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Ask Vakul Aren Your Own Question
Vakul Aren
Vakul Aren, Doctor
Category: Health
Satisfied Customers: 4011
Experience:  MBBS,DTM&H( Univ of Liverpool),34yrs experience in practice
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My Alprazolam (2mg 4times per day) does nothing for my

Customer Question

My Alprazolam (2mg 4times per day) does nothing for my anxiety any longer. Do I dare take more
JA: How long have you been dealing with this? Is there anything in particular that seems to make the symptoms better or worse?
Customer: I am my husbands caregiver, I need my knee replaced as it is bone on bone but cannot get it done until I get lower back surgery. I am in constant pain and am quite depressed. Husband is on oxygen.
JA: Anything else in your medical history you think the doctor should know?
Customer: Yes, since I had surgery three times in the last three years I got on oxycodone (never took pain pill prior for any length of time) and I now am up to 6 5mg oxy per day.
Submitted: 1 month ago.
Category: Health
Expert:  Vakul Aren replied 1 month ago.

Hello,I am Dr. Aren and I will help with your query.Benzodiazepines like Alprazolam if taken for a period of time tend to develop tolerance,that is you will need higher and higher doses to achieve the same effect.You are already on a high dose of alprazolam,taking more will probably not help.You need to add an antidepressant like a Tricyclic Antidepressant drug (Amytriptiline) or a SSRI drug like Fluoxetine/Sertaline to fight your depression.Long acting benzodiazepines like Clonazepam or LOrazepam(clonafit/Larpose) may be added for a couple of weeks till the antidepressant drug takes effect,It would be prudent to stop the Alprazolam as it has a strong addiction potential,clonazepam/Lorazepam will give thew same anxiolytic effect.THe addition of an antiepressant will help reduce your need for analgesics.