![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 19 to 43 of 71. Go back in thread:
Posted by Dr. Bob on August 14, 1999, at 11:56:14
In reply to Re: Lorazapam - Br. Bob,am I right?, posted by GS on August 4, 1999, at 0:47:30
> there seems to be 2 schools of thought in the psychiatric profession about benzodiazapines. To generalize, 1) Benzodiazapines are not good for long term treatment of any anxiety disorder
> 2)Benzos are good for long term treatment of anxiety disorders
> THE PROBLEM IS:
>
> The 1st group are in my opinion overrating the tolerance and dependence issues surrounding this class of drugs because of lack of understanding in prescribing and managing them.Yes, those are two sides of the benzodiazepine issue, and the 1st group may sometimes overestimate the risks. OTOH, the 2nd group may sometimes underestimate the risks, too...
Bob
Posted by GS on August 14, 1999, at 14:33:26
In reply to Re: Lorazapam - right enough, posted by Dr. Bob on August 14, 1999, at 11:56:14
> > there seems to be 2 schools of thought in the psychiatric profession about benzodiazapines. To generalize, 1) Benzodiazapines are not good for long term treatment of any anxiety disorder
>
> > 2)Benzos are good for long term treatment of anxiety disorders
>
> > THE PROBLEM IS:
> >
> > The 1st group are in my opinion overrating the tolerance and dependence issues surrounding this class of drugs because of lack of understanding in prescribing and managing them.
>
> Yes, those are two sides of the benzodiazepine issue, and the 1st group may sometimes overestimate the risks. OTOH, the 2nd group may sometimes underestimate the risks, too...
>
> Bob
************************************************The underestimation of risk would be from the ill informed
practitioners from the first group (the under educated, biased, and poor managers) not the second! If not for the skill and knowledge of group two, there wouldn't even be a debate about the issue. They're the ones battling ignorance and underestimation!
If a psychopharmacologist is worth their salt, they will have taken TIME to manage and oversee benzos properly (looking for drug seeking behaivors, quizzing the patient about QUALITY of sleep, having them keep mood/sleep logs, knowing whether or not there is an accurate diagnosis in the first place, etc.)
I don't understand your post frankly. My FULL POSTED description of group 2 did not include doctors that irresponsibly prescribe - underestimating benzos problems....quite the opposite!GS
Posted by Paul on August 14, 1999, at 16:21:12
In reply to Re: Lorazapam - Sorry but you're wrong, posted by GS on August 14, 1999, at 14:33:26
> > > there seems to be 2 schools of thought in the psychiatric profession about benzodiazapines. To generalize, 1) Benzodiazapines are not good for long term treatment of any anxiety disorder
> >
> > > 2)Benzos are good for long term treatment of anxiety disorders
> >
> > > THE PROBLEM IS:
> > >
> > > The 1st group are in my opinion overrating the tolerance and dependence issues surrounding this class of drugs because of lack of understanding in prescribing and managing them.
> >
> > Yes, those are two sides of the benzodiazepine issue, and the 1st group may sometimes overestimate the risks. OTOH, the 2nd group may sometimes underestimate the risks, too...
> >
> > Bob
> ************************************************
>
> The underestimation of risk would be from the ill informed
> practitioners from the first group (the under educated, biased, and poor managers) not the second! If not for the skill and knowledge of group two, there wouldn't even be a debate about the issue. They're the ones battling ignorance and underestimation!
> If a psychopharmacologist is worth their salt, they will have taken TIME to manage and oversee benzos properly (looking for drug seeking behaivors, quizzing the patient about QUALITY of sleep, having them keep mood/sleep logs, knowing whether or not there is an accurate diagnosis in the first place, etc.)
> I don't understand your post frankly. My FULL POSTED description of group 2 did not include doctors that irresponsibly prescribe - underestimating benzos problems....quite the opposite!
>
> GS
Sounds like this one was a little too controversial for Dr. Bob to give us an opinion on. But quoting Dr. Robert Dupont, former director of the National Institute of Alcoholism and Drug Abuse,he states:"I have yet to see a patient become addicted to benzodiazepenes without a history of substance abuse. Dr. Dupont suggests "the concept of using the lowest possible dose of a benzodiazepine for the shortest period of time is inconsistent with sound clinical practice. This concept needs to include the important qualification that our goal is to maximize the patient's ability to function well and to enjoy life. Benzodiazepenes are among the safest and most effective treatments in all of medicine, including their role in the treatment of anxiety disorder." Amen
Posted by GS on August 14, 1999, at 18:26:42
In reply to Re: Lorazapam - Sorry but you're wrong, posted by Paul on August 14, 1999, at 16:21:12
> > > > there seems to be 2 schools of thought in the psychiatric profession about benzodiazapines. To generalize, 1) Benzodiazapines are not good for long term treatment of any anxiety disorder
> > >
> > > > 2)Benzos are good for long term treatment of anxiety disorders
> > >
> > > > THE PROBLEM IS:
> > > >
> > > > The 1st group are in my opinion overrating the tolerance and dependence issues surrounding this class of drugs because of lack of understanding in prescribing and managing them.
> > >
> > > Yes, those are two sides of the benzodiazepine issue, and the 1st group may sometimes overestimate the risks. OTOH, the 2nd group may sometimes underestimate the risks, too...
> > >
> > > Bob
> > ************************************************
> >
> > The underestimation of risk would be from the ill informed
> > practitioners from the first group (the under educated, biased, and poor managers) not the second! If not for the skill and knowledge of group two, there wouldn't even be a debate about the issue. They're the ones battling ignorance and underestimation!
> > If a psychopharmacologist is worth their salt, they will have taken TIME to manage and oversee benzos properly (looking for drug seeking behaivors, quizzing the patient about QUALITY of sleep, having them keep mood/sleep logs, knowing whether or not there is an accurate diagnosis in the first place, etc.)
> > I don't understand your post frankly. My FULL POSTED description of group 2 did not include doctors that irresponsibly prescribe - underestimating benzos problems....quite the opposite!
> >
> > GS
> Sounds like this one was a little too controversial for Dr. Bob to give us an opinion on. But quoting Dr. Robert Dupont, former director of the National Institute of Alcoholism and Drug Abuse,he states:"I have yet to see a patient become addicted to benzodiazepenes without a history of substance abuse. Dr. Dupont suggests "the concept of using the lowest possible dose of a benzodiazepine for the shortest period of time is inconsistent with sound clinical practice. This concept needs to include the important qualification that our goal is to maximize the patient's ability to function well and to enjoy life. Benzodiazepenes are among the safest and most effective treatments in all of medicine, including their role in the treatment of anxiety disorder." Amen
**********************************************
Of course. When I was being scared half to death from a psy doc who kept refusing to treat me properly, creating more anxiety about the drug than the actual disorder, it created needless suffering for years! And he was a well respected head of a major university's psy program having recently graduated from the very institution that is at the forefront of psy drug research - Rush St. Lukes! Shows it can happen anywhere.
