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Dr. Bob is Robert Hsiung, MD,
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Posted by Quintal on August 10, 2007, at 14:41:52
In reply to Re: beta carbolines to reverse benzo cognitive pro » linkadge, posted by Quintal on August 10, 2007, at 13:04:15
I can't be the only one that's getting sick and tired of this thread. As a concession to peace I'm willing to concede this:
The overwhelming majority of studies show significant cognitive impairment at typical therapeutic doses of benzodiazepines in the majority of volunteers. However, there is evidence that a minority of individuals, by dint of either leviathan brain or quirk of metabolism, or possibly some other unknown mechanism, can consume small-to-moderate doses of benzodiazepines with little adverse effect on learning and memory.
Q
Posted by linkadge on August 10, 2007, at 14:59:20
In reply to Re: beta carbolines to reverse benzo cognitive pro » linkadge, posted by Quintal on August 10, 2007, at 13:04:15
>I feel the operant word here is 'too'.
Alright, ha ha. I major in math and physics; bad spelling/grammer is a prerequisite.
>I'm not sure where that statement came from, but >I'm sure I didn't say it. There are a huge >number objective scientific studies from a wide >variety of sources demonstrating amnesia and >cognitive impairment at therapeutic doses of >benzodiazepines.
Yes, but only a small number of them are assesing the potential for such side effects to be long term / permanant. The only side effects are somewhat proven to occur in some patients are short term cognative problems which really don't concern me.
The assertion that benzodiazapines cause permanant brain damage is intrinsically a very challenging one to establish. Comorbidity, comedication, multiple substance use / alchohol use. Secondary effects such as masking of vitamin deficiancies. Asessment times (ie sufficiant time would need to be given for a complete withdrawl).
A more accurate assesment would compare long term benzodiazapine users with drug naive age matched individuals with an anxiety disorder. Ie. to asess the effect of an anxiety disorder itself on cognition. The effect of a stressfull lifestyle would also need to be accounted for. Stressfull lifestyles are linked to cognative decline!
As a side example, studies designed to asess the effect of long term neuroleptic use on cognition are generally difficult seeing as neuroleptic naive age matched (disease duration matched) schizophrenics also generally show cognative disturbance. (There is a progressive loss of grey matter in schizophrenia with or without treatment)
>The fact that you can find a handful to the >contrary based on some esoteric mechanism or >medical condition doesn't alter the conclusions >of the overwhelming body of scientific evidence. >You can't prove a negative.
I still don't see what you are getting at. The notion that long term benzo use leads to permanant cognative decline is a relativly recent one. Only time will help to clarify the incidence / validity of such preliminary claims.
>A *lot* of studies support the fact that >benzodiazepines cause significant amnesia and >cognitive impairment at therapeutic doses. When >a finding is easily replicated by independant >researchers around the word this forms evidence. >Collecting these studies is easy as apple->gathering in the fall, they being so plentiful. >To find studies to the contrary you need to go >cherry-picking.
Hundreds of studies have established the possability that SSRIs can cause sexual side effects. That doesn't mean everybody gets them.
I don't see what you are trying to say(?).>I'm jumping on no bandwagons link. I'm inclined >to ask you to read that statement, reflect on it >a while, then review my post further up this >thread containing the amnesia studies.
I don't even think we are arguing the same thing here. I agreed with you in the beginning that benzodiazapines *can* cause cognative side effects or else I woudn't have started this thread!!?
>I disagree with this. I too went to college and >got decent grades, top of my class in biology, >passed my driving test etc. Still, I was >significantly impaired compared to my >unmedicated state.
Thats great. You cannot proove however, that every individual who takes a benzodiazapine looses cognative capacity. Infact just the existence of one study suggesting that benzdiazapine use can improve cognative performance makes it impossable to prove a totality.
The doses of benzodiazapine I use to help anxiety, are in the magnitude of those used in this study.
Linakdge
Posted by Quintal on August 10, 2007, at 15:40:17
In reply to Re: beta carbolines to reverse benzo cognitive pro, posted by linkadge on August 10, 2007, at 14:59:20
>Yes, but only a small number of them are assesing the potential for such side effects to be long term / permanant. The only side effects are somewhat proven to occur in some patients are short term cognative problems which really don't concern me.
Well they concern me, and their existence is confirmed by these studies. The evidence shows that cognitive problems last as long as treatment continues, and that the risk of depression increases with length of treatment, so this is a concern for anyone taking benzodiazepines long-term.
>The assertion that benzodiazapines cause permanant brain damage is intrinsically a very challenging one to establish.
Linkadge, I said no such thing. There is no evidence as yet that benzodiazepines cause permanent brain damage. Heather Ashton herself confirms this. At worst, there are functional changes at receptors that may cause lingering withdrawal symptoms in a minority of individuals. In my own case the withdrawal symptoms disappeared within the first month, full psychological adjustment to living without benzos took longer of course. The cognitive and memory problems were resolved within a week of quitting.
>I still don't see what you are getting at.
I'm saying that the overwhelming body of evidence demonstrates significant cognitive and memory impairment at typical therapeutic doses of benzodiazepines in the majority of subjects. For some people this is a serious problem, others a nuisance, and a small minority seem to be unaffected. When questioned many benzodiazepine users claim to be unaffected, but objective studies of their performance show otherwise. It should be borne in mind that people under the influence of alcohol (and many other drugs) tend to dangerously overestimate their performance and competence, even to the point of denying any impairment at all. The evidence shows a similar effect with benzodiazepines.
