Brief Answer:
stop marijuana, clonazepam (klonopin) is better than xanax

Detailed Answer:
Hello,

Thanks for writing to us. I can understand your concern. You are likely suffering from panic disorder - a type of anxiety disorder.
Marijuana can help to make person relax however as soon as its effect goes away, rebound anxiety is more severe. I strongly recommend stopping self-medicating with Marijuana.

Best treatment of any anxiety disorder includes both medicines and cognitive behavior therapy (CBT).

In mild cases only CBT is sufficient. In moderate to severe cases initially medicines and then CBT is added. And later on medicines stopped gradually.
If medicines alone are used chances of relapse are more after stopping the medicines.

In medicines SSRI group of drugs (fluoxetine, paroxetine, sertraline, escitalopram) are main stay of the treatment. I prefer paroxetine. Benzodiazepines group of drugs (clonazeapm, lorazepam or etizolam) are used initially for short duration for fast symptomatic relief.

You have tried mirtazapine (remeron), zoloft (sertraline), prozac (fluoxetine). I use mostly paroxetine (depaxil) in panic disorder. In benzodiazepine xanax is potent anti-anxiety drug. However due to shorter half-life it can cause dependence and tolerance so chances of dependence and abuse are high. I recommend clonazepam (klonopin) instead of xanax for immediate relief of anxiety symptoms.

For a while if you have severe anxiety and you have xanax you can use it as per instruction of doctor to get relief.

You can discuss with your treating doctor about my recommendation and change/start treatment.

Hope I have answered your query, I will be happy to help further.

Regards,
Dr.Chintan Solanki.

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