I now am being treated with respect and care by another doc that knows what's going on because I feel better and function better than ever. As he says, just get the ball in the hole!He trusts my self evaluations.
This is my 3rd Psy doc and we finally have it right. As you may be able to tell, I have alot of resentment for the needless suffering and lost happiness over those years.
If you read my original post of 8/4 about the subject, it is the one that is complete and not cut and pasted out of context.GS
Posted by Paul on August 14, 1999, at 22:37:51
In reply to Re: Lorazapam - Sorry but you're wrong, posted by GS on August 14, 1999, at 18:26:42
> > > > > there seems to be 2 schools of thought in the psychiatric profession about benzodiazapines. To generalize, 1) Benzodiazapines are not good for long term treatment of any anxiety disorder
> > > >
> > > > > 2)Benzos are good for long term treatment of anxiety disorders
> > > >
> > > > > THE PROBLEM IS:
> > > > >
> > > > > The 1st group are in my opinion overrating the tolerance and dependence issues surrounding this class of drugs because of lack of understanding in prescribing and managing them.
> > > >
> > > > Yes, those are two sides of the benzodiazepine issue, and the 1st group may sometimes overestimate the risks. OTOH, the 2nd group may sometimes underestimate the risks, too...
> > > >
> > > > Bob
> > > ************************************************
> > >
> > > The underestimation of risk would be from the ill informed
> > > practitioners from the first group (the under educated, biased, and poor managers) not the second! If not for the skill and knowledge of group two, there wouldn't even be a debate about the issue. They're the ones battling ignorance and underestimation!
> > > If a psychopharmacologist is worth their salt, they will have taken TIME to manage and oversee benzos properly (looking for drug seeking behaivors, quizzing the patient about QUALITY of sleep, having them keep mood/sleep logs, knowing whether or not there is an accurate diagnosis in the first place, etc.)
> > > I don't understand your post frankly. My FULL POSTED description of group 2 did not include doctors that irresponsibly prescribe - underestimating benzos problems....quite the opposite!
> > >
> > > GS
> > Sounds like this one was a little too controversial for Dr. Bob to give us an opinion on. But quoting Dr. Robert Dupont, former director of the National Institute of Alcoholism and Drug Abuse,he states:"I have yet to see a patient become addicted to benzodiazepenes without a history of substance abuse. Dr. Dupont suggests "the concept of using the lowest possible dose of a benzodiazepine for the shortest period of time is inconsistent with sound clinical practice. This concept needs to include the important qualification that our goal is to maximize the patient's ability to function well and to enjoy life. Benzodiazepenes are among the safest and most effective treatments in all of medicine, including their role in the treatment of anxiety disorder." Amen
> **********************************************
> Of course. When I was being scared half to death from a psy doc who kept refusing to treat me properly, creating more anxiety about the drug than the actual disorder, it created needless suffering for years! And he was a well respected head of a major university's psy program having recently graduated from the very institution that is at the forefront of psy drug research - Rush St. Lukes! Shows it can happen anywhere.
> I now am being treated with respect and care by another doc that knows what's going on because I feel better and function better than ever. As he says, just get the ball in the hole!He trusts my self evaluations.
> This is my 3rd Psy doc and we finally have it right. As you may be able to tell, I have alot of resentment for the needless suffering and lost happiness over those years.
> If you read my original post of 8/4 about the subject, it is the one that is complete and not cut and pasted out of context.
>
> GS
Glad that you were able to find adequate help. I had a visit with my current doc. last week and he didn't even know what I was taking! I had sent him a fax two weeks before our appointment to express some concerns about side effects, and he informed me that he didn't read any faxes that are over a page! My fax was like a page and a half. And this guy is board certified, and a UCLA med school grad. I'm definitely changing docs, but I feel that I have the moral obligation to report this guy to the APA, or do something before he kills somebody. I could have had a suicide/homicicidal threat in the faxes he received, but didn't have 3-5 minutes(max) to read.I also have no insurance currently. It seems that prisoners get far better psychiatric care, and other medical care than the uninsured. I'm currently in grad. school, and don't have the $$ for insurance. Well, I've got modest coverage, but psych. care would be considered "pre-existing". Perhaps the only good thing to come out of this summer of violence, may be increased funding for community mental health. GA plans to cut our gutted system by another 20% next year. Something's gotta give!
Thanks for all your knowledgeable, informative posts. Paul
Posted by alan on August 15, 1999, at 4:33:06
In reply to Re: Lorazapam - right enough, posted by Dr. Bob on August 14, 1999, at 11:56:14
With some trepidation:
It must be borne in mind that our society has for many years been in the grip of a drug hysteria
which hinders rational thought about any drug with with abuse potential. It has been extreme enough to prevent terminal patients from geting adequate pain relief! Physicians are not immune.
Because of said hystria, physicians must protect themselves, sometimes at cost to the patient.
Finally, the 'recovery community' has had a great deal of influence. But it is dominated by people who have little interest in science, and often downright hostility. It seems to largely derive from AA which is basically a cult, tho a cult that seems to work for many people, perhaps precisely because it is a cult.
Posted by Susan on August 15, 1999, at 19:20:22
In reply to Re: Lorazapam - right enough, posted by alan on August 15, 1999, at 4:33:06
> With some trepidation:
> It must be borne in mind that our society has for many years been in the grip of a drug hysteria
> which hinders rational thought about any drug with with abuse potential. It has been extreme enough to prevent terminal patients from geting adequate pain relief! Physicians are not immune.
> Because of said hystria, physicians must protect themselves, sometimes at cost to the patient.
> Finally, the 'recovery community' has had a great deal of influence. But it is dominated by people who have little interest in science, and often downright hostility. It seems to largely derive from AA which is basically a cult, tho a cult that seems to work for many people, perhaps precisely because it is a cult.Alan, are you referring to Alcoholics Anonymous as a cult?
Posted by GS on August 16, 1999, at 10:43:11
In reply to Re: Lorazapam - Br. Bob,am I right?, posted by GS on August 4, 1999, at 0:47:30
> > > > > How can I find out what a lethal dosage of Lorazapam is?
> > > >
> > > > Why do you ask?
> > > >
> > > > Bob
> > >
> > > James here....
> > >
> > > There is an ez answer to this, but I would like you to answer Dr. Bobs question first !
> > > I just started taking lorazapam for anxiety and am wondering how much I could take before I need to worry about phycological addition or overdose. I notice in some articles doeses of up to 10mg, while my persecription is for 1mg tablets, and I sometime take tables. but, I've noticed the effect continues to diminish.
> > > james
> ________________________________________________
> The dosage needed depends on how bad the anxiety is that you are experiencing. First, there seems to be 2 schools of thought in the psychiatric profession about benzodiazapines. To generalize, 1) Benzodiazapines are not good for long term treatment of any anxiety disorder - cognitave therapy in combo with a sedating anti-depressant(such as Serzone)should be all that is about necessary. 2)Benzos are good for long term treatment of anxiety disorders because that is what they are....anti-anxiety agents made specifically for that purpose. Just keep it well managed...especially with a short half-life benzo like Xanax or Ativan. Supplement with cognitive therapy.
