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Dr. Bob is Robert Hsiung, MD,
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Posted by Quintal on August 6, 2007, at 19:31:00
In reply to beta carbolines to reverse benzo cognitive probs, posted by linkadge on August 6, 2007, at 11:04:16
Yes, coffee used to wake me up and help my 'cognitive functioning' while I was taking benzos. It was the only time I've been able to tolerate coffee. As Phillipa says, if the beta carboline compounds are benzodiazepine receptor antagonists wouldn't that produce mild withdrawal symptoms in people who are dependent on them? If benzo cognitive problems are a serious problem and beta carbolines reverse them by acting as antagonists, wouldn't it be more economical to just stop taking benzos or skip a dose?
Q
Posted by LlurpsieNoodle on August 6, 2007, at 19:46:54
In reply to Re: beta carbolines to reverse benzo cognitive pro » linkadge, posted by Quintal on August 6, 2007, at 19:31:00
I think there's fairly good evidence that coffee supports cognitive functioning for non-med folks too. faster decision times, lower error rates, etc.
As far as benzo-related cognitive impairment, I haven't noticed any. I take about .5-1mg a day, and have been at that level for about 6 months now.
In fact, I noticed that once the anxiety was cleared out of the way I was thinking MUCH more clearly. no more ruminative thoughts and self-monitoring.
second-guessing is a big cognitive blood-sucker.
-Ll
Posted by LlurpsieNoodle on August 6, 2007, at 19:48:17
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by LlurpsieNoodle on August 6, 2007, at 19:46:54
Oh, and did I mention that I have an interview to work at a coffee shop on Wed.? I figure I'll work part time, and write my scholarly tomes the other part time while highly caffeinated.
-Ll
Posted by Quintal on August 6, 2007, at 20:09:08
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by LlurpsieNoodle on August 6, 2007, at 19:46:54
People aren't often aware of how much their cognitive functioning is impaired by benzos until after they've quit. I recall how often you say you dislike taking benzos because they take away your ability to be vigilant of your surroundings. In that way they are aversely affecting your cognitive functioning. The thing about benzos and similar drugs is that they often make you feel and think that you're performing much better than you really are. Tolerance to both the cognitive blunting and therapeutic effects can occur quite rapidly - that's probably why you're taking more now than you did at the beginning, though tolerance can come under a number of guises.
Q
Posted by Phillipa on August 6, 2007, at 20:50:45
In reply to Re: beta carbolines to reverse benzo cognitive pro » LlurpsieNoodle, posted by Quintal on August 6, 2007, at 20:09:08
Quintal sorry disagree again guess we always will. Where the English see no harm in codeine we see no harm in benzos as long as not abused. Oh I just realized I'm one half English. Love Phillipa
Posted by LlurpsieNoodle on August 6, 2007, at 20:54:58
In reply to Re: beta carbolines to reverse benzo cognitive pro » LlurpsieNoodle, posted by Quintal on August 6, 2007, at 20:09:08
Hi Quintal :)
> People aren't often aware of how much their cognitive functioning is impaired by benzos until after they've quit. I recall how often you say you dislike taking benzos because they take away your ability to be vigilant of your surroundings. In that way they are aversely affecting your cognitive functioning.
Interesting point. I'm going to debate you a bit though. One of the things about PTSD is that it also adversely affects cognitive processing. Hypervigilance (as opposed to Alastair Moody-style "constant vigilance") takes a lot of cognitive load and constant processing, and the brain's attention and working memory is limited. Hypervigilance may increase the scope of attention, but there may be fewer resources left over to hold all of this information in memory, or to consolidate it to make sense out of it all. An example from my own life is that I used to work in an office within earshot of several other offices. I was unable to focus on my work because I was always monitoring what was going on in other places, especially when I detected sounds of stress or strife. Now, if I were a soldier, and I needed to be hyperaware of every little snapping twig in the forest, this would be of benefit, but as a grad student, it was very disruptive. Part of me always felt endangered when I heard strife. (still does). So, I guess it depends on one's job description and the immediate cognitive demands of the task. You are absolutely correct that I have complained that they make me less sensitive to things. I complain when I'm on the bus and all of a sudden I notice that I'm being "sloppy" purse is open, transit card sticking out of my pocket, looking unfocused. I don't complain when I'm able to sit down and work in my office for more than 10 minutes without getting up to pace (or do the internet equivalent of surfing).
