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Linda D.
Linda D., Psychotherapist, LMSW, CASAC
Category: Mental Health
Satisfied Customers: 498
Experience:  LMSW, CASAC
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I have dealt with panic/anxiety disorder . I am

Customer Question

I have dealt with panic/anxiety disorder for years. I am currently taking 1mg Xanax XR in a.m. and 1mg in p.m. Also Effexor XR 150mg. I've been on this dosage for almost 13 years, with an occasional use of .25 Xanax as needed. Within the last 7 months I have experienced my husband having a stroke and 2 months ago learning my 45 year old daughter's breast cancer has returned and metastasized to the pleura of her lung and in her spine. This last news threw me into what my therapist calls a crisis mode and I am experiencing continuous anxiety all day. My doctor told me to add .5 Xanax XR at midday. He also said I could cut it in half because I have a very hard time going on or off meds because I metabolize meds quickly. If I take the whole .5 XR, I will be in a state of sedation for at least 10 days. The half dose, not so bad or so long,Here are my questions...I'd be interested in what you think would be best for me to do...bite the bullet and go on the .5mg or cut it in half?. Secondly, and most important to me, is how long will it take to see the calming of my anxiety after I have started upping the meds. I appreciate your help. Thank you
Submitted: 6 months ago.
Category: Mental Health
Expert:  Linda D. replied 6 months ago.
Hello my name is ***** ***** I am a licensed psychotherapist in private practice in New York State. thank you for reaching out to Just Answer.First, I want you to know i am so sorry for your families health issues. They are very serious and I can certainly understand why you are in distress at this time. it is very important that to the best of your ability for your sake and the sake of your family that you take very good care of yourself. I would recommend that you take the 1/2 tab of the xanax first to see if this is enough to help you. You should start to feel the effects very quickly as xanax has a very quick half life. I would try this dose for the next three days to see if you get the effect you need and if not then you can go to the full dose or use the full dose on the days you are having a difficult time and half dose on your better days. Please understand that your anxiety will also be influenced by the cognitive messages that your brain hears and believes, so as much as possible please try to stay just int he day, control any fears you may have about the future. Just today, do the best you can to stay just in today. We do not know what will happen in the future. And try to externalize your feelings as much as possible; talk to your support system about what you are feeling, go for walks, write in a journal, etc. I hope all of this information is helpful to you. Please let me know if there is anything else I can do to help. i am here for you. Sincerely, ***** ***** LMSW, CASAC
Customer: replied 6 months ago.
Thank you for your advise, Linda. The "staying in today" is what we are working on in therapy. Also, just to be sure I got it right, you said to start off with the 1/2 dose of Xanax....you do understand that I am talking about the XR of Xanax, not the regular .5. My pdoc said it's OK to cut it in half and I've never had a problem when I've done it before, but a lot of others say never ever cut an ER in half. You probably wonder why I'm asking this again. Well, I guess with my anxiety running rapid, I don't quite trust my own thinking right now. Thank you for your concern for my family.
Customer: replied 6 months ago.
Thank you for your advise, Linda. The "staying in today" is what we are working on in therapy. Also, just to be sure I got it right, you said to start off with the 1/2 dose of Xanax....you do understand that I am talking about the XR of Xanax, not the regular .5. My pdoc said it's OK to cut it in half and I've never had a problem when I've done it before, but a lot of others say never ever cut an ER in half. You probably wonder why I'm asking this again. Well, I guess with my anxiety running rapid, I don't quite trust my own thinking right now. Thank you for your concern for my family.
Expert:  Linda D. replied 6 months ago.
I totally understand your concerns, and yes you are right, I am sorry I missed this in your quest,. The .5 XR should not be cut in half. You will need a new prescription for the lower dose. Linda D., LMSW, CASAC
Expert:  Linda D. replied 6 months ago.
Hello, I just wanted to check in and see how you are doing with your anxiety tonight. and again, I wanted to apologize for my missing that you were asking about Xanax ER. My advice of how to take it is still the same, but honestly I was helping two other individuals at the same time I was responding to you and they were both in a lot of distress and I was rushing too much. Cutting the Xanax xr is not dangerous but it can intensify the effect of the Xanax.Also there is a gelatin that can be released in your mouth that does not feel or taste good that is how the medication releases more slowly. I wish you all the best and will understand if you decide not to rate my service to you. Today was the first time I made a mistake in answer a customer and I feel terrible about it. We all take our professions very seriously and care a great deal here at Just Answer about the people who reach out to us. sincerely, ***** ***** LMSW, CASAC

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