> THE PROBLEM IS:
>
> The 1st group are in my opinion overrating the tolerance and dependence issues surrounding this class of drugs because of lack of understanding in prescribing and managing them. Also, misinterpretation of the PDR as well as listening to other psychiatrists with similar prejudice telling of THEIR OWN prejudice and ignorance concerning the side effects of benzos.
>
> It is a semantic argument actually. What is dependence? That if you stop taking benzos you'll become anxious again? Yes there is withdrawl involved in abruptly stopping benzos rather than tapering but does that constitute dependence? No. Yes, one can build up a tolerance to dosage but not something that can't be managed (unless they are being abused or not being taken as instructed).
>
> For instance, it doesn't take alot of imagination to know that Ativan can be managed with an augmentation of a small amount of the low or no side effect mood stabilizer Neurontin (900 - 1200mg)to help with Ativan going in and out of
> the system therefore aleviating the drug induced anxiety.
> Also, keep the Ativan at a constant level whether it is 2 or 6 or I've read up to 10 mgs. daily...whatever allows you to function the way you need to without the affliction of an anxiety disorder! That is the whole point! So what if you take 3 -4 mgs or 5 -6 mgs. a day! Does it in conjunction with cognative therapy techniques alleviate your anxiety disorder?
> Don't be scared off by the argument that you are addicted to benzos when benzos are what stops the disease that you're afflicted with! A non -prejudicial psychopharmacologist will help manage your suffering and allay your unfounded fears of addiction that are imposed upon you by the first group of psychiatrists mentioned above. The point is, get the ball in the hole. Until these prejudiced doctors stop heaping these needlessly anxiety - provoking "facts" there will continue to be your type of sad questions worried about by many, many patients in need of relief.
>
> If you have an anxiety disorder, you take inti-anxiety drugs (until the purists come up with something THAT WORKS for you with less side effects).
>
> Am I pretty much on target Dr. Bob? (assuming that she has a properly diagnosed anxiety disorder).
>
> GS
*******************************************************
Any comments, similar experiences with this issue surrounding benzos.....Dr.s , patients??GS
Posted by Elizabeth on August 16, 1999, at 20:34:34
In reply to Re: Lorazapam - right enough, posted by Dr. Bob on August 14, 1999, at 11:56:14
> Yes, those are two sides of the benzodiazepine issue, and the 1st group may sometimes overestimate the risks. OTOH, the 2nd group may sometimes underestimate the risks, too...
I have a question, Dr. Bob: have you ever seen any problems with the long-term use of benzodiazepines for anxiety disorders (as opposed to, say, insomnia)?
According to the studies I've seen, patients treated for anxiety disorders with benzos rarely, if ever, abuse their medication, so that's why I'm asking.
Posted by Dr. Bob on August 17, 1999, at 21:07:54
In reply to bzd risks - q for Dr. Bob, posted by Elizabeth on August 16, 1999, at 20:34:34
> > Yes, those are two sides of the benzodiazepine issue, and the 1st group may sometimes overestimate the risks. OTOH, the 2nd group may sometimes underestimate the risks, too...
>
> I have a question, Dr. Bob: have you ever seen any problems with the long-term use of benzodiazepines for anxiety disorders (as opposed to, say, insomnia)?
>
> According to the studies I've seen, patients treated for anxiety disorders with benzos rarely, if ever, abuse their medication, so that's why I'm asking.There have been times when I've wondered, but there haven't (yet) been any when I've been sure. Of course, that doesn't mean there aren't any risks. Maybe I've just been lucky.
Bob
Posted by alan on August 28, 1999, at 6:51:13
In reply to Alan, are you talking about Alcoholics Anonymous?, posted by Susan on August 15, 1999, at 19:20:22
> Alan, are you referring to Alcoholics Anonymous as a cult?
I'll just say this. There are many people who seem to have derived immense benfit from AA, and I would not want to say anything that could even possibly maybe be an occasion for them to stop gaining those benefits.And I should have been much more careful in my use of words. "Cult' has become one of those terms that should be outlawed by the word police; folks have become more interested in whether or not X is a (shudder! shudder!) cult than in what X does for or against human welfare.
I do think scientifically trained and comitted people should begin to have more influence in the field of drug abuse treatment.
Posted by Ellen on August 28, 1999, at 7:05:01
In reply to bzd risks - q for Dr. Bob, posted by Elizabeth on August 16, 1999, at 20:34:34
> >I have been on klonopin for a while now, and though Ihave read on these posts people that go back and forth about whether to be on them or not is mind boggling. Trust your doc and if not find a new one. I had the same thoughts about being on them long term as does everyone, so I went off. Huge mistake. My anxiety was awful, and that is an understatement. If you need them as part of your therapy for now or for ever and your doc is using it part of your drug therapy, use them. I take 3000mg of neurontin and 2.5 mg of klonopin a day. It works for me. Sure I am concerned about being addicted, but I already am so now I don't worry about it anymore.. I have no side effects to speak of at this point, becasue my body as adjusted to all these med. My point is , is that if your doc says take them and you trust him or her, do it. Don't go by what others write or tell you. If it works for you and you feel better, stay on it. Feeling better far out weighs being addicted to a drug. good luck. Ellen
Posted by Steve on August 28, 1999, at 17:20:07
In reply to Re: Lorazapam-inviting all comments about benzos, posted by GS on August 16, 1999, at 10:43:11
> > > > > > How can I find out what a lethal dosage of Lorazapam is?
> > > > >
> > > > > Why do you ask?
> > > > >
> > > > > Bob
> > > >
> > > > James here....
> > > >
> > > > There is an ez answer to this, but I would like you to answer Dr. Bobs question first !
> > > > I just started taking lorazapam for anxiety and am wondering how much I could take before I need to worry about phycological addition or overdose. I notice in some articles doeses of up to 10mg, while my persecription is for 1mg tablets, and I sometime take tables. but, I've noticed the effect continues to diminish.
> > > > james
> > ________________________________________________
> > The dosage needed depends on how bad the anxiety is that you are experiencing. First, there seems to be 2 schools of thought in the psychiatric profession about benzodiazapines. To generalize, 1) Benzodiazapines are not good for long term treatment of any anxiety disorder - cognitave therapy in combo with a sedating anti-depressant(such as Serzone)should be all that is about necessary. 2)Benzos are good for long term treatment of anxiety disorders because that is what they are....anti-anxiety agents made specifically for that purpose. Just keep it well managed...especially with a short half-life benzo like Xanax or Ativan. Supplement with cognitive therapy.
> > THE PROBLEM IS:
> >
> > The 1st group are in my opinion overrating the tolerance and dependence issues surrounding this class of drugs because of lack of understanding in prescribing and managing them. Also, misinterpretation of the PDR as well as listening to other psychiatrists with similar prejudice telling of THEIR OWN prejudice and ignorance concerning the side effects of benzos.
