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As I have stated in the past....I'm in charge of mom's meds and try to stay on top of this the best I can. I call in refills as necessary since auto refill caused too many problems. Mom has been on Xanax for the past five months......taking one every evening. When she was down to five pills I called in for refill. I found out today that her PC would not refill the prescription and I am concerned about possible withdrawal. Doc is not in office tomorrow, so I'm at a loss until Monday. Just curious if anyone else has experienced stopping this med abruptly? Am I overreacting by being concerned about potential withdrawal?

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I take xanax but not very often. You can't " call in" that rx.,you have to physically go get the prescription.,maybe that is what is going in?
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Midkid58 Jul 2019
Actually, you CAN call in Xanax. It's a benzodiazepine---and in all the states I know of, it can be phoned in.
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Abby, has your Mom's doctor asked for her to come into the office for a check-up? Usually when one is one that family of prescription medicine, the doctor needs to see the patient every six months. That is what I need to do as I am also on Xanax.

I bet the refills were only for 4 or 5 refills. That is how my primary doctor has my prescription. Thus, it makes me need to go see her for a check-up.
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Abby2018 Jul 2019
She is seen on every six weeks
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It is a controlled substance, doctors are being closely monitored due to abuse. You will have to take her into her doctor, every 6 months.
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Have you spoken to the doctor? Is s/he refusing to renew because she needs to be seen before another script is written? Most psych drugs cannot be renewed for long without the physician examining the patient.

I would Google "xanax withdrawal" and check Mayo Clinic and Web MD for accurate information.

Does mom's insurance company have a nurse line you can call?

Put a call into the doctors office tomorrow and talk to her or him about what needs to happen to get a new script.
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Abby2018 Jul 2019
The way her insurance works is that you can only request refills when you are 5 days out. The pharmacy has to call the PC monthly for approval, which has not been an issue since she a visits every six weeks. I have no idea why she was declined, since he never mentioned tapering her off or stopping the med. She saw her rheumatologist today her authorized a 30 day supply. Will be contacting PC on Monday.
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I'd halve the ones you have left to stretch things out and help with any withdrawal side effects.
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Didn’t the bottle say how many refills she hadn’t left? Xanax is schedule IV controlled substance which means it the prescription cannot be refilled more than 5 times or more than 6 months after the prescription is written. You will need to take mom in to see the doctor in order to get a new prescription. Ans definitely ration what she has left. If the bottle didn’t specify how many refills she had, and the doctor didn’t explain the need to bring her in after 5 refills, it might be something to complain to him about.
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Abby2018 Jul 2019
It is a 30 day supply and she's been seeing her primary once every three weeks. He never mentioned weaning her off or expressed concern with taking this longterm. I was completely blindsided.
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A heart Dr. put my mother-in-law on the very lowest dose once a day. Five months later when she saw her primary care Dr., she took her off. She put her back on Buspar & when that got in her system she quit the Xanax. The drugs work differently & I was afraid of withdrawal issues, but it went smoothly.
Can you speak to the DR. About putting your Mom on something non-addictive & with little side effects before just quitting cold turkey?
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Abby2018 Jul 2019
Thanks Molly....my plan for Monday since I was able to get a 30day script from her rheumatologist
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The advice is "do not stop Xanax without talking to your provider first."