>The thing about benzos and similar drugs is that they often make you feel and think that you're performing much better than you really are.
I agree with you. I would never take a benzo in a situation in which my peak performance was demanded*. That's why my pdoc told me NOT to take a benzo before my dissertation defense. We decided on betablocker instead. I'm a really good violinist, but when I'm drunk I'm a virtuoso, at least in my mind. The benefit of playing violin drunk is that most of the audience is drunk too. someone says "hey Llurpsie, play us some violin" "you sure?" "screeeeetttchhh" "zzzzZZZzzz" etc
>Tolerance to both the cognitive blunting and therapeutic effects can occur quite rapidly - that's probably why you're taking more now than you did at the beginning, though tolerance can come under a number of guises.
I think I'm more tolerant to the cognitive blunting (and/or I've developed alternate strategies). As far as my dosage is concerned, (mental run-through of my history with klonopin...) first it was .5mg a few times a week (writing dissertation. then it was .5mg most days a week (meeting with advisor about dissertation). then it was about 1.5mg everyday (withdrawing from cymbalta and other nasties) then it was .5mg most days (defending and submitting dissertation) and it remained at that dose, and my life remained chaotic. Had a crisis about 2 weeks ago. Got kind of messy and suicidal. Dose was increased to 1mg day, and I was under strict orders that this was not an optional medication. But recently the tide has turned and I've been feeling more "settled". I'm optimistic that I won't need to take .5mg 2x a day.
Anyways, pdoc had me convinced long ago that klonopin has far fewer side effects than alcohol, which I rarely drink these days.
nice to discuss with you Q
-Ll*unless my peak performance demanded appearing relaxed.
Posted by Quintal on August 6, 2007, at 21:57:16
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by Phillipa on August 6, 2007, at 20:50:45
Well I think we do agree Phillipa, I've never said benzos are harmful in a physical sense or toxic in any way, but they can and do affect your memory and concentration over time, and sometimes cause depression or make it worse. Most rational doctors here will prescribe benzos for short periods where they're needed, but of course benzophobia does seem to be quite rampant. There's also an attitude that's the the opposite of benzophobia, where people refuse to admit benzos can be as problematic as they really are. The same with SSRIs as well. Balanced opinions are hard to find.
Q
Posted by Phillipa on August 6, 2007, at 22:09:17
In reply to Re: beta carbolines to reverse benzo cognitive pro » Phillipa, posted by Quintal on August 6, 2007, at 21:57:16
Quintal no argument with me on SSRI's misused too much in my opinion always thought so. Love Jan bed is calling pdoc appointment tomorrow want to come? I mean to the appointment.
Posted by Quintal on August 6, 2007, at 22:42:36
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by LlurpsieNoodle on August 6, 2007, at 20:54:58
Well I don't know anything about PTSD so I can't debate with you on that point. I just remember you saying that Klonopin took away your ability to be vigilant and you found this unnerving because you felt you needed that to keep yourself safe, or words to that effect. Of course hypervigilance might be a symptom of the condition (as it is with social anxiety) so drugs that reduce alertness might be beneficial in that sense.
Yeah, it's almost funny the way benzos were prescribed for nerves before driving tests and exams etc! That said, there was an article in the paper a few weeks ago that told of a new wonder drug to ease anxiety during public speaking. Nearly everyone tested found a drastic reduction in their symptoms. Of course I was intrigued so I read further, and found the new wonder drug in question was called Seroquel.
