My Dilemma (Effexor & Xanax)

Several weeks into my bout with T, I have become reliant on Benadryl or Tylenol PM in order to sleep. Every night is unpredictable. Fall asleep within an hour some nights, seemingly up for 3-4 hours others, and when sleep finally occurs, it is a mere twilight, with waking spells usually each hour. Went to my GP who prescribed a minimal dose (37.5mg) of Effexor each day in order to become less anxious over my T (I also have H) and 1 small dose of Xanax (0.25mg) for aid in sleep. I am freaking out over whether to take these, due to the horrors which have been known to arise from them in certain cases. Worse case, I am currently living with my elderly father who also takes Effexor (and has taken 37.5 for 14 years-not for T). he hates that I visit this site and he always tells me that my unwillingness to heed my doctor and fight "what is best" is killing him slowly. I'm stuck between the proverbial rock & a hard place...What to do??

 

No experience with Effexor. Not a fan of benzos, but that was due to taking multiple doses a day for a few months. Prior to that I had taken 0.25 occasionally for anxiety or to sleep. I wouldn't hesitate to take 0.25 mg to sleep in the first weeks of having T. Sleep is important. An alternative would be ambien though it will have its own set of issues.

 

Have you tried using a noise generator to help with sleep? I listen to white noise every night to mask the T and help me sleep. You can try taking the Effexor for a few days and see how you feel. If it made your ears ring louder or bothered you, you could stop taking it. I've taken benzos (klonopin) on and off for years, and have not have any problems. I keep the dose low and never go over that amount in a day.

 

I take 75mg of Effexor and does nothing for tinnitus but im ok on it....lots od love glynis

 

I was reluctantly to take drugs in the beginning. Now I'll take anything that will help and for me the benzos do help. Sadly my doctor won't prescribe long term so I have to use only on the very worst days....I also take ambien for sleep everyday so maybe you could ask for that instead of benzos as I think the isn't a withdrawal as there is with benzos if you take regularly.

 

You should go down on your knees and thank your doctor everytime you see him for being restrictive regarding benzos. If more doctors where just that, there would be a lot less suffering.
Take it from me. I have had doctors throwing benzo after me for years and it has destroyed my life. At least part of it. When you first get dependent on them your life will never be the same again. Trust me. One doesn´t know what anxiety or sleep deprivation is before you experience benzo withdrawl symptoms which just last and last and last...

 

But isn't ambien also ototoxic?

 

Sorry for the length of the post. I have spent a lot of time worrying about ototoxicity without paying attention to the fine print, and I now find it is helpful to try to quantify the risk. As I said above, I think sleep is important. But if sleep came with a high probability of permanently increasing tinnitus, that is not a good thing... So I looked into ambien a bit. For the record, I have taken it prior to having tinnitus with no problems. The bigger side effects I am aware of are that you can appear to be completely awake - have conversations (I did this), get up and do things, etc without any memory of the events.

It depends on what you mean by "ototoxic". If you mean is it known to cause permanent hearing loss, then no I don't think it is.

Tinnitus is listed as a side effect - as it is on almost every drug that I have seen - and I do the same kind of research you are doing. It turns out that there is more information on Ambien than there is on some other drugs I have researched. The following information is taken from http://www.rxlist.com/ambien-side-effects-drug-center.htm

"Special senses: Frequent: diplopia, vision abnormal. Infrequent: eye irritation, eye pain, scleritis, taste perversion, tinnitus."

So it is listed as an "infrequent" side effect but it isn't immediately clear what "infrequent" means. It turns out that "infrequent adverse events are those occurring in 1/100 to 1/1,000 patients".

Where do they get these frequencies from? (emphasis added)
"AMBIEN was administered to 3,660 subjects in clinical trials throughout the U.S., Canada, and Europe. Treatment-emergent adverse events associated with clinical trial participation were recorded by clinical investigators using terminology of their own choosing. To provide a meaningful estimate of the proportion of individuals experiencing treatment-emergent adverse events, similar types of untoward events were grouped into a smaller number of standardized event categories and classified utilizing a modified World Health Organization (WHO) dictionary of preferred terms.

The frequencies presented, therefore, represent the proportions of the 3,660 individuals exposed to zolpidem, at all doses, who experienced an event of the type cited on at least one occasion while receiving zolpidem. All reported treatment-emergent adverse events are included, except those already listed in the table above of adverse events in placebo-controlled studies, those coding terms that are so general as to be uninformative, and those events where a drug cause was remote. It is important to emphasize that, although the events reported did occur during treatment with AMBIEN, they were not necessarily caused by it."

So these are things that were reported to have occurred at least one time for one person. In an analysis like this, there is no way to show causality. After all, arthritis is also listed as an "infrequent" side effect!

What is more interesting is the comparison of "adverse events" between the treatment group and control group. They have some information on that. Tinnitus isn't mentioned, but dizziness is.

Just to conclude, some of the frequent side effects are ataxia, confusion, euphoria, headache, insomnia, vertigo, dyspepsia, hiccup, nausea, upper respiratory infection, lower respiratory infection, urinary tract infection.

I could do without most of these, but euphoria doesn't seem too bad. Ironic that insomnia is listed as a 'frequent' side effect.