Posted by Elizabeth on June 27, 2001, at 11:31:23
In reply to Re: benzos » gilbert, posted by paulk on June 26, 2001, at 21:08:06
> >Study after study shows that panic patients don't abuse benzos
>
> I agree – but I have also see the few who get into trouble.The question I'd ask is, were these patients diagnosed with panic disorder?
> I agree again – The biggest problem with Benzos is that they can interfere with learning and memory – I remember a pre med student who took 1mg/day of valium for a semester – had poor final scores and tells me he can’t remember much of that semester.
People who have that sort of problem tend to notice it pretty quickly. (Although I have to say, I've encountered a lot of pre-meds who weren't on any Valium and whose grades probably would have been better if they had been. < g >)
> Benzos can kill sex for some people. Again YMMV.
CNS depressants seem to have opposing effects on men's and women's sexuality (at least, alcohol and barbiturates do).
A common side effect of benzos, which most people don't seem to know about, is that they can make you really hungry. On several occasions, I've found myself getting really hungry after coming down from a panic attack with the aid of Xanax or Ativan. And once, when I was really depressed and wouldn't eat or drink anything, a concerned friend convinced me to take a Xanax. Within 30 minutes I was not only up and about, but fixing myself some pasta. *That* was impressive.
> I don’t think MOAIs are for most folks – but they have been reported to work very well for people with atypical depressionThey work for a wide variety of types of depression, not just atypical (although they haven't been tested adequately in melancholic depression, the existing data are positive). I definitely don't have atypical depression, but of all the standard antidepressants that I've tried, the MAOIs have come the closest to fixing whatever's wrong with me. Most people with melancholia take tricyclics, Effexor, or Remeron, etc. I couldn't tolerate tricyclics or Effexor, and Remeron didn't seem to work.
> I agree to a point – Benzos had a bad rap even when the patent was in place.
Like SSRIs and Ritalin, they were vastly overused. That probably accounts for a lot of it.
> I would have to disagree. Some depressed folks are pushed farther into depression with Benzos
Yes. Xanax seems to be superior in this regard (it even acts as an antidepressant for some).
> there have been many suicides with benzos plus alcohol.
Yeah, but blaming the benzos for that is kind of silly. There've been many suicides with any-drug-you-name-it plus alcohol. There've also been plenty of accidental deaths from alcohol poisoning, no other drugs required. Alcohol is just plain toxic.
> I would like to see suicide statistics of SSRIs vs Benzos. I bet SSRI would have fewer.
Let's leave out polydrug overdoses; those can get really complicated. The number of suicides committed with SSRIs alone is incredibly low. But so is the number with benzos alone. In order to get enough benzos to commit suicide, you would have to acquire a huge amount, by hoarding them, getting them on the black market, going to multiple doctors, etc. -- even an entire month's supply for someone taking them regularly would be very unlikely to kill a normal healthy adult.
Also, let's not forget that benzos have been around for more close to 50 years, while SSRIs have been around for about 15 years. (I'm not sure exactly when fluvoxamine, the first marketed SSRI, first became available, but it was only after Eli Lilly's impressive marketing of Prozac in the USA that the use of SSRIs became widespread.)
> I don’t think he was a typical benzo user – he didn’ t have it together enough to manage his own meds – really should have been in a halfway house and given benzos when he was in mania – he took a LOT of benzos – more than anyone else I have known.
How many? You said he was on Restoril -- that's a sleeping pill. Was a cause of death ever determined? Was there a quantitative toxicology screen? If not, it's hardly reasonable to attribute his death to any one thing. Like I said, people in that situation -- severely mentally ill, nobody to support them, probably don't have access to the best medical care, etc. -- are endangered in all sorts of ways.
> Some one taking an antipyschotic is in a whole differnt world that folks with anxiety and depression - they have breaks with reality - don't know what is real or in their head. Effexor is not listed for use for Schizophrenia or Mania.
Lots of people with bipolar disorder can't get by on mood stabilisers alone; they need to take an antidepressant too. There's also something called schizoaffective disorder -- schizophrenia plus major depression or bipolar disorder. Psychotic depression needs to be treated either with a combination of antidepressants and antipsychotics or with ECT. Many people with schizophrenia suffer from major depressive episodes following psychotic episodes ("crashes," you could say; the research diagnostic criteria set is labelled "postpsychotic depressive disorder of schizophrenia"), and they need to be treated with antidepressants. Some people with OCD and certain types of severe nonpsychotic depression need antipsychotics in addition to antidepressants. People with borderline personality disorder or complex posttraumatic stress disorder often need a combination of several different types of drugs (which may include antipsyhotics) in addition to intensive psychotherapy.
Mental illness is not an either-or thing, not by any means.
> I would be much more worried about the memory and learning effects of benzos than the choking risk.
I think that the high-potency benzos cause less cognitive impairment than the low-potency ones --although Halcion, the most potent benzo of all the marketed ones, is known to cause memory lapses -- which is why it's only used as a sleeping pill; while Librium, a very low-potency benzo, doesn't seem to cause much impairment at all.
Also, a lot of people *don't* suffer these side effects at all, especially those who are able to get by on low doses. Even when I was taking Klonopin (4 mg) every day, I didn't have a problem with memory or learning (and as a science student, I'd certainly notice any such impairment). I think I mentioned that I know someone who used to abuse Xanax and was at one point taking over 100 mg/day. Guess what? He's a scientist too (we went to school together), and he was actually functioning surprisingly well on that amount of Xanax. (Today he's stable on I think somewhere around 10 mg/day -- for depression as well as panic disorder -- and is completely functional, much more so than he was without medication. He's also stopped self-medicating altogether.)
> My point remains, that there are SOME people who have big time trouble with benzos. Most people use them very well, and IMHO benzos are under prescribed.
Most people use them properly *and* don't have significant side effects. Most people who have panic disorder would choose benzos over antidepressants any day. In fact, I bet that a lot of people with depression would prefer to take high doses of Xanax or Deracyn than have to deal with all the side effects of antidepressants.
-elizabeth
poster:Elizabeth
thread:65795
URL: http://www.dr-bob.org/babble/20010625/msgs/68076.html