Dosing question

I am currently on 2.5mg alprazolam per day divided into 4 doses and getting ready to start tapering.  My question is this…. I have been dosing at .5 around 8 am, another .5 around 2pm, then another .5 around 8 pm leaving 1.0 mg at bedtime. My psychiatrist was aware of this (let him go yesterday).  The hope was to have the larger dose at bedtime to try and get sleep.  Not working… at least working anymore. Lately I feel like it actually wires me up.  I’ve been reading about blood serum levels.  Have I messed myself up with this schedule?  Also..  should my taper be 5-10% off the total 2.5mg divided equally?  Help!

Lots of people dose Xanax 4x times a day due to interdose withdrawal. It sounds logical to me to dose the way you tried to in order to try and boost your sleep, so I don't think you messed anything up. It doesn't have to be spaced exactly even - unless your main issue is interdose withdrawal. It's all about what works for you.

 

  Also..  should my taper be 5-10% off the total 2.5mg divided equally?  Help!

 

Your taper should be 5-10% of the total daily dose. Usually people will start by reducing one of their doses and then alternate, trying to keep the doses even. But once again, this is all based on what works for you. 

 

If your dosing times and the larger dose seem to be problematic and revving you up you might want to try and sort this out first before you start tapering. Are you having interdose withdrawal?

I do have interdose withdrawals sometimes that have become more frequent in the last couple of weeks.  I feel my heart start to race and get shaky.  Sometimes I am able to exercise or distract myself to make the 6 hours. I’m pretty sure that is because I’m now tolerant to this dose … but I don’t want to up-dose,  I want get started moving forward.  I am already not sleeping well.. I’ve had 3 zero to 1 hour nights in the last week so there is that.  But I have not slept well since this whole ordeal began in May. 

It does sound like it could be tolerance. At what time do you take the bedtime dose?

Usually between 10-11. 

Do you make it until the 8am dose with the interdose withdrawal? Are you satisfied with keeping your current dosing schedule?

 

I honestly don't think there's much we can do about the insomnia since it started prior to tapering. It sounds like tolerance. 

 

 

I do make it until 8 most nights.  The insomnia is a real problem.  Melatonin helps some

I am open to any suggestions about the dosing schedule.  And anything anyone has to help with the insomnia.

I am open to any suggestions about the dosing schedule.  And anything anyone has to help with the insomnia.

 

You've probably considered or tried the following, but I'll throw in my 2 cents for insomnia:

          Seroquel

          Hydroxyzine

          Promethazine

          Remeron (I think you said you don't want an A/D, though)

          Baby Aspirin (Beck's choice)

          Tylenol (Kate's sister's choice)

I am open to any suggestions about the dosing schedule.  And anything anyone has to help with the insomnia.

 

Well, it's a good sign that you're making it to the next morning. I think you should ask the folks on The Xanax Club what they think about your dosing (times and doses). I only dose once a day so I'm not too familiar with the challenges of multiple dosing. I do know it becomes more difficult to change this once you start tapering. That's if you need to change it.

 

You can read through some of Shayna's posts. She struggled severely with insomnia and is now doing fairly well. To the left of her profile is the option "Show posts" - click on that and you can browse her posts.

Thank you! Tried Seroquel.. not good for me. But I can look into the others.