 3-4 day breaks between doses would help. If you do need to take it daily for more than a couple of weeks consider asking your doctor for hydroxyzine and swap between it and alprazolam from time to time.
References:
[1]
Muceniece R, Saleniece K, Krigere L, et al. (2008) Potato (Solanum tuberosum) juice exerts an anticonvulsant effect in mice through binding to GABA receptors. Planta Med. 2008 Apr;74(5):491-6. (Abstract)
Kavvadias D, Abou-Mandour AA, Czygan FC, et al (2000) Identification of benzodiazepines in Artemisia dracunculus and Solanum tuberosum rationalizing their endogenous formation in plant tissue. Biochem Biophys Res Commun Mar 5;269(1):290-5 (Abstract)
Sand P, Kavvadias D, Feineis D, et al. (2000) "Naturally occurring benzodiazepines: current status of research and clinical implications." Eur Arch Psychiatry Clin Neurosci vol 250(4) 194-202 (Abstract)
Kotz U, (1991)
Occurrence of "natural" benzodiazepines.
Life Sci;48(3):209-15 (Abstract)
Unseld E, Krishna Dr Fischer C, et al (1989) Detection of desmethyldiazepam and diazepam in brain of different species and plants. Biochem Pharmacol Aug 1;38(15):2473-8 (Abstract)
Wildman J, Ranalder U. (1988)
Presence of lorazepam in the blood plasma of drug free rats.
Life Sci. 43(15):1257-60. (Abstract)
Wildmann J. (1988)
Increase of natural benzodiazepines in wheat and potato during germination.
Biochem Biophys Res Commun. Dec 30;157(3):1436-43. (Abstract)
Wildmann J, Vetter W, Ranalder UB, et al (1988)
Occurrence of pharmacologically active benzodiazepines in trace amounts in wheat and potato.
Biochem Pharmacol. Oct 1;37(19):3549-59. (Abstract)
Sangameswaran L, Fales HM, Friedrich P, De Blas AL. (1986)
Purification of a benzodiazepine from bovine brain and detection of benzodiazepine-like immunoreactivity in human brain
Proc Natl Acad Sci U S A. 1986 Dec;83(23):9236-40. (Abstract | Full text - PDF)
(N-desmethyldiazepam is a metabolite of diazepam)
[2]
Baraldi M, Avallone R, Corsi L, et al (2000) Endogenous benzodiazepines. Therapie Jan-Feb;55(1):143-6 (Abstract)
[3]
Als-Nielsen B, Gluud LL, Gluud C. (2004)
Benzodiazepine receptor antagonists for hepatic encephalopathy.
Cochrane Database Syst Rev. 2004;(2):CD002798. (Abstract)
Zeneroli ML, Venturini I, Stefanelli S, et al, (1997) Antibacterial activity of rifaximin reduces the levels of benzodiazepine-like compounds in patients with liver cirrhosis. Pharmacol Res , Jun;35(6):557-60 (Abstract)
[Note: no benzodiazepine synthesizing gut flora has been isolated and they almost certainly don't exist in humans]
The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.
PDU, what can I say ?? Thank you for the info & taking the time to share it ! Your efforts & time are greatly appreciated ! I had a minor anxiety issue today for about an hour, but "fought" through it and it subsided. For the more "serious"or lengthy attacks, I will utilize the Xanax...
Update..Sunday I did end up taking 1/2 of a tab. It relaxed me and helped me sleep. Monday was bad, anxiety ALL day until early evening. Didn't take anything. Today, Tuesday, this morning the anxiety is here. Hope it clears up earlier than it did yesterday. 2 days away from week 4. I hope a turn a corner soon...
The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.
Thanks PDU...I'll keep plugging away....
Wed Update ** Best day so far ! Slept from 11pm to 6am without taking any sleep aide. Did wake up for a few moments but fell right back asleep. Anxiety today is almost nil. Tomorrow is start of week 4. I'm sure there may be some more up/downs, but for today, I'll take it !
Hope everyone has a good day !
Friday Update ** Not too bad a Thursday, Anxiety in the afternoon was pretty high. Soon as I got home from work, it started to settle. Mornings are still kind of rough. I'm still having some abdominal "discomfort" that I believe is from restarting the Fluox, but I have a appointment with a GI doctor next week as this has been going on for a few weeks. Today is the 1st day of week four...moving on !
Have a good day all !
Last edited by Conelrad; 10-01-20 at 14:50. Reason: added info
It most likely is the fluoxetine, or being exacerbated by it. The gut is the most serotonergic organ of the body by far making about 50 times as much serotonin as the brain. The enteric nervous system (ENS), the mini brain which controls the gut can be more affected initially by serotonergic ADs than the brain is. The mix of gut flora is also affected by ADs and the brain. The ENS is connected to the brain via the valgus nerves and it seems to be the dominant partner including having a strong influence on mood and emotions (it also influences the heart and lungs via the vagus nerves). In turn the ENS is influenced by the gut microbiome. How you feel can literally be affected by your poop! Indeed, it is possible to make a good case for us being merely the life support system for the bugs in our guts who can lead us on a merry chase at times.
The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.
Update to Friday update *** Anxiety was pretty high today. My stomach was (rib area) was bothering me a lot too. Got home from work and broke down an took a 1/4 tab of Xanax (my wife had to talk me into taking it). Calmed me down nicely and I noticed my abdominal pain subsided quite a bit...I'm thinking I may have to give the Fluox a little more time, if the anxiety doesn't lessen, I may have to see my doctor and talk about upping the dosage ?
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