Posted by Alan on December 5, 2002, at 11:07:58
In reply to Re: Social Anxiety in OZ (Damn Benzophobes) » Alan, posted by Squiggles on December 5, 2002, at 10:09:03
> Good grief - i would say that your assessment
> of The Merck is on the side of arrogance,
> considering the caliber of doctors who have
> contributed to this tome; not to mention the
> similarities to other medical reference texts.Sorry I was not clear enough in my explanation. It is the EDITING for common consumption that I am referring to. I have no problem with the part on bzds except that it is perhas incomplete, specifically:
"Withdrawal from benzodiazepines produces a similar withdrawal syndrome, although it is rarely as severe. The syndrome may be slow in onset because the drugs remain in the body a long time. A withdrawal syndrome of varying severity has been reported in persons who have taken therapeutic doses, although the prevalence of this unusual phenomenon is unknown. Withdrawal may be most severe in those who used drugs with rapid absorption and quick decline in serum levels (eg, alprazolam, lorazepam, triazolam). Many persons who misuse benzodiazepines have been or are heavy users of alcohol, and a delayed benzodiazepine withdrawal syndrome may complicate alcohol withdrawal. The benzodiazepine receptor antagonist flumazenil has been approved for treatment of severe sedation secondary to benzodiazepine overdose. Its clinical usefulness is not well defined because most persons who overdose on benzodiazepines recover without intervention. Occasionally, when used to reverse sedation, flumazenil precipitates seizures."
But the CONTEXT in which it appears gives it nearly the same stigma and fear factor as the other more heavy-duty CNS depressants - especially to the med-phobic anxity sufferer. It's medically correct but incomplete but not put into context as to it's risk factor (for instance that it is in the lowest classifications of scheduled meds for abuse potential, class IV - "very low abuse potential".
>
> Could you recommend a better, more 'pro-benzo'
> or should i say 'pro-your perspective' medical
> reference text, and point to the chapter you
> have seen so we can share information?This is old ground. The WHO report prety much sums it up for me along with the more recent one about SSRI withdrawal.
>
> I'm afraid that a catchword like "benzophobic"--
> though possibly suited to marketing persuasion
> techniques and rhetoric, does not move me; not
> in the light of evidence and what doctors are
> aware of regarding this class of drugs, including
> my own doctor. This does not imply that the
> antidepressants, esp. the SSRIs (a glory drug if
> i ever saw one) are not with similar problems
> of "discontinuation syndrome" which has lately
> come to light.
>
> As Ray Nimmo used to say (and i believe he
> quoted me LOL - "the truth will out"). The truth
> does come out after a generation of people taking
> a certain class of drugs--it is just difficult
> to do with the poor animals that the drugs are
> tested on--their lives being nasty, brutish,
> and short.
>
>
> SquigglesBZDS have been aroud almost 50 years and have exhausted their life-cyle of overprescription and real life clinical testing and the key results are in (if 50 years means anything or everything to anybody or everybody, who knows?).
They are some of the most safe reliable anxiolytics on the planet WHEN PRESCRIBED AND MANAGED PROPERLY as implied in the WHO report. Even the title of the report, "The Rational Use of BZD's" implies this basic concept.
I don't believe that the present debate is a pro/anti one and think that this analysis misses the entire point. It's not as black and white as that. It actually muddles the issue.
It's the grey areas that are not being considered that does the individual in treatment the biggest disservice. Not offering bzds on equal footing with all other anxiety treatments is not a "PRO" benzo stance but is really the "compromise" or moderate position in light of all of the evidence.
The PRO bzd stance would be to say, "no therapy, no anthing, just bzds all of the time". In that context the persctive broadens quite a bit...because there are those biopsychiatrists that take this stance not only with the bzds but even moreso - to an appaling degree with the commercially driven AD's.The "truth" is not fact alone or is it purely "evidence" either. If an individual is to be administered to with respect and freedom of choice, this bias against the use of bzds should essentially be taken out of the picture.
More later..
alan
poster:Alan
thread:130480
URL: http://www.dr-bob.org/babble/20021203/msgs/130639.html