> >
> > It is a semantic argument actually. What is dependence? That if you stop taking benzos you'll become anxious again? Yes there is withdrawl involved in abruptly stopping benzos rather than tapering but does that constitute dependence? No. Yes, one can build up a tolerance to dosage but not something that can't be managed (unless they are being abused or not being taken as instructed).
> >
> > For instance, it doesn't take alot of imagination to know that Ativan can be managed with an augmentation of a small amount of the low or no side effect mood stabilizer Neurontin (900 - 1200mg)to help with Ativan going in and out of
> > the system therefore aleviating the drug induced anxiety.
> > Also, keep the Ativan at a constant level whether it is 2 or 6 or I've read up to 10 mgs. daily...whatever allows you to function the way you need to without the affliction of an anxiety disorder! That is the whole point! So what if you take 3 -4 mgs or 5 -6 mgs. a day! Does it in conjunction with cognative therapy techniques alleviate your anxiety disorder?
> > Don't be scared off by the argument that you are addicted to benzos when benzos are what stops the disease that you're afflicted with! A non -prejudicial psychopharmacologist will help manage your suffering and allay your unfounded fears of addiction that are imposed upon you by the first group of psychiatrists mentioned above. The point is, get the ball in the hole. Until these prejudiced doctors stop heaping these needlessly anxiety - provoking "facts" there will continue to be your type of sad questions worried about by many, many patients in need of relief.
> >
> > If you have an anxiety disorder, you take inti-anxiety drugs (until the purists come up with something THAT WORKS for you with less side effects).
> >
> > Am I pretty much on target Dr. Bob? (assuming that she has a properly diagnosed anxiety disorder).
> >
> > GS
> *******************************************************
> Any comments, similar experiences with this issue surrounding benzos.....Dr.s , patients??
>
> GSI was on 2 mg/day of Klonopin for 5 years and stopped w/o difficulties about 8 months ago.
Posted by GS on August 29, 1999, at 0:38:09
In reply to Re: Lorazapam-inviting all comments about benzos, posted by Steve on August 28, 1999, at 17:20:07
stopped w/o difficulties about 8 months ago. *****************************************************
Klonopin is really a long half life benzo. Did you stop by tapering off the dosage? Why did you stop? Was it for an anxiety disorder?
Sounds really interesting.Sometimes Klonopin is used to taper off of shorter acting benzos like ativan or xanax so as to lessen the withdrawl symptoms such as anxiety and siezures.
Maybe the half life of klonopin is so long that withdrawl hardly happens at all. Is this true in your case Steve?
GS
****************************************************
Posted by Amy II on September 14, 1999, at 13:03:25
In reply to Re: Lorazapam-inviting all comments about benzos, posted by GS on August 16, 1999, at 10:43:11
> > > > > > How can I find out what a lethal dosage of Lorazapam is?
> > > > >
> > > > > Why do you ask?
> > > > >
> > > > > Bob
> > > >
> > > > James here....
> > > >
> > > > There is an ez answer to this, but I would like you to answer Dr. Bobs question first !
> > > > I just started taking lorazapam for anxiety and am wondering how much I could take before I need to worry about phycological addition or overdose. I notice in some articles doeses of up to 10mg, while my persecription is for 1mg tablets, and I sometime take tables. but, I've noticed the effect continues to diminish.
> > > > james
> > ________________________________________________
> > The dosage needed depends on how bad the anxiety is that you are experiencing. First, there seems to be 2 schools of thought in the psychiatric profession about benzodiazapines. To generalize, 1) Benzodiazapines are not good for long term treatment of any anxiety disorder - cognitave therapy in combo with a sedating anti-depressant(such as Serzone)should be all that is about necessary. 2)Benzos are good for long term treatment of anxiety disorders because that is what they are....anti-anxiety agents made specifically for that purpose. Just keep it well managed...especially with a short half-life benzo like Xanax or Ativan. Supplement with cognitive therapy.
> > THE PROBLEM IS:
> >
> > The 1st group are in my opinion overrating the tolerance and dependence issues surrounding this class of drugs because of lack of understanding in prescribing and managing them. Also, misinterpretation of the PDR as well as listening to other psychiatrists with similar prejudice telling of THEIR OWN prejudice and ignorance concerning the side effects of benzos.
> >
> > It is a semantic argument actually. What is dependence? That if you stop taking benzos you'll become anxious again? Yes there is withdrawl involved in abruptly stopping benzos rather than tapering but does that constitute dependence? No. Yes, one can build up a tolerance to dosage but not something that can't be managed (unless they are being abused or not being taken as instructed).
> >
> > For instance, it doesn't take alot of imagination to know that Ativan can be managed with an augmentation of a small amount of the low or no side effect mood stabilizer Neurontin (900 - 1200mg)to help with Ativan going in and out of
> > the system therefore aleviating the drug induced anxiety.
> > Also, keep the Ativan at a constant level whether it is 2 or 6 or I've read up to 10 mgs. daily...whatever allows you to function the way you need to without the affliction of an anxiety disorder! That is the whole point! So what if you take 3 -4 mgs or 5 -6 mgs. a day! Does it in conjunction with cognative therapy techniques alleviate your anxiety disorder?
> > Don't be scared off by the argument that you are addicted to benzos when benzos are what stops the disease that you're afflicted with! A non -prejudicial psychopharmacologist will help manage your suffering and allay your unfounded fears of addiction that are imposed upon you by the first group of psychiatrists mentioned above. The point is, get the ball in the hole. Until these prejudiced doctors stop heaping these needlessly anxiety - provoking "facts" there will continue to be your type of sad questions worried about by many, many patients in need of relief.
> >
> > If you have an anxiety disorder, you take inti-anxiety drugs (until the purists come up with something THAT WORKS for you with less side effects).
> >
> > Am I pretty much on target Dr. Bob? (assuming that she has a properly diagnosed anxiety disorder).
> >
> > GS
> *******************************************************
> Any comments, similar experiences with this issue surrounding benzos.....Dr.s , patients??
>
> GS
Hey there. I can tell you that I have had 3 psychiatrists and not a one of them agrees with ativan. they say it is addicting and it is only good for short term.. I mean come on if it helps you what the hell is the problem.. I had three medical doctors that i have seen go ahead and prescribe it but only a small subscription and said go see your psychiatrist. Well everytime i go to see him he won't even listen to me about the ativan. That is the only thing htat has really helped me with my SEVERE anxiety disorder but he would rather have me suffering every night and every day until the "normal" medicine he has put me on, celexa kicks in.. I don't understand why i can't take 2 mgs a day for a couple of months unti the effects of celexa kicks in this is torture. I have state funded insurance so i have no choice about what psych i go see. I hate this my life is nightnare. I find something that f---ing works for me and the guy looks at me like i am stupid for asking him to please put me on it.. I swear they sometimes don't even understand the pain and horror this disease is. Do they really care. He gets frusterated with m e when i try to give him info thati find on the web.. I feel like i will never get any relieve imean this is bad.. what do i do. ?? Help? AmyII
Posted by Sean on September 14, 1999, at 15:56:41
In reply to Re: Lorazapam-inviting all comments about benzos, posted by Amy II on September 14, 1999, at 13:03:25
> > > > > > > How can I find out what a lethal dosage of Lorazapam is?
