Hi there,
Thought I'd report my experience with Xanax over a period of 4-5 months. It is the most reliable drug for me during POIS. I have had some sleeping issues and started taking it daily in the most responsible way I thought possible, keeping journals of times, doses etc.
I began on the lowest dose (0.25 mg). It was effective and totally wiped out symptoms for 3+ hours per pill. I started taking 1 pill in the morning and then 1 in the afternoon during POIS, and then also taking it daily regardless of POIS. It continued to work well. However, I gradually built up a tolerance and by the 3 month mark I was taking 0.75-0.85 mg only once per day maximum, each morning. I should note that throughout the entire time I took these pills I took 1 day breaks on average once every 5 days to reduce tolerance/dependence potential. It didn't work, so after about 4 months, I went off them cold turkey as a test. The first week was very difficult, and I was prepared to take pills if it got too difficult, but I am on holidays so I felt I could manage it. This was not the safe way to do this and you are supposed to taper slowly to a lower dose but since I had taken day breaks, sometimes 2 day breaks, I thought I could manage it with lots of meditation and exercise and no stress. I would never recommend going cold turkey as I did - that week was extremely difficult.
Anyway, I tested it after a week and 0.5 mg is now having the normal effect. I won't take it more than once daily at most and will try to keep it only for emergencies (family functions etc). Hopefully tolerance will continue going down and I will rest on 0.25 mg daily as an emergency option rather than 0.5 mg. Considering some people take up to 10 mg per day, I figured I wasn't doing too badly. The trick is to stay conscious of tolerance, only increase by tiny tiny amounts if totally necessary, take days off if possible, and really, only use it if totally necessary. Even if there will be a slight amount of suffering, I will resist taking it. Only in real emergencies. Anyone who has taken Xanax will tell you how addictive they are, and the severity of rebound anxiety which can last years if not forever. This is not a recommendation for anyone, just something to consider with your doctor. Fortunately I am in Asia and have time to experiment with these pills as you can buy them OTC.
I will trial Sertraline for PE this week as many studies show it helps, so I will try to go off Xanax that day. Taking Sertraline only "as needed" basis.
Anyway, thought I'd share this.
Xanax is IMO one of the most dangerously addictive drugs you can take and tolerance builds up quickly. They say it's worse than opioids and hard drug use. I agree. Rebound effects are insane. That week off was barely manageable and unless on holidays, it would have been impossible.
Just putting this out there for those who struggle to go outside during POIS. It's good for emergencies, I guess due to GABA.
Yesterday I tested 25 mg of Sertraline for first time during POIS and it had zero effect.