[Guest]

Dr.,

My GP claims that he doesn't want me to take my Xanax daily (even if I am willing to deal with potential dependency) because tolerance develops and will make the dependency situation even worse while decreasing the effectiveness. My understanding from my own research is that outside of substance abusers who use BZs for a "high" and need to continually increase it to get that "high", no real evidence has shown that clinically significant tolerance develops within prescribed limits for therapeutic anxiolytic purposes such as Panic(not sedative use for insomnia, which I understand is really a side effect and tolerance does develop quite rapidly sometimes). In fact, one of the studies I read followed 20 year users which showed an average drop in dosage (although this study may be inherently flawed as those who develop tolerances would likely not have been able to continue the drug for 20 years).

1. Who is correct, me or my GP?

2. In your clinical experience, what percentage range of patients who use BZs regularly on a long-term basis (>12 months) do develop tolerances?

Thanks as always.

[Guest]

Of the benzos, I think that Xanax has the highest risk for abuse. This is a personal opinion. I have stopped prescribing it. It is an FDA approved drug and others use it without hesitition. Studies show that most people (95%) do not abuse their medication. The ones that do have a penchant for alcohol and drug abuse before the benzo. That being said, I think that a longer acting agent is less prone to abuse.
[quote] Dr. ,

My GP claims that he doesn't want me to take my Xanax daily (even if I am willing to deal with potential dependency) because tolerance develops and will make the dependency situation even worse while decreasing the effectiveness... [/quote]