Posted by Kon on May 4, 2005, at 22:26:47
In reply to Re: is klonopin really all that addictive? » tendency, posted by Mr.Scott on May 2, 2005, at 20:53:46
There are probably more studies suggesting that tolerance to anti-anxiety effects is more of a rarity than a common occurrence, even after long-term use. As one of many examples, a recent 2005 review suggests that clinical evidence does not support the development of anti-anxiety tolerance in most cases. There is also little evidence of any relationship between half-life of a benzo used in anxiety disorders and potential irreversible cognitive impairment. To the best of my knowledge no such long-term comparisons have ever been made. And despite some speculation that long-term benzo use may cause permanent brain damage that could be observed, overal neuroimaging studies have been unable to find brain abnormalities in patients treated long term with benzodiazepines. There are some cognitive deficits seen that appear to recover somewhat following discontinuation of long-term benzo use (although not completely) but "the deficits appear to be insignificant in the daily functioning of most patients."
Wrt to severity of withdrwal, in reviewing 9 controlled long-term benzo studies (mean 3 years, range 1-16 years) followed by abrupt discontinuation of benzo, Perry et al (2003) write:
"Overall, withdrawal symptoms occurred in ~ 50% of patients receiving a therapeutic dose of benzo for an average of 3 years. Most symptoms experienced were of mild to moderate intensity...A review of the controlled studies of long-term therapeutic doses of benzo indicates that nearly 50% of patients ingesting a benzo for an average of 3 years will experience a minor withdrawal syndrome when the drug is discontinued."
http://www.vh.org/adult/provider/psychiatry/CPS/33.html
Not to deny that a major withdrawal cannot occur occasionally but this doesn’t appear to be the norm. Even in Ashton’s anti-benzo site if you look at Tyler’s work (another author on the site) you will find similar data. Ashton’s much higher incidence of serious withdrawal symptoms (100%) is because her subjects were highly selective (long-term benzo users who had already previously failed to quit benzos). So if you take the worse of the crop, you will overestimate incidence and severity of withdrawal. It’s like taking the worse 10% and claiming that that’s the norm.
poster:Kon
thread:491592
URL: http://www.dr-bob.org/babble/20050504/msgs/493918.html