Smarie78

Interesting thread. My Abf use to take Effexor for depression and since he's been off of it his relapses have started. His depression tends to catapult him into drinking so now going back on Effexor. I've heard SSRIs sometimes increase the cravings for booze for A's so im a little worried. He did say he was sober while on it though and he certainly has a comorbid illness ( I would venture to say depression and Borderline PD along with addiction.)

I don't have a problem with addiction and have been on SSRIs for nearly 20 years (low dose). I do have other issues though that I am never sure are caused by the SSRI or not. At any rate, somethings gotta give for the Abf. He must go back to whatever the hell he was doing when he was maintaining sobriety.

timetohealguy

Hi Firesprite,

Thanks for your reply.

Part of why I have researched all this medication stuff is to help me understand what happened. At the time this all happened I had no idea what was happening or any idea why, which was incredibly stressful.

While this was all happening I fell into a short term form of depression and I was so overwhelmed by it all at the time that I couldn't process it, so I actually find researching this stuff therapeutic.

Although this all happened some time ago, I am still suffering a form of PTSD, so in terms of "Not anything that you are still dealing with in your life?", while it was my ex who was having these medication issues, those issues affected both our lives every single day for a number of years and I am still healing from the trauma of it all. I post in some other threads about what I'm doing for myself - this thread has a different goal.

One of the methods for healing PTSD is a kind of exposure therapy where talking about traumatic stuff gradually reduces the impact that it has on you. The first weekend I joined this forum, it felt overwhelming for me to face the reality of everything that happened. I joined the forum, read a bunch of stuff and then felt quite overwhelmed for a few days afterwards.

But I stuck with it and pushed through those feelings, and now the forum has become a very positive thing for me.

Part of why I decided to talk about these medication issues in a thread instead of just privately in sessions with the therapist who is helping me, is in the hope that it will help someone else on the forum who may be going through something similar with their spouse either now or in the future. Or it may help someone else understand something they have already experienced but could not make any sense of.

When all this was going on for me, I tried to find info to help me cope, but didn't have much success. There were so many things going on that I couldn't narrow it down. There was a mix of multiple prescription medications, plus alcohol, multiple medication withdrawals, interdose withdrawal, and the resulting behaviours of all that. It was chaos. I had no idea where to start to try to make any sense of it all. And I had no idea where to even start to try to get my ex healthy again.


It was only when I started reading Dr Peter Breggin's books and articles, and digging into medical journals referred to in articles that I started to be able to make any sense of what had occurred. I started seeing behaviours that I had seen from my ex being talked about in these journals and articles as known symptoms of benzo withdrawal.

That her behaviour changed dramatically during the day made no sense to me at the time, because she was taking her medication at the right amount and times she was supposed to. When I learnt what interdose withdrawal was, suddenly that seemingly senseless change in behaviour made sense. I then realised these changes were happening at roughly the same times each day - before I couldn't see that. And that feeling of being able to understand why something is happening when you are in a chaotic situation, is very empowering and reduces stress enormously.

I had no idea what GABA was initially. I had no idea that the government prescribing regulations said that xanax should only be prescribed short term. My ex and I just put our faith in her doctor and didn't question it.

Now that I know so much more about it all, and am learning more every day, it really strikes me that a wider awareness of these issues can only help people.

Some person in the same position that we were in might find this thread in a search and then have a starting point to start becoming informed and to be able to ask questions of their doctor. There is nothing wrong with patients and their families being informed so that they can ask educated questions of their doctors and about their medications.

When we were going through all this stuff, I felt so confused about it all and at the time I was just not in the right place to join a forum and say "hey, this is what my spouse is doing, what should I do ?".

Instead I just read a lot. So I would not be surprised if there are a lot of people who are having problems with their spouse who read posts on the forum looking for info but who are not members of the forum.

If this thread helps prevent just one family going through what my ex and I went through, then it makes a difference.

timetohealguy

The section of that video starting at 4 minutes 30 seconds about patients on medication not recognising the adverse effects is very well explained.

The part at 5 minutes 40 seconds about why some people on medications change how they treat their spouse is also very well explained.

