Posted by zeugma on November 29, 2003, at 10:25:32
In reply to Re: Benzo Blabber!, posted by Caleb96 on November 27, 2003, at 16:26:48
> This debate has been going on for years. I remember when Xanax came out in the early 1980s, the literature (and sales reps!) told MDs that Xanax didn't aggravate depression like Valium. The bottom line is benzodiazepines (BZs) are DOWNERS, and as a general rule, downers aggravate depression when taken for long periods. This is one reson why doctors tell their patients not to drink if they have depression. Alcohol is a downer (see below). My educated (but not expert advice) is that BZs, to varying degrees, aggravate depression. ADs may couteract this enough that overall, you feel much better. If you're still anxious, BZs can be useful in alleviating symptoms and is worth the price of a possible redution in effect of the AD.
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> DETAILS (Not essential reading):
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> My guess is, by their nature, bezodiazepines are sedatives, so they tend to keep your CNS neurons in a less polarized state. In other words, it takes more effort (by adjacent neurons) to evoke a response in the neuron. That's kind of a crude explanation of why BZs are calming.
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> Second, BZs act on the same chloride ion channel as acohol. Normally, an endogenous ligand (that's a fancy way of saying a special chemical found naturally in the CNS) binds to a receptor site on the chloride ion channel and allows chloride ions enter the neuron. That special chemical is named GABA or gamma-aminobutyric acid. When chloride ions enter the neuron, they depolarized it to some degree (in other words, depolarization makes the neuron less likely to fire--it takes more input from neighboring nerve cells to get a response.
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> You're probably thinking, where the heck is this guy going with this. Well, BZs bind to a subunit of the chloride ion channel and enhance GABAs effect--in other word, GABA kind of becomes a super-GABA, and makes the nerve even more resistant to firing. This is also why alcohol works, but its mechanism is a little different. The key result is you have a calming, sedating effect we associate with benzodiazepines. If you take enough, you'll get "drunk."I suppose this is another reason SSRI's are seen as such a boon by pdocs: they treat anxiety without inducing depression. The problem is I have severe, treatment-resistant anxiety, and it interferes with my ability to participate in normal activities even when I'm not depressed. Which is depressing in itself, even if it doesn't immediately trigger depression. It's interesting that prior to Klonopin, the only thing that worked for my debilitating social anxiety was alcohol. Alcohol, of course, has so many side effects and is so short-acting that it is not a viable treatment :)
I suppose this is why NARDIL is such a wonder drug. It treats the terrible, treatment-resistant anxiety AND it knocks out the depression too. How do you think Nardil does this exactly? Specifically, how does Nardil's effect on anxiety NOT stem from some kind of CNS depressant effect that leads to depression? Any other drugs that might mimic this effect?
Thanks,
z
poster:zeugma
thread:283057
URL: http://www.dr-bob.org/babble/20031126/msgs/284949.html