Will I Get Addicted To Xanax?  I'm Against SSRI's.

QUESTION:

Dear Dr. Heller,

I suffer from panic attacks and a lot of stress.  I am 27 years old and have developed these attacks over the past 2 years.  I have been taking Xanax for the past 3 months.  I do not take it every day, just when I need it, which seems to be every other or every two days.  The dose that I take is usually .50 mg twice or three times as needed on those days.  I am worried about becoming addicted to the drug.  I don't think that I am yet because on the days I don't take it I don't feel any withdrawal effects and I do not take it regularly every single day.

My doctor wants me to take Paxil but after reading about Paxil and all the side effects I do not want to take it or any other SSRI.  Are there any other medications besides Benzodiazepines and SSRI'S that can be used for panic disorder?  I really do not want to use a drug that I have to take every day and can become dependant on.  That is why I like the Xanax because I can take it when I need it and it works!  But like I said, I would like some advice on using it every two or three days when I need it.

My doctor did prescribe 45 Xanax .50 mg pills but did not give me another refill on them, he told me to "research" other medications and to get back with him if I want to try something else, but he is very against using Xanax due to the possibility of addiction.

My biggest question is will I become addicted if only taken as needed?

Any help would be great!

Thanks.

ANSWER:

You can become dependent upon them taking it as you are.  It's better to become dependent upon Xanax than suffer panic attacks, however.

Taking SSRI's is an excellent idea, and works extremely well for most panic disorder patients.  They are much safer than Xanax.  If the generalized anxiety disorder is present, particularly the cognitive component (persistent worry), the BuSpar will most likely be needed prior to taking an SSRI.  In my practice, unless the patient needs the positive effects specific for Prozac I'll prescribe Paxil 40mg daily for panic.

The older tricyclic antidepressant imipramine can help some patients with panic.