> > > > > >
> > > > > > Why do you ask?
> > > > > >
> > > > > > Bob
> > > > >
> > > > > James here....
> > > > >
> > > > > There is an ez answer to this, but I would like you to answer Dr. Bobs question first !
> > > > > I just started taking lorazapam for anxiety and am wondering how much I could take before I need to worry about phycological addition or overdose. I notice in some articles doeses of up to 10mg, while my persecription is for 1mg tablets, and I sometime take tables. but, I've noticed the effect continues to diminish.
> > > > > james
> > > ________________________________________________
> > > The dosage needed depends on how bad the anxiety is that you are experiencing. First, there seems to be 2 schools of thought in the psychiatric profession about benzodiazapines. To generalize, 1) Benzodiazapines are not good for long term treatment of any anxiety disorder - cognitave therapy in combo with a sedating anti-depressant(such as Serzone)should be all that is about necessary. 2)Benzos are good for long term treatment of anxiety disorders because that is what they are....anti-anxiety agents made specifically for that purpose. Just keep it well managed...especially with a short half-life benzo like Xanax or Ativan. Supplement with cognitive therapy.
> > > THE PROBLEM IS:
> > >
> > > The 1st group are in my opinion overrating the tolerance and dependence issues surrounding this class of drugs because of lack of understanding in prescribing and managing them. Also, misinterpretation of the PDR as well as listening to other psychiatrists with similar prejudice telling of THEIR OWN prejudice and ignorance concerning the side effects of benzos.
> > >
> > > It is a semantic argument actually. What is dependence? That if you stop taking benzos you'll become anxious again? Yes there is withdrawl involved in abruptly stopping benzos rather than tapering but does that constitute dependence? No. Yes, one can build up a tolerance to dosage but not something that can't be managed (unless they are being abused or not being taken as instructed).
> > >
> > > For instance, it doesn't take alot of imagination to know that Ativan can be managed with an augmentation of a small amount of the low or no side effect mood stabilizer Neurontin (900 - 1200mg)to help with Ativan going in and out of
> > > the system therefore aleviating the drug induced anxiety.
> > > Also, keep the Ativan at a constant level whether it is 2 or 6 or I've read up to 10 mgs. daily...whatever allows you to function the way you need to without the affliction of an anxiety disorder! That is the whole point! So what if you take 3 -4 mgs or 5 -6 mgs. a day! Does it in conjunction with cognative therapy techniques alleviate your anxiety disorder?
> > > Don't be scared off by the argument that you are addicted to benzos when benzos are what stops the disease that you're afflicted with! A non -prejudicial psychopharmacologist will help manage your suffering and allay your unfounded fears of addiction that are imposed upon you by the first group of psychiatrists mentioned above. The point is, get the ball in the hole. Until these prejudiced doctors stop heaping these needlessly anxiety - provoking "facts" there will continue to be your type of sad questions worried about by many, many patients in need of relief.
> > >
> > > If you have an anxiety disorder, you take inti-anxiety drugs (until the purists come up with something THAT WORKS for you with less side effects).
> > >
> > > Am I pretty much on target Dr. Bob? (assuming that she has a properly diagnosed anxiety disorder).
> > >
> > > GS
> > *******************************************************
> > Any comments, similar experiences with this issue surrounding benzos.....Dr.s , patients??
> >
> > GS
> Hey there. I can tell you that I have had 3 psychiatrists and not a one of them agrees with ativan. they say it is addicting and it is only good for short term.. I mean come on if it helps you what the hell is the problem.. I had three medical doctors that i have seen go ahead and prescribe it but only a small subscription and said go see your psychiatrist. Well everytime i go to see him he won't even listen to me about the ativan. That is the only thing htat has really helped me with my SEVERE anxiety disorder but he would rather have me suffering every night and every day until the "normal" medicine he has put me on, celexa kicks in.. I don't understand why i can't take 2 mgs a day for a couple of months unti the effects of celexa kicks in this is torture. I have state funded insurance so i have no choice about what psych i go see. I hate this my life is nightnare. I find something that f---ing works for me and the guy looks at me like i am stupid for asking him to please put me on it.. I swear they sometimes don't even understand the pain and horror this disease is. Do they really care. He gets frusterated with m e when i try to give him info thati find on the web.. I feel like i will never get any relieve imean this is bad.. what do i do. ?? Help? AmyIIRight on Amy. Of course when I had lightening bolts
zapping through my body, etc..., my doc was having
problems with me *staying* on xanax because in my
fear-based world, I was convinced he was going to
addict me.How about Neurontin? It may help and satisfy your
doctor's problems with prescribing ativan.Good luck,
Sean.
Posted by Amy II on September 14, 1999, at 18:50:27
In reply to Re: Lorazapam-inviting all comments about benzos, posted by Sean on September 14, 1999, at 15:56:41
> > > > > > > > How can I find out what a lethal dosage of Lorazapam is?
> > > > > > >
> > > > > > > Why do you ask?
> > > > > > >
> > > > > > > Bob
> > > > > >
> > > > > > James here....
> > > > > >
> > > > > > There is an ez answer to this, but I would like you to answer Dr. Bobs question first !
> > > > > > I just started taking lorazapam for anxiety and am wondering how much I could take before I need to worry about phycological addition or overdose. I notice in some articles doeses of up to 10mg, while my persecription is for 1mg tablets, and I sometime take tables. but, I've noticed the effect continues to diminish.
> > > > > > james
> > > > ________________________________________________
> > > > The dosage needed depends on how bad the anxiety is that you are experiencing. First, there seems to be 2 schools of thought in the psychiatric profession about benzodiazapines. To generalize, 1) Benzodiazapines are not good for long term treatment of any anxiety disorder - cognitave therapy in combo with a sedating anti-depressant(such as Serzone)should be all that is about necessary. 2)Benzos are good for long term treatment of anxiety disorders because that is what they are....anti-anxiety agents made specifically for that purpose. Just keep it well managed...especially with a short half-life benzo like Xanax or Ativan. Supplement with cognitive therapy.
> > > > THE PROBLEM IS:
> > > >
> > > > The 1st group are in my opinion overrating the tolerance and dependence issues surrounding this class of drugs because of lack of understanding in prescribing and managing them. Also, misinterpretation of the PDR as well as listening to other psychiatrists with similar prejudice telling of THEIR OWN prejudice and ignorance concerning the side effects of benzos.
> > > >
> > > > It is a semantic argument actually. What is dependence? That if you stop taking benzos you'll become anxious again? Yes there is withdrawl involved in abruptly stopping benzos rather than tapering but does that constitute dependence? No. Yes, one can build up a tolerance to dosage but not something that can't be managed (unless they are being abused or not being taken as instructed).
