How To Withdraw From Alprazolam?

Brief Answer:
Recommend discussing things with your doctor

Detailed Answer:
Good morning XXXX. My name is Dr. Dariush Saghafi and I am a neurologist from XXXXXXX OH. We're neighbors it would seem. I am both in private practice as a general neurologist and headache specialist as well as on the Neurology Staff of the XXXXXXX Stokes VA Medical Center in XXXXXXX in case you just happen to be a vet. If so, perhaps a lot of your medications are from the VA since I recognize many similar generic types of drugs that are typically prescribed from those facilities.

At any rate I'd like to address your concerns on the "serious side effects" of alprazolam. I'm not exactly sure which TV news report you may be referring to and must tell you that I am personally not a fan of placing people (especially individuals over the age of 65) on a lot of unnecessary drugs for their health. My belief is that the body with proper minimal care has tremendous abilities to heal itself and does not need the majority of chemical substances that drug companies would have us believe we need in order to function properly. I also agree that being on drugs such alprazolam without reassessing their absolute need or efficacy on a periodic basis is a mistake.

I see this happening in the practice of medicine where patients (especially in the elderly population) will be on multiple medications without being "checked up on" regularly to see how the medications are doing for them, if there've been any changes along the way to warrant a new look at whether or not that drug needs to be modified, eliminated, or otherwise tweaked in some way to coincide with symptoms.

In your case I see that you've been diagnosed with a generalized anxiety disorder and so I can understand why you may have been prescribed and continued on something like alprazolam. More recently reports have started to surface that this class of medication may have adverse effects on the brain when taken for long periods of time and these effects range from mild confusion and disorientation which can persist even after discontinuation of the drug to XXXXXXX dementia which we would typically diagnose as Alzheimer's or something similar. Having said that let me say that I have patients both in and out of the VA who have spectactular benefits from their drugs given for anxiety and so notwithstanding the recent reports you may've seen, at least in those patients the use of these types of drugs probably far outweighs the potential risks or downsides.

And so, the same could be said for the balance of your somewhat long'ish list of drugs, wouldn't you say? There are probably several drugs listed there which may or may not be absolutely vital or have a crystal clear data supported reason for you to be taking, yet you take them because someone felt you'd benefit from their effects as opposed to trying more conservative approaches such as good diet and exercise, mental relaxation techniques, learning how to make sleep more restorative and effective which could lower levels of anxieties and depression, headaches, addressing nightmares, other sleep disorders, restless legs syndrome, possible PTSD, etc.

However, in the end, my philosophy has always been that if a patient feels uncomfortable about being on a particular medication due to any number of reasons....including the media's hype (which by the way is often times exaggerated or premature in its dissemination of information) that the patient and I need to have a discussion. I can say that in my particular case I don't have very many of those conversations since my prescribing of medications is limited to those situations where the patient simply will not be compliant in any other way despite best efforts and education and opportunities at visits where they simply cannot or will not take my advice to change their lifestyle or try something less wieldy than having to take pills for the rest of their lives. So in some cases, I must admit defeat in that setting and patients will be on pills. But I am constantly thereafter checking up on their usage and doing everything possible to make sure that the medication is actually effective in some way and if not looking to retire it from their regimen as soon as possible.

So now, to come full circle to the alprazolam if you are moved by what you heard on TV my advice is the following. Jot down EXACTLY what it is that you heard about with the medication and take this in to your doctor with the same concerns as you've expressed here. DO NOT SUDDENLY stop ANY medication that you have been taking for any length of time since there are potential consequences. In the case of alprazolam you could suffer from convulsions or seizures if you were to suddenly stop it but you can certainly be tapered down. That is a discussion you need to have with your provider and especially since you carry a diagnosis of GENERALIZED ANXIETY DISORDER. Your primary doctor may wish to refer you to a well trained and interested neurologist who deals with these sorts of issues to watch you carefully as you come down from your medications to make sure you don't have a rough ride.

Perhaps, you are interested or ready to discuss with your provider other options to treat the mental diagnosis by learning relaxation techniques, deep breathing exercises, biofeedback, cognitive behavioral therapy, and many many other NON-PHARMACOLOGICAL ways of reducing stress and anxiety to the point of not needing medication support. In my opinion, if you could accomplish something like that and be successful? Hey, you can be my poster child for someone who made some major lifestyle changes to get off some of the most difficult drugs to get off known to man which are so engrained in our culture! You get the idea....

Good luck to you with your quest on finding a more healthy lifestyle by taking less medication. I fully support that point of view and wish you well in your endeavors.

I would take that same thought process and ask your provider if you really NEED to be on at least several other medications as well or are there options to NOT TAKING THEM without compromising your overall health and well being if you're willing to do other things or make changes in your life.

If I've helped answer your questions I'd very much appreciate your written feedback and a STAR RATING for this question as the powers to be love seeing HAPPY PATIENTS when it comes to these consults! Keeps them throwing the peanuts at us! HA!

If you have further questions on anything I've written you may specifically direct your them to myself (DARIUSH SAGHAFI, MD) and I will receive notification for response. I am also available by live webcam teleconferencing through the internet where we can do both video based as well as text based exchanges and speak in real time.

You can look me up on that platform Wed-Sat from 3a-6a (ET) and Sundays 11p-3a at www.healthtap.com/drsaghafi.

Also, if you have no further questions or comments I'd be greatful for your CLOSING THE QUERY on your end so that the network can process, archive, and credit the work appropriately and have it available for future reference.

This consultation required 43 minutes of physician specific time in reviewing, researching, and drafting for final documentation and envoy the case inquiry.

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