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  • Q&A with Australian Health Practitioners

    What are alternatives to benzos (Oxazepam/Xanax) that are strong?

    Currently on 60-90 mg of Oxazepam at night, and my brother has been abusing Xanax for 6 weeks (up to 16mg) and I am helping him get off them.

    I am concerned about both our usage of Benzosbas medium to long term solutions. We both would prefer to find something we can use that is less addictive. We are concerned about loosing our jobs if we don't find a way to find a different solution.
  • Find a professional to answer your question

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    Jennifer Grant

    Psychologist

    New practice opened Feb 2018. Seewebsite www.coffspsychneuro.com.au I'm passionate about working with people from all walks of life to help them create a more vital, … View Profile

    You don’t say what Oxazepam is being prescribed for. Its addictive properties and other side effects mean it is rarely a good longer term treatment for any psychological condition (eg, anxiety, panic). Same for Xanax. However, neither should be stopped or reduced without medical supervision.
    There are other ways of responding to the symptoms of anxiety and panic, and other ways of reducing the debilitating effects of anxious/panicky bodily sensations and thoughts. You say you’re looking for something strong and long lasting, and something that will enable you to remain effective at work. I encourage you to consider psychological therapy as a way of meeting these goals. Acceptance and Commitment Therapy (ACT) is an evidence-based effective therapy for anxiety and panic. You may not have tried it previously as it has not been around for as long as Cognitive Behaviour Therapy (CBT). Completing an ACT program of treatment is not easy. But neither is being addicted to benzos.  You can find an ACT psychologist by looking at the therapist listings on www.actmindfully.com.au.
    Please talk with your medical practitioner. Openly and honestly tell him/her about your concerns and goals. Discuss psychological therapy. Maybe you and your brother can go through this together?
    I wish you and your brother well on your journeys to recovery.

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    Dr Cahal Meegan

    Clinical Psychologist, Psychologist

    I am a registered clinical psychologist readily available to assist you in understanding and improving your quality of life impacted by mental illness, relationship or … View Profile

    I agree Jennifer's answer to this question, it is not clear why benzodiazepines are being prescribed in your case and this is important to answering your question.  Certainly benzo's are best used only in acute, crisis type situations to help with adjustment and severe distress.  Thus they would typically be used for a few days to no more than a couple of weeks.  As a longer-term strategy they are problematic particularly as they are highly addictive and may in the longer term only compound problems they were originally prescribed to address.  
    Most of the common SSRI (selective serotonin reuptake inhibitors) anti-depressants can be very helpful for different types of anxiety and may be more appropriate in the medium to long term.  However as Jennifer has already noted combined treatment of medication plus ACT or another established cognitive behavioural therapy would be a recommended option.  Your GP is a good place to start for advice on both medication and accessing psychology services.   

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    My research interests include immunology and the mechanisms of amyloid formation. The latter has implications for people who are dealing with Alzheimer's Disease, Parkinson's Disease … View Profile

    I agree with the suggestions made by Jennifer and Cahal.

    I am not a health professional but, because of my background, I have a fairly good understanding of molecular pharmacology. A dose of " 60-90 mg of Oxazepam at night" is way outside normal clinical guidance - see http://www.rxlist.com/serax-drug/indications-dosage.htm for more on this.

    As Jennifer and Cahal have suggested, I think that you should talk to your prescribing doctor about this. Ask him/her why s/he has recommended such a high dose. Llsten carefully to his/her comments and, if you are not convinced, approach another GP for a second opinion.


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    Andy Day

    HealthShare Member

    My Grandmother, my Mother, my older brother and sister and myself all suffered from anxiety. I had my first full blown panic attack when I was 10 years of age and that was 58 years ago. I was plagued by them for the next 35 years. I went from a high performing student to the school dunce in 5 years. I couldn't take exams, I couldn't socialize, I couldn't sing in the choir and the sport I loved as a child stopped because of fear. I tried everything from cognitive therapy to natural remedies to a zillion brands of mind numbing anti-depressants. I tried physiologists, counsellors and everything else in-between. I was in a living hell. Going to work was a battle everyday and personal relationships were ruined by anxiety. When I was in my mid 40's I ended up going to a physiatrist who prescribed Xanax. At last I was free. I finished my working career in a managerial position and I could even go on stage and make presentations to large audiences. I'm now told that the 2x1/2 of 2mg of Xanax I take are bad for me and I must stop taking them. Well medical profession, you are now going to give me more ineffective and mind numbing anti-depressants and send me back into hiding in my cupboard under the stairs and it's all for my own good!! How tritely you treat this subject. I wish that at least once you'd all have an anxiety attack and live in fear for the rest of your lives waiting for the next one. 

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