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Benzo anti-anxiety tolerance confusion

Posted by Kon on April 28, 2004, at 1:40:50

Some opposing views/quotes on this topic below. If you suffer from any type of anxiety and been on any benzo for a while, what has been your personal experience wrt anti-anxiety tolerance-YES or NO? What benzo did you use?

TOLERANCE-YES:

Ashton(1989): 'Tolerance to the anti-anxiety effects may develop more slowly. But Peter Tyrer, in a recent study of patients with anxiety disorders in Nottingham, found that benzodiazepines did little to reduce anxiety after people had been taking them for just four weeks.'

Ashton (2002): 'Tolerance to the anxiolytic effects develops more slowly but there is little evidence that benzodiazepines retain their effectiveness after a few months. In fact long-term benzodiazepine use may even aggravate anxiety disorders. Many patients find that anxiety symptoms gradually increase over the years despite continuous benzodiazepine use, and panic attacks and agoraphobia may appear for the first time after years of chronic use. Such worsening of symptoms during long-term benzodiazepine use is probably due to the development of tolerance to the anxiolytic effects, so that "withdrawal" symptoms emerge even in the continued presence of the drugs. However, tolerance may not be complete and chronic users sometimes report continued efficacy, which may be partly due to suppression of withdrawal effects.'

Allgulander C (2003): 'Benzodiazepines are not recommended for long-term treatment of GAD, due to associated development of tolerance..'
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TOLERANCE-NO:

Davidson (1991): 'Twenty-six socially phobic outpatients were treated with clonazepam for the relief of symptoms. At evaluation, which took place after an average of 11.3 months of continuous treatment, 22 (84.6%) patients showed good improvement and 4 (14.4%) showed no improvement or were not recovered. The dose declined over time, from a peak mean of 2.1 mg/day to a mean of 0.94 mg/day at follow-up.'

Worthington (1998): 'Clonazepam doses remained stable over time. Results of this study suggest that treatment of panic disorder with the HPB clonazepam achieved and maintained a therapeutic benefit similar to that obtained with alternative pharmacologic treatments, without the development of tolerance as manifested by dose escalation or worsening of clinical status.'

Verster (2004): 'Alprazolam has a fast onset of symptom relief (within the first week); it is unlikely to produce dependency or abuse. No tolerance to its therapeutic effect has been reported. Alprazolam has a fast onset of symptom relief (within the first week); it is unlikely to produce dependency or abuse. No tolerance to its therapeutic effect has been reported.'


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poster:Kon thread:340882
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