I cannot find out what you are supposed to do if your provider is not available to be talked to. You can't call the doctor's office, today, now, and keep ringing until you get an answer from somebody qualified as to what you're supposed to do?
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worriedinCali Jul 2019
Some people go to the ER and are able to get a couple pills.
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My mom was on Xanax for 10 years - totally addicted. Her doctor put her on it when she found my stepfather's body when he collapsed from a fatal heart attack while chopping wood. No one ever even suggested she wean off. She changed doctors along the way and her new one decided to stop the Xanax cold turkey. That poor woman went through horrible withdrawal with no idea what hit her. Nausea, headache, tremors, hallucinations. I called the doctor's office after hours and got the on-call doc. He okayed a prescription for a week's worth and I doled them out one pill, then a half pill, then a half every other day over several days until she was safely weaned off. Definitely call the office or go to an emergency room.
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Abby2018 Jul 2019
Had a standing appt. with Rheumatologist for today who wrote a script for 30 days. Will call her PC on Monday. Thank you for the feedback.
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My mom has been on that garbage drug for decades. She's been hospitalized twice in the last two months for mis-managing the medication. The first time, she had doubled-up and then ran out, so had withdrawl symptoms within 24-48 hours and had to be taken to the ER. Just this week she took a little too much, washed it down with wine, was hospitalized again and is now in a mental health ward. This drug is horrible and I believe has caused significant damage to both parents, who have been on it since the 1980s. Dad is in a dementia care home and basically a zombie. He swore by this drug and took it 365 days a year for sleep. Read the list of side effects, they really do result from use of this drug.
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anoni0000 Jul 2019
It depends on the dose and whether they're taking it round the clock. It's the shortest acting anti-anxiety med. That's why it's good if only taking a low dose for sleep. I've been on it at night for sleep disorder due to PTS. It also depends on what else a person is on, whether one drinks, etc. Some people have serious side effects, but for those who need it, it's a life saver. For me it was a life saver. Nothing else worked. I'd no sooner fall asleep and I would be wide awake - it was the only thing that enabled me to stay asleep once I got there. I'm truly sorry your parents had negative outcomes.
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I agree, he refused because he needs to see her.

Most DEA controlled substances need a doctors script every month. They can not be called in and at one time they could not be faxed, but that may have been changed. I worked for a Pharmaceutical company. Pharmacies would have to send in DEA forms for certain Drugs. Their records had to show what was ordered had a prescription to fill. No stocking the item.
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Abby2018 Jul 2019
He just saw her three weeks ago.....and sees her once every six weeks. He mentioned nothing of this at the last visit.
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Call right away as soon as you can and tell office that a complete dead stop on a medication like xanax constitutes negligent treatment, because it does. You should now have complete instructions on how to withdraw her from this medication. Meanwhile, you do have medication for her until you get ahold of the doctor, who may want to reassess her for need. One pill a day is not a terribly high dose, but he may need to see her before reordering. The truth is that doctors now are being looked at VERY carefully if they order these medications for patients, and they are pretty scared.
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Abby2018 Jul 2019
Went to mom's rheumatologist and expressed concerns....she wrote a new script for 30 days with instructions to contact PC on Monday. She was as confused as me.....mom is on a very low dose and helps her to sleep without wandering which allows peace of mind for my dad. She just saw her primary 3wks ago and he said nothing about tapering her off. Thanks for your answer.
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Abby, I'm so glad you found a workaround!
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Do not discontinue any daily med without a consult with the doctor and/or pharmacist. Drug interactions are very different from person to person.

Not a do-it-yourself project.
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Drs are under SUCH scruntiny with so many drugs. My own PCP talks with me every single month about the Tylenol with codeine that I take for arthritis (and now bone pain from cancer) The pendulum has swung so far from the middle--My PCP is really frustrated about his inability to care for his chronic pain patients. Same with benzos. Those are highly addictive and it can take YEARS to de-compress from them. Your dr is being a jerk. Sounds like you did a safe go-around for mom.

Personally, until you have walked in my shoes and felt MY anxiety and insomnia and pain, you don't KNOW what I'm feeling. Sometimes you have to dr shop to find one who is willing to help you and do so in a compassionate manner.

My KIDS were super, super judgmental about my need for a mild benzo, until THEY started having anxiety problems. Shoe on the other foot changed it all for them.

We do not know another's person's pain and problems. Don't judge.
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GraceNBCC Jul 2019
I waited 4 months for a new patient appt for a new PCP. In the first 4 minutes she says, ' I don't prescribe benzos!"
No suggestion on what doctor or specialist in town I should go to for them. She acknowledged I should not just stop after 10 years at same dose.
I'm a retired MHP, and I know the danger. This is hurting patients.
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Anybody who wants to learn about this drug: Google "Benzo Buddies" or the "Benzo Information Coalition".
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If she's only taking it at night, and only a .5 mg dose, it's not as bad as if she would have been taking it around the clock. Still, she should have been tapered to halves first. I'd consult with another doctor.
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What dosage is she on? I would think after 5 months you are more than likely already physically dependent on the drug. Quitting cold turkey can lead to seizures. I myself have had the experience and it was horrific. Xanax is one of the worst drugs to be on as it’s 1/2 life is only 6 hours. Valium also known as diazepam has up to an 80 hour half life a much better drug to be on and get off of. I would call her doctor ASAP if the pharmacy is not filling her script hope this helps.
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You definitely have to be weaned off of Xanax you can’t just stop cold turkey you go into the most horrible withdrawals. I know this from personal experience.
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I speak from experience here. Please be careful. Xanax is a controlled drug. Sadly, with new laws being implemented in many states, due to the opioid crisis, doctors are abruptly refusing to renew many of the controlled substances, no matter how long the patient has taken them, no matter the dose taken. Elderly persons are at particularly high risk of severe withdrawal and complications.

