Posted by paulk on June 26, 2001, at 16:22:10
In reply to benzos » paulk, posted by Elizabeth on June 26, 2001, at 2:56:27
>“They do have other effects in addition to MAO inhibition, though: Nardil is also an inhibitor of GABA metabolism, while Parnate is *thought* to have some sort of dopaminergic effect (perhaps induction of dopamine release: Parnate is chemically extremely similar to amphetamine).
!@# Lawyers – I sure wish that information had been in the PDR. –The Nardil has just kicked in in the last week or so – I still question that the low BP is caused by other than the increase in the monoamines – from what I understood until 90% of the MAO is knocked out There isn’t enough rise in neuro transmitters to do anything.
I seem to be doing OK except I am starting to have trouble with word selection – and sometimes the wrong word will come out. I wonder if it is a side effect of the GABA? Perhaps I should take the med at night? I am still at the high dose 60/mg day – perhaps it will get better when they lower the does back down. Was the inhibition of the GABA metabolism a direct effect of the drug or secondary?
>
> > It isn’t pretty. I went to a funeral of a friend who had lost his hygiene habits after too many bezo over 15 years. He died choking to death on a hotdog. (this is not a joke)>That's terrible, but I do hope your example doesn't scare people unnecessarily! I really would be interested to know the details, if you're comfortable discussing them -- like the individual's age, why he was taking the benzos (and which ones and how much), whether he had other medical conditions that could have contributed, etc.
>Some people abuse benzos, and they can develop truly massive tolerance. The worst case of this I've heard of involved a guy who was using more than 100 mg of Xanax a *day*. Some people have general sedative abuse problems, and they often combine benzos with other CNS depressants, such as alcohol, barbiturates, meprobamate, industrial solvents (inhalants), etc. As I mentioned, most people who abuse benzos also abuse other drugs.
>However, most anxiety patients who take therapeutic doses (which can mean up to around 6 mg/day of Xanax or Klonopin) do not have problems with them. They certianly don't become demented or unable to care for themselves; on the contrary, benzos can eliminate crippling anxiety. It is true that some people suffer cognitive impairment (slowed thinking, memory problems) from benzos; these people usually end up taking alternative anxiolytics (such as antidepressants) instead (although most people I know who take ADs for panic disorder still occasionally need to take benzos).
He was taking – I think it was Restaril – (sp??) . He was very bi-polar yet a dear friend – very smart – didn’t usually go psychotic in his mania. He really needed to be in a halfway house to have someone monitor is medications. The lack of supervision is what I blame for his death. I think the benzos may have surpressed his gag reflex or dis-coordinated his swallowing enough to cause the problem. I don’t think this would be a common problem with people who can manage there own meds.
> > > I guess I’ve seen too many people who got in trouble with benzos when I was in hospital. That dosen’t mean everyone will, but some do.
> >That's rather surprising. Anxiety patients tend to use medication as directed or, if anything, to use *less* than the prescribed amount, not more.
Most of these people were in the hospital because they had benzo problems – sort of self-selected. Remember everyone reacts differently.> > I would humbly disagree; the short half-life of Xanex causes withdrawal symptoms of ‘panic and anxiety’ in some patients with a single dose.
It sure does it to me. – That’s why I’m interested in the slow release version. I would take it for anxiety and it worked – wonderfully – but then as it wore off I would feel even worse than before.>Some people might experience rebound anxiety (just as people who use short-acting benzos such as Halcion for insomnia may be subject to waking up in the middle of the night when the med wears off), but if they are truly taking the drug only on an occasional basis, rebound effects (if any) are unlikely to be serious. Also, people who have continuous anxiety (rather than, or in addition to, short-lived anxiety or panic attacks) will become anxious again after a benzo wears off: that's not a rebound reaction. Single, isolated doses of benzos do not cause dependence, by any definition you use.
I didn’t use Xanex after the prescription ran out because of that problem – I didn’t get addicted – but I sure wanted to keep taking more and more, but realized I shouldn’t. I really liked and hated the drug. Sure wish I could try the XR version.
> > When I took Xanex – I would get quite irritable as the drug wore off. This makes a drug spiral – take Xanex for anxiety – it works, but as it wears off anxiety is there, but worse – take more – and more. Now, this doesn’t happen to everyone – but it sure happens to some folks.
>Ahh. Irritability isn't an indication for benzos, and they have been known (and documented) to cause bad reactions in some people who had preexisting mood-regulation disorders (which often tend to manifest as irritability or atypical/mood-reactive depression).
I would say that irritability is a symptom of anxiety?? The irritability wasn't there until the drug was wearing off. You might be forgetting the wide variation of how these drugs effect people. (YMMV grin). I know the nasty discontinuation effects of Effexor – yet for many folks they can stop cold with out any problem.
> > They tapered – the anxiety returned – only treatment was CWSP.
>"CWSP?" (Is there something I'm supposed to know about here?)
CWSP = Cold Wet Sheet Packs – THE non-drug treatment for anxiety. (I wouldn’t want it done to me – its not fun to watch – but it seems to work a bit.
I’m thinking that there needs to be a new specialty in medicine – an endroconologist/pycopharmacologist. It sure would be nice if there were better and objective tests that could show what drugs to try first. – perhaps spinal fluid tests or long term urine collection for cortisal tests?
Reminds me – I ran into yet another old friend who tried Effexor – told me he went sort of manic (couldn’t sleep – roofed a house all night long in the dark) – his doc now thinks he may be a bit bipolar. – Perhaps putting someone on a SSRI for a couple of days and re running psyc evaluation would help spot hidden bipolar tendencies? I think that side effect may happen more than one would believe by reading the PDR.
Paulk
poster:paulk
thread:65795
URL: http://www.dr-bob.org/babble/20010625/msgs/67981.html