This link goes straight to those parts of the video ...

http://www.youtube.com/watch?v=cwIDfcc5Z3w&t=4m30s

FireSprite

This makes complete sense to me TTHG, it helps me put your situation into a context I can understand..... I was interpreting your posts as you holding onto bitterness & looking for cozy compartments (mild blameshifting, even) for everything to fit into nicely. They didn't *sound* healing, you know?

As someone who spent 8ish months reading the forums at SR before ever creating a username & posting, I absolutely agree that far more people are reading than posting on a daily basis, and that our words often have a greater impact than we ever really know.

I'm just happy to hear that this isn't about focusing on her, it's about healing you. Carry On, Warrior.

schnappi99

For real doctors might work the drug rotation, adjust the prescription- but I would guess that most of these prescriptions are proforma signoffs by pill pushers- they get the drugs, the docs get paid- all good.

My wife has been on xanax for over a decade with the same doc, no talk at all about adjustment of the prescription- nor any discussion of the relationship to alcohol use/abuse... just a revolving prescription. The guy was happy to add ambien to the mix, which in combination with the alcohol use at the time blew things up considerably- I am profoundly grateful she's off that stuff- ambien is pure evil.

My wife's family has a history of depression & anxiety- so I don't have any problems with the need for xanax etc, but I don't see any credible evidence that there is a widespread practice of doctors reviewing xanax prescriptions.

jonbald

My understanding is that alcohol diminishes the good effects of the SSRIs. Alcohol and benzos are a different story, that can stone you in a heartbeat.

I take Ativan and it is prescribed 3x a day as needed. I've taken it now for several years. I take one at night as a sleeping pill. Even with that, I have some insomnia, but it helps me.

In the mornings my anxiety is a bit high and there is a pit in my stomach. I take one Ativan in the morning and it settles my stomach and I get on with the day. I do not hardly ever, if ever, take one during the day. I don't refill it as often as I can because I don't use the max dose the doctor gave me.

I rarely drink because as I've gotten older, all it does is make me sleepy. If I drink enough to get a buzz, it doesn't last long and I get sleepy. I just don't feel the need for it, so a very occasional drink is about it for me.

My son is an alcoholic. On two occasions he has gotten very drunk and stolen my Ativan (I now hide them well). When he did this he was so stoned he couldn't talk. He'd veer back and forth and could hardly stand up. Twice we took him to the ER when this happened. Once, he pissed himself trying to get to the restroom at the ER.

Benzos and alcohol are a very bad mix and should be avoided at all costs. Alcoholism by itself is horrible. Add depression, anxiety, ADD, social anxiety, oppositional disorder, low self-esteem to the alcohol and you have my son. It is sad and he is so low. I am dealing with a hard situation right now knowing when to kick him out of the house. He's had long enough after rehab to get on his feet and can't stay here much longer.

So, alcoholism is horrible. Some people can take benzos in a controlled way. Some people (my wife) are tremendously helped by SSRIs. A combination of either drug with alcohol is bad for different reasons.

Here's one that is bad too. My son's psychiatrist prescribed Adderall knowing that he is an alcoholic and had a previous problem with Adderall. What kind of psychiatrist would do that? Gees.

This has been rambling but it contains my perspective on these issues. Everyone is different and has to deal with their own reality.

timetohealguy

Hi schnappi99,

Has your wife's doctor been gradually increasing her xanax dose ?

With my ex, when she said that the xanax was no longer having the same effect, her dose was increased.

Eventually she reached a daily dose of xanax where her doctor would not increase the dose any higher - my ex told me that her doctor said she had reached some kind of safety limit for the amount of xanax she could safely take each day.

Soon after she reached that limit and her doctor would not prescribe a higher xanax dose, all hell broke loose. At that point, the person taking xanax is no longer getting the same relief from the xanax in relieving their anxiety symptoms that they once did. She started drinking even more.

It was a very bad situation. It was after that, that she decided to start withdrawing from xanax.

Dr Heather Ashton has a website about benzodiazepines and her Ashton Manual has a lot of info about withdrawing from benzodiazepines - this is the link to the Ashton Manual ...

benzo.org.uk : Benzodiazepines: How They Work & How to Withdraw, Prof C H Ashton DM, FRCP, 2002

Dr Ashton developed a series of slow withdrawal schedules which are in the manual.

timetohealguy

It is also worth discussing cross tolerance between medication and alcohol.

https://en.wikipedia.org/wiki/Cross-tolerance ... reads ...

