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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5220
Experience:  Dr. Mark is a PhD in psychology in private practice
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I saw a new psychiatrist on October 1st. Im almost 70. She

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I saw a new psychiatrist on October 1st. I'm almost 70. She advised me to stop taking xanax, as I'm too old now to take it, and it's contraindicated. I was only taking .5 mgs in the morning and at night. The doctor prescribed Buspar at 5 mgs twice a day. With the xanax I had bad balance, and then I started falling down off and on. She has probably saved me from having a broken hip. I don't want that! I did something stupid this morning at 11:00 am, I took .25 mgs of xanax, and it make me feel awful, I have some kind of fog in my head. I have bad balance, and my IBS has returned. I'm very shaky and nervous. Buspar helped yesterday. I didn't think I should be with drawing from a whole mg. of xanax all at once. What do you think? Is it too late to take my morning Buspar? I just feel completely awful!

Hi! I'll be glad to help you with this issue.

I can imagine how worrisome this situation must be for you. But please don't be too anxious. You took a relatively small dosage of Xanax. So please don't worry too much about this.

BuSpar is often prescribed as a replacement for Xanax. And it is often taken at the same time as you taper off the Xanax. So you can take the BuSpar and that would be a good idea.

There are no contraindications, meaning bad effects, that we worry about if taking BuSpar while weaning off Xanax. You should, however, avoid grapefruit juice or eating grapefruits. It's interesting that oranges don't have the same chemical interaction as grapefruit. So, suspend eating grapefruits or drinking grapefruit juice, okay?

Tell your doctor about your reaction to the .25 mg of Xanax so he/she knows. Don't be ashamed to just say that you were anxious and so took the Xanax or to tell him/her whatever the reason was. It's really okay. The doctor should know so it can be on your file that you had these reactions. They're not worrisome reactions. If, however, they do not recede by tomorrow, then call your doctor right away to let them know.

Okay, I wish you the very best!

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Customer: replied 3 years ago.

Dr. Mark,


Thank you for your answer. You have helped me to settle down a bit. But I'm still antsy, and my self-talk is back. The irritable bowel syndrome is in full force right now. When I don't have it very badly, I feel a lot better. I'm having some depression, although I take meds for that. But it appears as though I may have sleep apnea, and I know it's not a good thing to have. I will be seeing a doctor for that in a few days. In reading about sleep apnea I learned that it can cause depression, amongst other things. I'm still upset. I'm wondering if I should be taking BuSpar 3 times. It is 5 mgs.

No. Don't increase the dosage at this time until you talk with the doctor. Here's why:


We don't know how much of your symptoms are actually withdrawal symptoms from the Xanax. This is common. It happens to a lot of people when they stop taking Xanax after they've been taking it for a while. So you want to work out a strategy with your doctor that is longer term and stable.


Right now you're making decisions, or trying to, based on your anxiety and nervousness. That's not a good way to make these decisions. Rather, you need to take some deep breaths and do some relaxation exercises (I'll paste one in at the end of my posting to help you, okay?) and know that this is temporary and you'll talk with your doctor soon and work out a strategy for how to get through this. That's the right way to do this.


So, let me paste in the technique for you so you can get through this until you talk with your doctor:


Here are instructions on a therapeutic protocol called Progressive Muscle Relaxation (PMR). It's really quite easy to do almost anywhere. My patients suffering from depression or anxiety, when I teach them PMR at first are amazed how simple it is and that it is a psychological protocol. It was first used in the 1920s! Since then, of course, it has been refined and many studies have been done showing its effectiveness. You will practice PMR at first when you don't wake up with an attack so that you will be familiar with it. I want you to practice the PMR at least 5-6 times before an attack or feeling acute anxiety. Why? Because when you're in the throes of anxiety, you will only remember to do something you are very familiar with it. So practicing 5-6 times is really a minimum.

I want to stress the importance of breathing as well. Part of the physiology of what is happening to you in anxiety states is that your breathing is getting shallower. This reduces the oxygen in your blood to your brain. That increases the anxiety reaction, which strengthens the attack and you are in a vicious cycle! Not good. So breathing is the primary tool. I have found in my practice that learning breathing techniques can be helpful. But some of my patients are not interested in learning more than one thing at the beginning, so I have found that just reminding you to BREATHE deeply at the same time you are doing PMR is almost as good. If you are willing to take a yoga class and learn breathing techniques, that's the best. But, breathing deeply with your PMR will help.

So, we're ready for learning PMR. I want you to print my instructions below my signature and have a copy in each of the rooms of your home where you may be when you have an attack. And again, you need to practice this easy technique at least 5-6 times as soon as you can. It needs to become as natural to you as breathing. Ah, remember breathing?

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX


INSTRUCTIONS:

  1. After finding a quiet place and several free minutes to practice progressive muscle relaxation, sit or lie down and make yourself comfortable.
  2. Begin by tensing all the muscles in your face. Make a tight grimace, close your eyes as tightly as possible, clench your teeth, even move your ears up if you can. Hold this for the count of eight as you inhale.
  3. Now exhale and relax completely. Let your face go completely lax, as though you were sleeping. Feel the tension seep from your facial muscles, and enjoy the feeling.
  4. Next, completely tense your neck and shoulders, again inhaling and counting to eight. Then exhale and relax.
  5. Continue down your body, repeating the procedure with the following muscle groups:
    • chest
    • abdomen
    • entire right arm
    • right forearm and hand (making a fist)
    • right hand
    • entire left arm
    • left forearm and hand (again, making a fist)
    • left hand
    • buttocks
    • entire right leg
    • lower right leg and foot
    • right foot
    • entire left leg
    • lower left leg and foot
    • left foot
  6. for the shortened version, which includes just four main muscle groups:
    • face
    • neck, shoulders and arms
    • abdomen and chest
    • buttocks, legs and feet

Quickly focusing on each group one after the other, with practice you can relax your body like ‘liquid relaxation’ poured on your head and it flowed down and completely covered you. You can use progressive muscle relaxation to quickly de-stress any time.

What You Need:

  • A comfortable place.
  • Some privacy.
  • A few minutes.

Again:

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Customer: replied 3 years ago.

Dr. Mark,


You will get excellent from me. When I read what you said about this being temporary, I started to cry, and I still am. I needed to hear that! I won't change my dose of BuSpar. I will talk to my doctor. Thank you, XXXXX XXXXX so very much! If I have more problems I will always ask for you!

You are so welcome. And please don't forget to talk with your doctor to work out the long term strategy. Because you are so right and I'm glad you see it: it IS temporary!



All the best,


Dr. Mark
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