Posted by hiba on October 27, 2002, at 23:33:11
In reply to Re: Evidence Please!! Squiggles, ok » hiba, posted by Squiggles on October 27, 2002, at 8:11:10
Hello Squiggles,
Thank you for responding to my input. You are referring the sixth edition of Goodman and Gilman, which is slightly different from what I have in my hand. But I was referring the most updated version of it.
Even after reading those sentences, I don't see any instance of "Protracted withdrawal syndrome". It only says "withdrawal syndrome may not occur for week after abrupt discontinuation". Still fails to note a "Protracted withdrawal syndrome". PROTRACTED" means "lasting longer than expected or longer than usual". Does the book mention such a phenomenon? NO
The links which you provided took me to the anti-benzo group. I am sorry, I can't take their words without a grain of salt.
Then, interestingly if you read in your own response, there are a lot of points which I can use for my argument. "Although benzodiazepines have a reputation for causing only a low rate of *abuse* and *dependence*the possibility of this complication of chronic use must not be overlooked."
This is an instance.I think you will allow me to reproduce some sentences in your message with a slight change in fonts.
"Benzodiazepine MAY cause paradoxical effects.Anticonvulsant benzodiazepines SOMETIMES inducemotor stimulation and precipitate grand mal
seizures. Antianxiety benzodiazepines have been
reported to release bizarre uninhibited behavior in SOME USERS with low levels of anxiety. Paranoia,depression, and suicidal ideation OCCASSIONALLY accompany the use of antianxiety benzodiazepines".Note this "May, Sometimes, Some Users, Occassionally". It is sufficient to make this statement inconclusive.
Again let me quote from your own message.
"HIGH DOSES of benzodiazepines MUST BE given
for long periods of time and then ABRUPTLY withdrawan before marked withdrawal symptoms, including seizures, appear (see Allquander, 78)"Does this sentence help your arguments ? I don't think so. After reading it carefully, I think I can use it to argue. Mr. Alan will also benefit from it.
I have posted a link to Merck manual in one of my thread, assuming that will help benzo defenders. Still what you took from Merck is inconclusive.
"There is considerable debate about benzodiazepine
dependence. ... ABRUPT discontinuation after significant exposure may lead to withdrawal syndrome remarkably similar to that associated with alcohol withdrawal, including anxiety, irritability, tremor, nauseahypertension, tachycardia, hyperacusis, muscle twitching, hyperreflexia, depersonalization, hallucinations,
and major motor seirzures.....
Discontinuing the medicine will lead to a
complicated differential of drug withdrawal vs.
symptom reemergence. [in other words they don't
know if the withdrawal is continuing or if they
can attribute it to an "underlying disorder" popping
up again]."What is defined in this sentence is mainly the complication of an ABRUPT withdrawal. Did I ever argue Benzos can be abruptly stopped?? Rather I was insisting abrupt discontinuation from any psychoactive drug will cause complications.
And the last part of this sentence is not an evidence of "Protracted withdrawal syndrome". Longer than unusual withdrawal symptom is not mentioned here. Rather it makes a confusion over withdrawal symptom and underlying disorder.
((I notice that the words "protracted withdrawal
syndrome" do not occur. I would not take that
as evidence that this syndrome does not exist
therefore. It is quite possible that follow-up
studies of ABRUPTLY (??)discontinued patients were
not undertaken at that time.))
How can a patient stop benzos abruptly if he or she is under medical supervision ? Weren't we discussing about medically supervised benzo users? Besides Dear Squiggles, Benzos are here for over 40 years. And I was referring the drug manuals which published after the year of 2000. I wonder when they are going to find "BENZOS ARE ADDICTIVE AND THEY WILL CAUSE PROTRACTED WITHDRAWAL SYNDROME"? If 40 years are not enough to make a remarkable finding, I don't think another 40 years or more will make any difference.Lastly I should reveal why I am more allegic to anti-benzo group: I have seen a number of patients in my experience who gave up their benzos for the sake of this group and suffered. Now what is common in psychiatric practice is "If a medication works for a patient, DON'T change it." Because psychiatry has come upto realize how complicated psychiatric disorders are. So do you think I should back those benzophobics ??
Good luck Squiggles, Take care
HIBA
poster:hiba
thread:124171
URL: http://www.dr-bob.org/babble/20021025/msgs/125503.html