> > > >
> > > > For instance, it doesn't take alot of imagination to know that Ativan can be managed with an augmentation of a small amount of the low or no side effect mood stabilizer Neurontin (900 - 1200mg)to help with Ativan going in and out of
> > > > the system therefore aleviating the drug induced anxiety.
> > > > Also, keep the Ativan at a constant level whether it is 2 or 6 or I've read up to 10 mgs. daily...whatever allows you to function the way you need to without the affliction of an anxiety disorder! That is the whole point! So what if you take 3 -4 mgs or 5 -6 mgs. a day! Does it in conjunction with cognative therapy techniques alleviate your anxiety disorder?
> > > > Don't be scared off by the argument that you are addicted to benzos when benzos are what stops the disease that you're afflicted with! A non -prejudicial psychopharmacologist will help manage your suffering and allay your unfounded fears of addiction that are imposed upon you by the first group of psychiatrists mentioned above. The point is, get the ball in the hole. Until these prejudiced doctors stop heaping these needlessly anxiety - provoking "facts" there will continue to be your type of sad questions worried about by many, many patients in need of relief.
> > > >
> > > > If you have an anxiety disorder, you take inti-anxiety drugs (until the purists come up with something THAT WORKS for you with less side effects).
> > > >
> > > > Am I pretty much on target Dr. Bob? (assuming that she has a properly diagnosed anxiety disorder).
> > > >
> > > > GS
> > > *******************************************************
> > > Any comments, similar experiences with this issue surrounding benzos.....Dr.s , patients??
> > >
> > > GS
> > Hey there. I can tell you that I have had 3 psychiatrists and not a one of them agrees with ativan. they say it is addicting and it is only good for short term.. I mean come on if it helps you what the hell is the problem.. I had three medical doctors that i have seen go ahead and prescribe it but only a small subscription and said go see your psychiatrist. Well everytime i go to see him he won't even listen to me about the ativan. That is the only thing htat has really helped me with my SEVERE anxiety disorder but he would rather have me suffering every night and every day until the "normal" medicine he has put me on, celexa kicks in.. I don't understand why i can't take 2 mgs a day for a couple of months unti the effects of celexa kicks in this is torture. I have state funded insurance so i have no choice about what psych i go see. I hate this my life is nightnare. I find something that f---ing works for me and the guy looks at me like i am stupid for asking him to please put me on it.. I swear they sometimes don't even understand the pain and horror this disease is. Do they really care. He gets frusterated with m e when i try to give him info thati find on the web.. I feel like i will never get any relieve imean this is bad.. what do i do. ?? Help? AmyII
>
> Right on Amy. Of course when I had lightening bolts
> zapping through my body, etc..., my doc was having
> problems with me *staying* on xanax because in my
> fear-based world, I was convinced he was going to
> addict me.
>
> How about Neurontin? It may help and satisfy your
> doctor's problems with prescribing ativan.
>
> Good luck,
>
> Sean.Hey Sean.. You won't believe this but i went to see my psychiatrist today and he prescibed neurontin. told me he wanted me to take a half a milligram at night and 1 mg if i needed it but try to stay away from it. I don't know anything about it. Any info. Is it like Ativan. he also wants em to stay on 10 mg of celexa for a few eeks then up dose to 20 mg with half mg of Neurontin. I hope this helps me. I am so sick of trying to get docs to listen to me.
AmyII
Posted by Ian on September 15, 1999, at 8:36:58
In reply to Re: Lorazapam-inviting all comments about benzos, posted by Amy II on September 14, 1999, at 18:50:27
It appears to me that the benzo thing is a bit of a lottery.I've met one or two people who claim benzodiazpines have mad a real mess of there lives listing every concievable side effect and claiming they have lost years of there lives on them. On the other side I've met plenty of sprightly little old ladies who have been taking 10mg of Temazepam or 5mg of Nitrazepam to get them off to sleep for the last ten fifteen years with no ill effects.
Realy the benzo's in that sense are very similar to alcohol in the way people use them. The cross over of CNS suppressing effects is quite clear,benzos are used to lessen the effects of alcohol withdrawal and personally I've used them (or chlormetiazole) when confronted with post op orthopaedic patients beginning to lose it when their system hasn't had the rather generous Scotch nightcaps that they are used to.
This is another amiguous answer but I suppose it highlights the fact that the person the drug is given to or the reason for giving it are often the determinates of whether a drug is deamed good or bad, addictive or non addictive.
Posted by Amy II on September 15, 1999, at 11:53:11
In reply to Re: Lorazapam-inviting all comments about benzos, posted by Ian on September 15, 1999, at 8:36:58
> It appears to me that the benzo thing is a bit of a lottery.I've met one or two people who claim benzodiazpines have mad a real mess of there lives listing every concievable side effect and claiming they have lost years of there lives on them. On the other side I've met plenty of sprightly little old ladies who have been taking 10mg of Temazepam or 5mg of Nitrazepam to get them off to sleep for the last ten fifteen years with no ill effects.
> Realy the benzo's in that sense are very similar to alcohol in the way people use them. The cross over of CNS suppressing effects is quite clear,benzos are used to lessen the effects of alcohol withdrawal and personally I've used them (or chlormetiazole) when confronted with post op orthopaedic patients beginning to lose it when their system hasn't had the rather generous Scotch nightcaps that they are used to.
> This is another amiguous answer but I suppose it highlights the fact that the person the drug is given to or the reason for giving it are often the determinates of whether a drug is deamed good or bad, addictive or non addictive.Well the doctor prescribed klonopin not Neurontin. My mistake. :) I have looked this thing up and i don't know if i want to take it there are some really harsh i mean harsh side effectrs if there is anybody out there that has taken this drug ofr anxiety please let me know i don't want ot start taking it until i hear some experiences.
Posted by Bob on September 15, 1999, at 12:09:53
In reply to Re: Lorazapam-inviting all comments about benzos, posted by Amy II on September 15, 1999, at 11:53:11
> I have looked this thing up and i don't know if i want to take it there are some really harsh i mean harsh side effectrs if there is anybody out there that has taken this drug ofr anxiety please let me know i don't want ot start taking it until i hear some experiences.
Someone, I can't recall who, just talked about her horror story in being forced to switch from klonopin to its generic "equivalent", clonazepam. Apparently, there's a much bigger difference between the brand-name and the generic than you'd think.
On the other hand, I've been taking clonazepam for a little over a year now, and its effects for me are so basic and subtle that I'm tempted to include it at the base of my personal hierarchy of needs, right along with food, water, shelter, and whatever else Maslow put in there. I've been going through some extremely stressful times at work, and its been rock steady for me.
... besides, my copay for generics is half ($5) my copay for brand-names, so I got that extra 5 bucks a month to spend on the more important things in life, like playing the lotto (you can't win if you don't play ;^)
Cheers
Bob
Posted by Sean on September 15, 1999, at 16:45:03
In reply to klonopin vs clonazepam, posted by Bob on September 15, 1999, at 12:09:53
> > I have looked this thing up and i don't know if i want to take it there are some really harsh i mean harsh side effectrs if there is anybody out there that has taken this drug ofr anxiety please let me know i don't want ot start taking it until i hear some experiences.