Klonopin certainly has fewer side effects than alcohol! That's why I used it to drown my sorrows after losing my job and dropping out of college - saves the risk of stomach ulcers, and of course my liver has survived unscathed (AFAIK). That's why it annoys me when people say benzos are only addictive to people who use them recreationally - it can happen quite easily to most people under the 'right' circumstances.
Of course if Klonopin was helping me and prevented me from injuring myself or worse, then I would keep taking it too. If I could control my use of it I would try to use benzos p.r.n, but I'm not sure how realistic that is being an ex-addict.
Q
Posted by Phillipa on August 6, 2007, at 22:55:16
In reply to Re: beta carbolines to reverse benzo cognitive pro » LlurpsieNoodle, posted by Quintal on August 6, 2007, at 22:42:36
Quintal that's right weren't you up to a very high dose of klonopin? I forgot about that no wonder your're so concerned. Love Phillipa
Posted by FredPotter on August 7, 2007, at 0:12:13
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by LlurpsieNoodle on August 6, 2007, at 19:46:54
Hey you guys. Can you explain exactly what sort of cognitive problems?
Posted by FredPotter on August 7, 2007, at 0:15:12
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by LlurpsieNoodle on August 6, 2007, at 20:54:58
Hey you guys. What's cognitive blunting? You're all talking psychobabble. Hurray!
Posted by Quintal on August 7, 2007, at 0:48:13
In reply to Re: beta carbolines to reverse benzo cognitive pro, posted by FredPotter on August 7, 2007, at 0:12:13
Poor memory Fred, a bit like the symptoms you describe in your thread below. Difficulty focusing and concentrating as well. Some benzos like Ativan are used in medical settings for this reason, so people forget what happened to them. I think your friend Heather Ashton explains in more detail in one of these videos:
http://www.youtube.com/watch?v=UsjhqdE7-6A&mode=related&search=
http://www.youtube.com/watch?v=UsjhqdE7-6A&mode=related&search=Q
Posted by Phillipa on August 7, 2007, at 21:30:48
In reply to Re: beta carbolines to reverse benzo cognitive pro » FredPotter, posted by Quintal on August 7, 2007, at 0:48:13
Quintal you know my pdoc has never heard of Heather Ashton and has published papers for Jama on addiction. Interesting as she also changed my valium to xanax today along with the luvox to continue. I had a bunch of suggestions none of which she liked. Love Phillipa
Posted by Quintal on August 7, 2007, at 22:42:25
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by Phillipa on August 7, 2007, at 21:30:48
Are you happy with switching to Xanax? Hmmm.... well that might explain why she's so happy with prescribing benzos :o) Heather Ashton's work is the most thorough research I know of in the area of benzodiazepine dependence and withdrawal, so it's surprising/worrying that an addiction specialist has never heard of it. What else is she unaware of? Maybe it's because American doctors dislike the conclusions Ashton reaches? Still, that's a poor reason for excluding it. Even Dr. Bob's benzodiazepine equivalence chart contains no mention of Ashton's work. It's a shame because the tables he uses instead are of poor quality and contain serious (and blindingly obvious) inaccuracies. Unfortunately that seems to be the standard of American research on benzodiazepines in my experience.
What dose of Xanax did she give you?
Q
Posted by Phillipa on August 7, 2007, at 23:38:44
In reply to Re: beta carbolines to reverse benzo cognitive pro » Phillipa, posted by Quintal on August 7, 2007, at 22:42:25
Quintal lower than the pdoc up here only a total of 2mg a day. But I still find it interesting that codeine is over the counter in England and you can take much as you want without even a script. Hummmmm to that one too. She used to be on google Judith Yongue. Can't remember middle initial, And you must have read about your pic on social you really are a good looking guy. Love Phillipa
Posted by Quintal on August 7, 2007, at 23:46:36
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by Phillipa on August 7, 2007, at 23:38:44
How much Valium were you taking before? No, you can't take as much codeine as you want. As with other countries where codeine is OTC, it has to be mixed with paracetamol, ibuprofen or aspirin to people raising the dose indefinitely. There are some pure codeine products available but very few pharmacists would be willing to dispense them to anyone that came asking, for obvious reasons.