My former, and I stress former, internist also did this to me, ignoring CDC guidelines for weaning, ignoring the good the drug was doing, ignoring that I was a model patient, never requested an increased dosage, never abused or sold my medications. The doctor did not discuss at my office visit, just simply didn’t renew, and refused to renew a medication I had benefitted from, for close to 15 years.

It caused an horrific withdrawal, with such bad diarrhea, that it threw my heart into tachycardia, caused by dehydration from unrelenting vomiting and diarrhea. Only with intervention from my own gastro, did I avoid heart attack and death, from the severe electrolyte depletion. The internist wouldn’t even take my calls due to severe dehydration, which she caused.

There are elderly people who are dying from the abrupt withdrawals from some of these medications. Exactly why the CDC put out the cautionary memo to prescribers, as doctors are misinterpreting the new laws and medical guidelines, and people are dying from the withdrawal. The dosage may be very low, but being elderly is a major factor in the medical crises people are being thrown into. My doctor said she thought I would benefit from pain management. That was the day (May 2, 2019) she decided to not renew the prescription. The issue is that there are aren’t enough pain management doctors out there, certainly not sufficient to see all the patients who are being thrown off their pain/controlled medicines. I am still waiting, will be two more months until I can get into a pain management doctor. So, instead of helping the patient until they can get a pain management appointment, the doctors are running like a flock of sheep, and not even discussing what they can do for the patient, what alternatives can be safely used until one can begin the pain management treatment.

It May be that state law has tied the doctor’s hands. But there is no excuse for the doctor being negligent. Even very low doses of these medications need tapered.
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gdaughter Jul 2019
Find a malpractice attorney and sue the witch. It's time they realize there are going to be consequences for this irresponsible and cruel behavior.
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Yes, unless the dosage has already been tapering down to near-nothing, an abrupt cessation is a bad idea. The only other reason to stop it abruptly (that I can think of) would be if the Xanax has been found to cause some OTHER serious problem... but whatever the reason is, the doctor should have explained it! Definitely get another doctor to look at this.
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It is a Bad idea to Go Cold Turkey and Yes...Could have Side Affects.
Make an Appointment and Talk Turkey to Tom when he is Back in the office. Or Find Quick another Doctor who will Help you. Anyone under the Sun, Hun, Who is on this Sort of Mind Drug, Need to be Weened OFF. Or CUT DOWN.
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Depends on her dose, depends on her other meds. Don't overreact. He may well have a very good reason for doing it. Xanax is a dangerous med, can be especially so for geriatric patients. If she is able to come off of Xanax, it's a very good thing. As for withdrawal, I did it (personally I mean) after 5 years. It was uncomfortable, but not horrible. I felt so much better after I quit. It's a much more dangerous med than most folks realize. So take a deep breath and talk to her doc. If she has a serious reaction, take her to the ER.
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Cupofjoe34 Jul 2019
Agreed and also the dosage matters you can taper if on the lowest dose with 5 pills left. But regardless this isn't a proper treatment option. Taper takes time and then if need be a new medication or vitamin can be implemented instead to keep her on a steady sleep regimen. If it's for anxiety their are 20 drugs off the top of my head that could be beneficial narcotic or not for her. It is carelessness. I would get a new dr... obviously you need guidance. Wish you the best.
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Yes it should be tapered off when taken daily. So check with them on Monday and see what they will do. I see no reason for them to refuse to refill it.
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Justme44 Jul 2019
Unless she is on painkillers. Its become a big no-no over last year or so. They make you choose pain relief or anxiety relief, unfortunately.
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psychiatrists are the best suppliers. They will give all you need and more.
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Certain medications require blood work to monitor kidney and liver functions. Others cannot be refilled unless the patient has seen the dr. recently. These are the reasons why My Mom's meds may not get refilled.
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Abby2018 Jul 2019
Recent blood work and was seen three weeks ago by the prescribing PCP.....which is what caused my confusion.
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I just want to throw this in, which is not helpful in a concrete way....but many years back, in the old days as I started this social work career I was interested in so many topics and to learn so much. So I went to a number of meetings of the American Psychiatric Assn. Have you ever been to a car show where there are multiple displays, sensory overload with noise, lights etc? This is what it's like in the exhibit hall with all the drugs and their manufacturers there. They would sponsor sessions and follow them with dessert receptions...I still can recall people that would grab a plate, stack it up with goodies, and head back to their hotel room. Just to say that the drug companies are more interested in selling and profits then they are about the well-being of patients in many instances. I hear things have changed, but as I have not been back, I can't verify it all. And beware that when you start asking for something in particular they may be suspicious, think you are looking for a quick fix. Terrible situation and I would not be going back to the MD who started all this grief. Idiots and politicians have generated this BS and are clueless to the grief and pain they cause for patients and their caregivers and loved ones.
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Abby, it would depend on the amount of medication she is taking. Is it 0.25mg, the lowest, or is it higher? If it's as low as .25 or .5, it shouldn't need to be weaned, but if it works well for her, go to another dr.

