Posted by ed_uk on November 27, 2004, at 18:24:57
In reply to Re: questions, internet anti-benzo movement, posted by Paul Smith on November 27, 2004, at 17:59:39
Hi,
I've never once come across a balanced site about benzodiazepines. Sites which describe the potential benefits of benzos as well as the potential risks would be very useful. There has been a major backlash against the benzos in the UK partly because they were so often prescribed in the past to people who never really needed them. My GP refuses to give me a prescription for even a few tablets of lorazepam!
I live in England. Here is the UK government advice on benzos. In most ways, the advice is sensible. It does, however, ignore the fact the some people do find long term treatment useful. Also, doctors in the UK tend to force patients to withdraw from benzos even when they have apparantly benefitted from them for many years without adverse effects.
BENZODIAZEPINES,
DEPENDENCE AND
WITHDRAWAL SYMPTOMS
There has been concern for many years regarding benzodiazepine dependence (Br.Med.J,1980:280, 910-912)*. Such dependence is becoming increasingly worrying.Withdrawal symptoms include anxiety, tremor, confusion, insomnia, perceptual disorders, fits, depression, gastrointestinal and other somatic symptoms. These may sometimes be difficult to distinguish from the symptoms of the original illness.
It is important to note that withdrawal symptoms can occur with benzodiazepines following therapeutic doses given for SHORT periods of time.
Withdrawal effects usually appear shortly after stopping a benzodiazepine with a short half life, or up to several days after stopping one with a long half life. Symptoms may continue for weeks or months. No epidemiological evidence is available to suggest that one benzodiazepine is more responsible for the development of dependency or withdrawal symptoms than another.
The Committee on Safety of Medicines recommends that the use of benzodiazepines should be limited in the following ways:
USES
As Anxiolytics
Benzodiazepines are indicated for the short-term relief (two to four weeks only) of anxiety that is severe, disabling or subjecting the individual to unacceptable distress, occurring alone or in association with insomnia or short-term psychosomatic, organic or psychotic illness.
The use of benzodiazepines to treat short-term 'mild' anxiety is inappropriate and unsuitable.
As Hypnotics
Benzodiazepines should be used to treat insomnia only when it is severe, disabling, or subjecting the individual to extreme distress.
DOSE
The lowest dose which can control the symptoms should be used. It should not be continued beyond four weeks.
Long-term chronic use is not recommended.
Treatment should always be tapered off gradually.
Patients who have taken benzodiazepines for a long time may require a longer period during which doses are reduced.
When a benzodiazepine is used as a hypnotic, treatment should, if possible, be intermittent.
PRECAUTIONS
Benzodiazepines should not be used alone to treat depression or anxiety associated with depression. Suicide may be precipitated in such patients.
They should not be used for phobic or obsessional states.
They should not be used for the treatment of chronic psychosis.
In cases of loss or bereavement, psychological adjustment may be inhibited by benzodiazepines.
Disinhibiting effects may be manifested in various ways. Suicide may be precipitated in patients who are depressed, and aggressive behaviour towards self and others may be precipitated. Extreme caution should therefore be used in prescribing benzodiazepines in patients with personality disorders.
poster:ed_uk
thread:420999
URL: http://www.dr-bob.org/babble/20041123/msgs/421036.html