I see she's an older doctor - graduated 45 years ago. Maybe she just can't be bothered to keep up to date with modern research any more?
Q
Posted by Phillipa on August 7, 2007, at 23:54:43
In reply to Re: beta carbolines to reverse benzo cognitive pro » Phillipa, posted by Quintal on August 7, 2007, at 23:46:36
Quintal she's still there I'll have to look. And she has Emsam so she's very up to date. Just 20mg is all. I can go from one to another they don't bother me as have done it many times before. And I know the luvox makes the valium stronger we talked about that and that's the reason she said a higher dose of luvox now too. And some codeine is better than none. Love Phillipa ps she has patients on nardil and parnate too
Posted by Quintal on August 8, 2007, at 0:13:13
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by Phillipa on August 7, 2007, at 23:54:43
So would she be willing to give you Nardil if the Luvox doesn't work out? That's probably the one drug that would help you the most.
Q
Posted by Phillipa on August 8, 2007, at 0:17:14
In reply to Re: beta carbolines to reverse benzo cognitive pro » Phillipa, posted by Quintal on August 8, 2007, at 0:13:13
Quintal I don't want nardil and would never take it. Maybe still the EMSAM as I just figured out it's the only ad with no weight gain as it doesn't go through the digestive tract. Liver yes stomach no. Posted a thread at the bottom of the board. Love Phillipa bed time now
Posted by Quintal on August 8, 2007, at 4:49:25
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by Phillipa on August 8, 2007, at 0:17:14
Yeah, that's what I thought from the beginning. So are you going to ask for EMSAM if Luvox doesn't work out? I suppose it means taking the risk of it making you better.
Q
Posted by Quintal on August 8, 2007, at 4:50:25
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by Phillipa on August 8, 2007, at 0:17:14
Posted by LlurpsieNoodle on August 8, 2007, at 6:32:15
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by Phillipa on August 8, 2007, at 0:17:14
> Quintal I don't want nardil and would never take it. Maybe still the EMSAM as I just figured out it's the only ad with no weight gain as it doesn't go through the digestive tract. Liver yes stomach no. Posted a thread at the bottom of the board. Love Phillipa bed time now
Phillipa, I thought you already tried emsam? maybe I'm mistaken, but if you did, what made you change your mind?
btw, there are lots of antidepressants that are weight neutral. the one I'm on (zoloft) shows slight weight loss initially (no wonder, my tummy hurts) but chronic use some moderate weight gain. I don't think that this is something that you can't manage with diet and exercise. And remember that studies show that the more exercise you get (I know about your bike riding- maybe add some weight lifting too?) you need a smaller dose of SSRI.
I hope the xanax works for you. Take as directed.
-Ll
Posted by linkadge on August 8, 2007, at 11:02:55
In reply to Re: beta carbolines to reverse benzo cognitive pro » LlurpsieNoodle, posted by Quintal on August 6, 2007, at 20:09:08
Actually, there is some evidence that low dose lorazepam (ie 0.25mg twice per day) improves a number of aspects of cognative functioning.
There was an article, I will look for it. It suggested that a number of spacial tasks could be improved with a low dose of lorazepam. A second study confirmed the findings.
They hypothesized it was related to CCK or something.
Linkadge
Posted by linkadge on August 8, 2007, at 11:08:50
In reply to Re: beta carbolines to reverse benzo cognitive pro » Phillipa, posted by LlurpsieNoodle on August 8, 2007, at 6:32:15
My main reasoning was this. The beta carbolines have a short half life. Probably shorter than the shortest acting benzo (I would need to double check that claim). Anyhow, say you needed to concentrate just for an hour, but you just took a long acting benzo recently. Have a cup of coffee?
Not to get into the whole upper + downer thing, but I just wonder.
Linkadge
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