Since you were able to have the rheumatologist fill the rx this time, will that physician continue writing it? Or, have you thought of having your Mom see a psychiatrist who could manage it? Just an FYI to you and everyone, if you would like, you can use a telepsychiatrist for a visit. There are various websites with tele medical practitioners as well as tele psychiatric visits. It's a great alternative to having to go in person, possibly with a long wait for an initial visit.

I myself have been using Xanax as 0.25mg prn (once in awhile) due to all the recent stress of multiple issues with my mom/home. It is a very useful/helpful medication when used properly. Good luck with your Mom!
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Abby2018 Jul 2019
Very low dose and helps significantly with her dementia and manageability.
But if the PC feels that she should no longer take it, I will honor that decision. My concern was taking her off so quickly. I'm waiting to hear back. My hope is that she will remain on her usual dose until her geriatric assessment next week.....and then make necessary changes if need be.
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I'm an Internist. I'm Somewhat permissive in my current practice, but used to blow benzo patients off in my last one. "I've been on it for Thirty years." But-I don't LIKE that type of drug, and it shouldn't be my problem. Also-addiction is not the only issue. Seniors can have Bad falls on that drug (there's a whole list of drugs-DeBeer's Criteria) that the Elderly should not take. Buspar helps anxiety without the addiction.

That SAID-this class of drugs (which includes Ativan, Klonopin, Valium and Xanax) is like Booze. Going off too fast is very dangerous. You need to wean them.
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Upstream Jul 2019
Thank you for your professional opinion. I took Ativan for a couple of years for sleep. Being young, I blew off reading the side effects. I had never really been on any prescription before, and I assumed side effects only happened to a very small percentage of the population. My family doctor told me one day he wanted me to taper off and he could no longer prescribe me the medication in good conscience. He told me it caused balance issues and I din't want to become a little old lady walking into a doctor and demanding my drugs. Fast forward a decade - my parents have been taking this stuff for decades and now it has caught up with them. Dad is in a dementia care home. Mom has been having abrupt & bizarre falls since she was in her mid 60s: broken hand, shoulder, back, black eye, etc. She goes over like a leaning tower, one time face-first into the lawn mower in the garage (that was the back eye and she wasn't even 70 yet). She's now on a walker and still in her 70s. Refuses to get off of the drug. I am so, so glad my doctor intervened. I tapered off without drama, felt a little wired and had trouble sleeping at first.
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I'm a 'elderly' woman and when need something strong enough to calm me down I take a 1 mg. melatonin pill that sits at my bedside table 24-7. You can't overdose on it and it's not addictive and easily obtained otc from any drug store or Walmart, etc.

Many people can benefit from melatonin as the brain produces it to naturally relax the body for sleep at night. But in this world sometimes we need help, right? This is cheap and effective too.

God Bless!
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