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Suggest The Ideal Dosage For Xanax Taken For Panic Attacks

Posted on Fri, 3 Jun 2016

Question: I took 1mg of Klonopin 7 hours ago, 60mg of Cymbalta 5 and a half hours ago, and 60mg of Oxycodone 5 hours ago, and 1.5mg of Xanax 2 and a half hours agor because I was and am having a pankc attack. My first and most concerning question is am I in any danger of an overdose? and my second question is simce I am still having a terrible panic attack can I take med more Xanax or Klonopin? all of these meds are prescribed to me. I do feel a little sleepy but am having a horrible panic attack and everytime i c,ose my eyes I freak out and panic worse, I'm so scared I am going to overdose. Please help fast.

Answered by Dr. Alexander H. Sheppe (36 minutes later)

Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

To answer your first question, you are not in danger of an overdose. The total benzodiazepine amount here, Klonopin 1mg + Xanax 1.5mg, is not enough to overdose, though you may as you say feel sleepy. The Cymbalta and oxycodone added to this are likewise not a dangerous combination here. As for your second question, for ongoing panic, I would take an additional Klonopin 0.5mg. Xanax is bad for panic attacks because it leaves the system quickly and can cause rebound anxiety -- Klonopin lasts longer and is safer and more effective here.

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Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Alexander H. Sheppe (25 minutes later)

I took .5mg of Ativan instead, also prescribed to me. is this going to cause anymore trouble? and if I am still having a severe panic attack how long should I wait before taking something else? and what should I take? sorry for all of this, these are probobly stupid questions but ever since reading about Serotonin Syndrome I have been extremly concerned about the medications I am on. Cymbalta 60mg 1x a day, 1mg of Xanax as needed 2x a day, .5mg of Ativan as needed 2x a day for breakthrough anxiety and 1mg of Klonopin as needed 2x a day for any days I know I have meetings or will be in large groups.

Answered by Dr. Alexander H. Sheppe (5 minutes later)

Brief Answer:
Followup

Detailed Answer:

Taking Ativan 0.5mg is also acceptable, as it is longer-lasting than Xanax and should treat your panic attack without rebound anxiety. I would wait two hours before taking anything else, as it can take 2 hours for Ativan to kick in. You are not at risk of serotonin syndrome, this only occurs when combining a TCA or MAOi antidepressant with another antidepressant, and you are not taking a TCA or MAOi. I do find it strange you are taking so many benzodiazepines -- you should really only be taking Klonopin as a long-lasting one and Ativan for immediate panic relief. Xanax is not a good medication and I recommend you stop this one.

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Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Alexander H. Sheppe (1 hour later)

final question I have been told on here a few times that Xanax if not very popular with Dr on here but then I read about klonopin and it says that can lead to Alzheimer's and it seems like from what I read Ativan and Xanax are the same thing. so I am very confused myself which I think causes more anxiety

Answered by Dr. Alexander H. Sheppe (4 minutes later)

Brief Answer:
Followup

Detailed Answer:
Benzodiazepines do not cause Alzhemier's, but when used long term they can all cause problems with memory and cognition. They are meant to be used for no more than 2 months, after which time antidepressants and psychotherapy should be used to treat anxiety. Xanax is the worst of the benzodiazepines because it has a very short half-life which causes rebound insomnia and rebound withdrawal.

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Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Alexander H. Sheppe (2 days later)

so i am asking this in my follow up because i trust you Doc, the mozt of anyone on here, I took 70mg of Oxycontin 3 hours ago and 1mg of Xanax 1 hour ago and my 60mg Cymbalta over 7 hours ago. I am going to a addiction treatment center in the morning with my brother to get help, but im worfied i wont make it because i overdose tonight please help. and so you know you are the reason i am seeking help its because of the email you sent me.

Answered by Dr. Alexander H. Sheppe (29 minutes later)

Brief Answer:
Followup

Detailed Answer:
I am very glad you are seeking treatment for addiction. This is the best decision you could make to get your health and your life back!

With Oxycontin 70mg (3 hours ago), Xanax 1mg (1 hour ago), and Cymbalta 60 (7 hours ago), you will not overdose. This of course is not healthy at all, but you are not at risk of overdose or death. You will make it to the treatment center in the morning.

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Above answer was peer-reviewed by : Dr. Deepak