[joe27]

I've been recently diagnosed with Generalized Anxiety Disorder (although I think my anxiety is temporary based on temporary life circumstances.) The doctor suggested I consider taking a Benzodiazepine when I feel the anxiety is too much to handle. I've done a lot of ready about Benzodiazepines and have come to find that you build tolerance to them as your brain tried to adjust and also learned about the potentially devastating and dangerous withdrawl symptoms that come from stopping cold turkey after taking them for an extended period.

My question is more regarding minimizing tolerance (coming off them is pretty simply - make sure you are taking one with a long half life and gradually reduce the dosage.)

I've seen two schools of thought on this. One school recommends using Benzos with longer half lifes like Valium and Klonopin/Rivotril in order to minimize the risk of withdrawl symptoms should the usage be abruptly discontinued even for a short time (like maybe losing your luggage with your medication or something - in that case if you were taking Xanax daily, you'd need to call the doctor and get to the pharmacy as quick as possible, however with Valium, you may begin to experience withdrawl, but the long half life would make getting to the pharmacy not so critical.)

Anyway, on to the subject at hand, tolerance. I have basically two questions. Would not a short-acting drug have less propensity to tolerance build up if the drug was taking infrequently. (Example, 1mg Xanax once a day versus 10mg Valium once a day, wouldn't the Xanax have less tolerance build up since the half-life is so much shorter? My second question is what is the threshold of dosing regimen for serious tolerance build-up in short half-life benzos?

It seems most people take Xanax or Ativan either as needed for panic disorder, or, 2-4 times a day in small doses for the more generalized anxiety disorder. Does anyone have any idea at what point in terms of total daily dosage, a significant tolerance build up occurs with these drugs? Significant is the keyword here. I know there will always be some tolerance build up from taking any amount of the drug. I also realize the rule of thumb is obviously take the least amount possible which offer the needed therapeutic effect.

But I'm curious, do people taking say, 1mg of Xanax total dose per day, either 1mg one time or .5mg two times, with maybe one day a week they take only .5mg that day or maybe nothing at all experience a serious tolerance build up? Or does it take more than that to get to the point where you are having to take 3-4 times the dosage you took initially to get the same effect. It seems the key would be to keep the dosage low enough, or infrequent enough, to where you could take a day or two off from taking the drug if you are 'having a good day'. I would then expect in that scenario tolerance build-up should not be a significant issue with these Benzos with short half lifes of around 12 hours.