>
> Someone, I can't recall who, just talked about her horror story in being forced to switch from klonopin to its generic "equivalent", clonazepam. Apparently, there's a much bigger difference between the brand-name and the generic than you'd think.
>
> On the other hand, I've been taking clonazepam for a little over a year now, and its effects for me are so basic and subtle that I'm tempted to include it at the base of my personal hierarchy of needs, right along with food, water, shelter, and whatever else Maslow put in there. I've been going through some extremely stressful times at work, and its been rock steady for me.
>
> ... besides, my copay for generics is half ($5) my copay for brand-names, so I got that extra 5 bucks a month to spend on the more important things in life, like playing the lotto (you can't win if you don't play ;^)
>
> Cheers
> Bob
I think the benzo risk may depend on an individuals
sensitivity to changes in the GABA-ergic system.
GABA is generally thought to confer an inhibitory
effect on the CNS which helps explain why benzos
work so well for anxiety which, subjectively, feels
like errant electricity in the brain and body, or
at least in the "fear" centers.From long personal experience with benzos, I
have found them irreplacable for acute anxiety.
They can be life savers in that sense: an evil
dose of anxiety on top of major depression puts
one at a high risk for suicide. Being hopless and
low energy is bad enough. Being hopeless and
anxious out of your mind to the point of total
derealization etc... is a recipe for disaster.I think (personal opinion here) that the brain
is rather malleable in some ways; the more anxiety
you get used to, the more you have - kind of like
kindling. By turning this signal down for say, 2
weeks, the nervous system has a chance to get back
into the swing of things.But, if you heavily down-regulate you GABA with acute
doses of benzos for a year, there will likely be
problems when coming off. A close friend of mine
found that his siezure threshold had been lowered
and the rate at which he slowed his medication
intake was critical.It is interesting to me that Gabapentin (Neuronten)
is also used for anti-siezure (epilepsy) which
is quite clearly a neurological storm in the brain.I wonder if people on Neuronten find that when they
come off that drug their siezure threshold is
lower?ANyway, I'm rambling on. Benzo are great acute
therapy. They save lives, are relatively safe, and
most people don't abuse them...Sean.
Posted by GS on September 15, 1999, at 22:40:51
In reply to Benzo Risks, posted by Sean on September 15, 1999, at 16:45:03
> I think the benzo risk may depend on an individuals
> sensitivity to changes in the GABA-ergic system.
> GABA is generally thought to confer an inhibitory
> effect on the CNS which helps explain why benzos
> work so well for anxiety which, subjectively, feels
> like errant electricity in the brain and body, or
> at least in the "fear" centers.
>
> From long personal experience with benzos, I
> have found them irreplacable for acute anxiety.
> They can be life savers in that sense: an evil
> dose of anxiety on top of major depression puts
> one at a high risk for suicide. Being hopless and
> low energy is bad enough. Being hopeless and
> anxious out of your mind to the point of total
> derealization etc... is a recipe for disaster.
>
> I think (personal opinion here) that the brain
> is rather malleable in some ways; the more anxiety
> you get used to, the more you have - kind of like
> kindling. By turning this signal down for say, 2
> weeks, the nervous system has a chance to get back
> into the swing of things.
>
> But, if you heavily down-regulate you GABA with acute
> doses of benzos for a year, there will likely be
> problems when coming off. A close friend of mine
> found that his siezure threshold had been lowered
> and the rate at which he slowed his medication
> intake was critical.
>
> It is interesting to me that Gabapentin (Neuronten)
> is also used for anti-siezure (epilepsy) which
> is quite clearly a neurological storm in the brain.
>
> I wonder if people on Neuronten find that when they
> come off that drug their siezure threshold is
> lower?
>
> ANyway, I'm rambling on. Benzo are great acute
> therapy. They save lives, are relatively safe, and
> most people don't abuse them...
>
> Sean.
************************************************Yeah Sean...
Gabapentin was intended as and is listed as an anti-siezure drug and mood stabilizer whose claim to fame is a low side effect profile. As I mentioned in an earlier post, prescribed in a relatively low dose in conjunction with ativan or similar benzo (for a legitimate anxiety disorder), the side effect of the shorter half life benzo going in and out of the system is then minimized.
You know looking at the last few posts about the unwillingness of an uninformed group of doctors to prescribe benzos for the long term treatment of anxiety disorders is exactly what motivated me to start contributing to this list in the first place (posts on 8/4 and 8/14).
My psychopharmacologist tells me that Gabapentin is used to help stop the withdrawl symptoms of alcohol and an overdose of benzos in the psyc unit at the hospital. I take several mgs of ativan on a daily basis and have for a couple of years and lead a high functioning existence now that my anxiety disorder is under control...this after the previous 5 years of trying every antidepressant and mood stabilizer known to man with another doc who refused to give me the relief that I needed with benzos for fear that I would become "addicted". I believe that the Gabapentin helps mediate the receptors in the brain that you mention - the ones that are also so influenced by ativan.
I'm interested to know what you mean by "seizure threshold" - as in epileptic seizure? - or as in drug induced seizure? I have no experience in this....
As far as going through withdrawl after a year on benzos, sure it would be hard - but alot easier than putting up with chronic anxiety instead. That is why there is no need to go off of them in the first place for a chronic condition (in both my and my docs opinion).
GS
**************************************************
Posted by Jeff on September 16, 1999, at 10:18:20
In reply to klonopin vs clonazepam, posted by Bob on September 15, 1999, at 12:09:53
Ivan Goldberg made a big point of telling me that there's a difference between generic lorazepam and brand name Ativan -and that his patients have better results. Even though insurance co's love the cheap generic I tried the brand and he was right. This wasn't a huge difference, nor one that would suggest risk in going the other direction - but it seemed to work better.
Posted by Sean on September 17, 1999, at 13:05:56
In reply to Re: Benzo Risks - To Sean, posted by GS on September 15, 1999, at 22:40:51
> > I think the benzo risk may depend on an individuals
> > sensitivity to changes in the GABA-ergic system.
> > GABA is generally thought to confer an inhibitory
> > effect on the CNS which helps explain why benzos
> > work so well for anxiety which, subjectively, feels
> > like errant electricity in the brain and body, or
> > at least in the "fear" centers.
> >
> > From long personal experience with benzos, I
> > have found them irreplacable for acute anxiety.
> > They can be life savers in that sense: an evil
> > dose of anxiety on top of major depression puts
> > one at a high risk for suicide. Being hopless and
> > low energy is bad enough. Being hopeless and
> > anxious out of your mind to the point of total
> > derealization etc... is a recipe for disaster.
> >
> > I think (personal opinion here) that the brain
> > is rather malleable in some ways; the more anxiety
> > you get used to, the more you have - kind of like
> > kindling. By turning this signal down for say, 2
> > weeks, the nervous system has a chance to get back
> > into the swing of things.