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"Cross-tolerance is a phenomenon that occurs when tolerance to the effects of a certain drug produces tolerance to another drug. It often happens between two drugs with similar functions or effects – for example, acting on the same cell receptor or affecting the transmission of certain neurotransmitters. Cross-tolerance has been observed with pharmaceutical drugs such as anti-anxiety agents and illicit substances, and sometimes the two of them together. Often, a person who uses one drug can be tolerant to a drug that has a completely different function. This phenomenon allows one to become tolerant to a drug that they have never even used before."
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Valium is a benzodiazepine, and so is xanax.

There is an article on Psychology Today ...

https://www.psychologytoday.com/blog...-brain-alcohol

... part of which reads ...

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"Nonetheless, alcohol shared properties with classical depressants, like valium. Experiments in mice showed that when given valium regularly, not only did they develop a tolerance to it, but they also developed increased tolerance to alcohol. Called cross-tolerance, it indicates that both drugs act at the same receptor, the GABA receptor. "
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The Truth About Cross-Addiction And Cross-Tolerance ... reads ...

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"Cross-tolerance means that when you develop a tolerance to a drug you will also have a tolerance to closely related drugs--but not to totally dissimilar drugs. The more closely related the two drugs are the stronger the cross tolerance effect will be. For example, Valium, Librium, Xanax, Ativan and Klonopin are all closely related drugs which belong to the benzodiazepine family of drugs. These drugs all affect the GABA receptors in your brain. If you become addicted to any one of these benzodiazepines then you can substitute any other because there is cross-tolerance. Since alcohol also affects GABA receptors there is some cross-tolerance with alcohol but not as much with each other since alcohol affects many different receptors."
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There is also an interesting discussion at ...

How I've been dealing with cross-tolerance (co-addiction to alcohol and xanax)

... which talks about the difficulty of getting off both xanax and alcohol, part of which reads ...

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"After decades of self-medicating my anxiety/panic/depression with benadryl, chlortrimeton, and alcohol, going from periods of total but very tense abstinence to moderate drinking to weekend binges and back to abstinence, around and around, always worried that I would become a mentally ill alcoholic like my mother, I was at last diagnosed with PTSD in 2004 - so late in my life. After SSRI's, klonopin, and valium caused terrible side effects in me, so much that I couldn't function at work, the psychiatrist prescribed xanax (but added offhand that cognitive therapy might help some). Xanax worked immediately and "beautifully", and both the psychiatrist and my PCP actually told me that I would probably have to take it the rest of my life, as my PTSD would not go away on its own.

This was the first I'd ever known or experienced benzos, but for a while, xanax really stopped the constant anxiety, difficulty sleeping, night terrors, even lessened the periods of depression, and lowered my blood pressure from its borderline hypertensive 140/90 to around 120/80 for the first time in decades. And it helped me drink less (I know that last part sounds alarmingly stupid, but at that time, I was ignorant of the consequences). The shocking thing I realize now is that neither the psychiatrist nor my PCP ever advised me to stop alcohol - in fact, my doctor encouraged "a glass of red wine every day for cardiovascular health" while writing out another prescription for xanax!! Most unfortunately, he prescribed benzos freely, not recognizing their potential for nightmarish addiction or their cross-tolerance with alcohol. He didn't take benzos himself. Just wine.

Somehow I managed to stay at 2 to 2.5mg of xanax for a few years, wondering why it was taking more than one glass of wine to feel any "relaxing buzz" at all. The original xanax buzz disappeared after a couple of years of use, and eventually I didn't (and still don't) feel even the slightest euphoria when it kicks in - it just stops the anxiety or the panic and leaves me feeling just kinda "blah", dead-headed, inert. But the amount needed to quell panic was already slowly creeping up and up.

These last few years have been filled with tragic deaths and catastrophic losses in my life, and my PTSD was fully re-activated. I made the awful mistake of taking more xanax out of desperation, trying to cope with fear and anguish on my own, as the techniques of the therapist assigned to me during this time only seemed to upset me more during our sessions - this therapist has since been dismissed. I kept escalating both xanax and alcohol, being so stressed and grief-stricken by almost non-stop traumatic events that I wasn't really caring about the horrifying levels of addictions that I was reaching, the extreme spikes of blood pressure, and not trying to figure out the actual cause of such frightening tolerances.