> >
> > But, if you heavily down-regulate you GABA with acute
> > doses of benzos for a year, there will likely be
> > problems when coming off. A close friend of mine
> > found that his siezure threshold had been lowered
> > and the rate at which he slowed his medication
> > intake was critical.
> >
> > It is interesting to me that Gabapentin (Neuronten)
> > is also used for anti-siezure (epilepsy) which
> > is quite clearly a neurological storm in the brain.
> >
> > I wonder if people on Neuronten find that when they
> > come off that drug their siezure threshold is
> > lower?
> >
> > ANyway, I'm rambling on. Benzo are great acute
> > therapy. They save lives, are relatively safe, and
> > most people don't abuse them...
> >
> > Sean.
> ************************************************
>
> Yeah Sean...
>
> Gabapentin was intended as and is listed as an anti-siezure drug and mood stabilizer whose claim to fame is a low side effect profile. As I mentioned in an earlier post, prescribed in a relatively low dose in conjunction with ativan or similar benzo (for a legitimate anxiety disorder), the side effect of the shorter half life benzo going in and out of the system is then minimized.
>
> You know looking at the last few posts about the unwillingness of an uninformed group of doctors to prescribe benzos for the long term treatment of anxiety disorders is exactly what motivated me to start contributing to this list in the first place (posts on 8/4 and 8/14).
>
> My psychopharmacologist tells me that Gabapentin is used to help stop the withdrawl symptoms of alcohol and an overdose of benzos in the psyc unit at the hospital. I take several mgs of ativan on a daily basis and have for a couple of years and lead a high functioning existence now that my anxiety disorder is under control...this after the previous 5 years of trying every antidepressant and mood stabilizer known to man with another doc who refused to give me the relief that I needed with benzos for fear that I would become "addicted". I believe that the Gabapentin helps mediate the receptors in the brain that you mention - the ones that are also so influenced by ativan.
>
> I'm interested to know what you mean by "seizure threshold" - as in epileptic seizure? - or as in drug induced seizure? I have no experience in this....
>
> As far as going through withdrawl after a year on benzos, sure it would be hard - but alot easier than putting up with chronic anxiety instead. That is why there is no need to go off of them in the first place for a chronic condition (in both my and my docs opinion).
>
> GS
> **************************************************GS -
Agreed on the chronic condition aspect of treatment.
I have an incredible addiction to - food. Man,
if I don't have it for few days I become shaky,
depressed, crabby, and I can think clearly...
Total withdrawl syndrome mang.Sean.
Posted by Michael on November 23, 1999, at 14:37:59
In reply to Re: Benzo Risks - To Sean, posted by Sean on September 17, 1999, at 13:05:56
> > > I think the benzo risk may depend on an individuals
> > > sensitivity to changes in the GABA-ergic system.
> > > GABA is generally thought to confer an inhibitory
> > > effect on the CNS which helps explain why benzos
> > > work so well for anxiety which, subjectively, feels
> > > like errant electricity in the brain and body, or
> > > at least in the "fear" centers.
> > >
> > > From long personal experience with benzos, I
> > > have found them irreplacable for acute anxiety.
> > > They can be life savers in that sense: an evil
> > > dose of anxiety on top of major depression puts
> > > one at a high risk for suicide. Being hopless and
> > > low energy is bad enough. Being hopeless and
> > > anxious out of your mind to the point of total
> > > derealization etc... is a recipe for disaster.
> > >
> > > I think (personal opinion here) that the brain
> > > is rather malleable in some ways; the more anxiety
> > > you get used to, the more you have - kind of like
> > > kindling. By turning this signal down for say, 2
> > > weeks, the nervous system has a chance to get back
> > > into the swing of things.
> > >
> > > But, if you heavily down-regulate you GABA with acute
> > > doses of benzos for a year, there will likely be
> > > problems when coming off. A close friend of mine
> > > found that his siezure threshold had been lowered
> > > and the rate at which he slowed his medication
> > > intake was critical.
> > >
> > > It is interesting to me that Gabapentin (Neuronten)
> > > is also used for anti-siezure (epilepsy) which
> > > is quite clearly a neurological storm in the brain.
> > >
> > > I wonder if people on Neuronten find that when they
> > > come off that drug their siezure threshold is
> > > lower?
> > >
> > > ANyway, I'm rambling on. Benzo are great acute
> > > therapy. They save lives, are relatively safe, and
> > > most people don't abuse them...
> > >
> > > Sean.
> > ************************************************
> >
> > Yeah Sean...
> >
> > Gabapentin was intended as and is listed as an anti-siezure drug and mood stabilizer whose claim to fame is a low side effect profile. As I mentioned in an earlier post, prescribed in a relatively low dose in conjunction with ativan or similar benzo (for a legitimate anxiety disorder), the side effect of the shorter half life benzo going in and out of the system is then minimized.
> >
> > You know looking at the last few posts about the unwillingness of an uninformed group of doctors to prescribe benzos for the long term treatment of anxiety disorders is exactly what motivated me to start contributing to this list in the first place (posts on 8/4 and 8/14).
> >
> > My psychopharmacologist tells me that Gabapentin is used to help stop the withdrawl symptoms of alcohol and an overdose of benzos in the psyc unit at the hospital. I take several mgs of ativan on a daily basis and have for a couple of years and lead a high functioning existence now that my anxiety disorder is under control...this after the previous 5 years of trying every antidepressant and mood stabilizer known to man with another doc who refused to give me the relief that I needed with benzos for fear that I would become "addicted". I believe that the Gabapentin helps mediate the receptors in the brain that you mention - the ones that are also so influenced by ativan.
> >
> > I'm interested to know what you mean by "seizure threshold" - as in epileptic seizure? - or as in drug induced seizure? I have no experience in this....
> >
> > As far as going through withdrawl after a year on benzos, sure it would be hard - but alot easier than putting up with chronic anxiety instead. That is why there is no need to go off of them in the first place for a chronic condition (in both my and my docs opinion).
> >
> > GS
> > **************************************************
>
> GS -
>
> Agreed on the chronic condition aspect of treatment.
> I have an incredible addiction to - food. Man,
> if I don't have it for few days I become shaky,
> depressed, crabby, and I can think clearly...
> Total withdrawl syndrome mang.
>
> Sean.I'm new here--so be kind. Had to add my 3 cents. Quess I've been a Klonopin "addict" fot almost ten years. That's ten years with "reasonable" control of my fears, too numerous to get into. Well--Klonopin 8 mg. in 1991 and for the coming few years, people wondered just how I could stay awke !! Well that just proves my point a dependence I have, not addiction. Need the drug, its helps me function and my p doc is in total agreement. Down to four mg. these days--did it on my own--no problems, Neurontin recently added up to 400 mg. three times a day. Takes a bit of getting use to...but when you do you feel that "fire" in your belly is gone, and you're off to a 'normal" day. Klonopin, I feel saved my life....now Neurontin just helps me live it to the fullest ever. Thanks for listening peoples. Hello all !!
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