After a few very scary "close calls" (some involving the police and a couple of medical crises - I think I was blest somehow and was protected from the worst consequences), I finally woke up and realized the horror of my situation with addiction. I was terrified that I was going to die like my brother had.

So now I'm working hard to decrease my dosage of xanax from the shocking 6mg I reached to at least as low as it was originally - 2 mg - or hopefully, none at all. But I'm having a hard time as most everyone in this forum is or was.

I've tried numerous times to taper both alcohol and xanax at the same time, but failed again and again. The slightest upset and I was back on both of them again. But I was finally advised on another forum that alcohol alone had to go first - completely - before I could even begin to tackle the xanax problem. I accepted this more experienced person's strong advice. So I again went through a week of the usual pure hell with alcohol withdrawal - but maintaining the xanax dosage during that time made it a little more bearable and do-able. I found a little glutamine helped reduce the cravings (but not the symptoms) - but too much glutamine made things worse - such a difficult balancing act! :-\

I finally got through it, and was alcohol-free for over a week when I was astounded and pleased that this soon after the acute alcohol withdrawal, I suddenly needed much less xanax to quell the anxiety/panic and to sleep. ;D I ... tapered from 6mg xanax a day to 4mg-4.5mg, depending on the stress of the day. I've been taking the least I could to keep a lid on my anxiety and get enough sleep, and forcing myself to walk, to exercise much more really helps. 4-4.5mg was the dosage I was taking a few years ago - suddenly it was all that was needed to bear life again. Alcohol itself was making me need 2mg more xanax to keep things bearable.

I never knew until recently that xanax and alcohol are medically known to be cross-tolerant, i.e., the more alcohol you drink, the more xanax is needed to stop anxiety or panic; and the more xanax you take, the more alcohol is required to reach any pleasant "high" at all - the two keep "one-upping" each other, so the amounts needed to get any effect from either one get greater and greater. (I know they both supposedly act on the same brain receptors, even though their effects feel quite different - at least, they do to me. As I said, xanax gives me no "buzz", no euphoria, but alcohol does; however, it is unpredictable now - sometimes it makes me feel horrible - which is good, actually - but I can't be certain anymore that alcohol will feel pleasant. But no problem as it's out of the scenario now.)

To give you an idea of how bad my cross-tolerance became, at 6 mg of xanax a day, a full glass of wine had no more effect on me than a glass of water - it took a bottle of wine to affect me like one glass of wine used to. And the 6 mg of xanax was quickly becoming insufficient to keep me from insomnia and anxiety.

I know this does not reflect initial experiences with the very dangerous combination of alcohol and xanax, which can make the user pass out into a coma-like state and even die.) But I had reached this horrifying tolerance after years of xanax and alcohol jacking each other up.

I'm meandering now, but as I said, my PCP knew nothing about the cross-tolerance of alcohol and xanax, or even the dangers of going cold turkey from benzos! When I finally expressed to him my great concern about my tolerance and addiction, he just told me to quit taking xanax cold turkey if I didn't want to continue - which, from 6mg to 0mg, could have killed me!! I talked to my wonderful old pharmacist, who promptly called him to tell him how dangerous that was! It's sad and unnerving that some physicians have little understanding of the benzodiazepines they prescribe. And for a decade, I had believed and trusted a doctor who didn't know anything about the poisons he was prescribing."
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schnappi99

Hi tth,

zoloft is her daily med, xanax as required of which she uses a fair bit each month (I am not pill counting so I guessing based on the pill bottles that come and go- she keeps them in an open storage container in the kitchen). The prescription levels have been the same for about 10 years. While she was drinking she experimented on her own with starting/stopping zoloft, that was when the doc also brought in ambien- that was the height of the nightmare.

When the drinking reveal occurred, in the midst of my codependency I called her doc and told him about the drinking. No obvious change to the prescription from what I can see on the basis of prescription refill messages on the shared voicemail. To the credit of my wife and the doc, they did find an alternative to ambien, lunesta seems to work for her.