>The notion that long term benzo use leads to permanant cognative decline is a relativly recent one. Only time will help to clarify the incidence / validity of such preliminary claims.
See above.
>Hundreds of studies have established the possability that SSRIs can cause sexual side effects. That doesn't mean everybody gets them.
Again, how is this relevant to a discussion of benzodiazepines? I think I've made considerable effort already to be fair in saying a small minority seem to be unaffected by the amnesic and cognitive blunting effects of small doses of benzodiazepines. However, the overwhelming body of evidence demonstrates significant cognitive and memory impairment at typical therapeutic doses of benzodiazepines in the majority of subjects.
>I agreed with you in the beginning that benzodiazapines *can* cause cognative side effects or else I woudn't have started this thread!!?
Yes, that would be logical. However, I think you've spent the majority of this thread trying to prove the contrary.
>You cannot proove however, that every individual who takes a benzodiazapine looses cognative capacity.
I have said no such thing.
>Infact just the existence of one study suggesting that benzdiazapine use can improve cognative performance makes it impossable to prove a totality.
I am not trying to prove a totality. I *am* saying the overwhelming body of evidence demonstrates significant cognitive and memory impairment at typical therapeutic doses of benzodiazepines in the majority of subjects.
Q
Posted by cactus on August 10, 2007, at 16:47:27
In reply to Re: beta carbolines to reverse benzo cognitive pro » linkadge, posted by Quintal on August 10, 2007, at 15:40:17
All I know is that if I get a little drowsy from my benzo's I'll have a coffee and I'm fine
Posted by Quintal on August 10, 2007, at 17:10:52
In reply to Re: beta carbolines to reverse benzo cognitive pro, posted by cactus on August 10, 2007, at 16:47:27
I did more or less the same thing cactus. Actually, we haven't even got round to looking at the original study on beta-carbolines yet have we? Could you dig it out for us please link? I think Ms. Noodle asked a question on this subject further up the thread.
Q
Posted by cactus on August 10, 2007, at 17:28:05
In reply to Re: beta carbolines to reverse benzo cognitive pro, posted by Quintal on August 10, 2007, at 17:10:52
> I did more or less the same thing cactus. Actually, we haven't even got round to looking at the original study on beta-carbolines yet have we? Could you dig it out for us please link? I think Ms. Noodle asked a question on this subject further up the thread.
>
> QThanks qunital, I'm having a coffee right now, well it is 8:30 in the morning on a cold wet winters day.
Posted by cactus on August 10, 2007, at 17:29:44
In reply to Re: beta carbolines to reverse benzo cognitive pro, posted by Quintal on August 10, 2007, at 17:10:52
and I just took my zoloft and rivotril
Posted by Quintal on August 10, 2007, at 17:59:59
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by cactus on August 10, 2007, at 17:28:05
I think all of us on this thread click on our notification updates with a feeling of trepidation and foreboding, so it was a welcome surprise to see your posts cactus. Strange to think of you hanging upside down there beneath my feet, sipping your coffee and quaffing your Rivotril as I type. All of us spinning round on a giant ball, itself just a tiny speck of dust, hurtling through an endless vacuum. Winter in the middle of summer indeed. But enough of my philosophical musings.
Guarana was quite effective at reversing benzo-induced sedation. I'm not sure if it contains beta-carbolines, mainly caffeine and other xanthines if I remember correctly. Gotu Kola also had some beneficial effects.
Q
Posted by cactus on August 10, 2007, at 19:25:42
In reply to Re: beta carbolines to reverse benzo cognitive pro » cactus, posted by Quintal on August 10, 2007, at 17:59:59
> I think all of us on this thread click on our notification updates with a feeling of trepidation and foreboding, so it was a welcome surprise to see your posts cactus. Strange to think of you hanging upside down there beneath my feet, sipping your coffee and quaffing your Rivotril as I type. All of us spinning round on a giant ball, itself just a tiny speck of dust, hurtling through an endless vacuum. Winter in the middle of summer indeed. But enough of my philosophical musings.
>
> Guarana was quite effective at reversing benzo-induced sedation. I'm not sure if it contains beta-carbolines, mainly caffeine and other xanthines if I remember correctly. Gotu Kola also had some beneficial effects.
>
> QThanks Q, I hope you're enjoying summer our winter has been freezing (for OZ that is) it was snowing everywhere last week about 40km's out of melbourne, roads blocked etc, we're not equipped for that. Thankyou also for you suggestions, I'll take them on board, I'm already a guarana energy drink pig.
Posted by Phillipa on August 10, 2007, at 21:03:36
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by cactus on August 10, 2007, at 19:25:42
Almost 40 years now of benzos and on and off them no withdrawal or cognitive impairment as I said guess a freak of nature. And I'm on less now then ever before explain this please? Love Phllipa
Posted by Quintal on August 10, 2007, at 21:47:17
In reply to Re: beta carbolines to reverse benzo cognitive pro, posted by Phillipa on August 10, 2007, at 21:03:36
These are extraordinary claims Phillipa, and they need to be supported by extraordinary evidence. So I'd like to do something else for a change. Could you explain something for me please? I don't think I've ever had a detailed and thorough account of your medication history, and before I can answer your question properly I need more information. I need to know this:
The dose of your first prescription.
The drug.
The duration of your first course of treatment.
Efficacy of this course of treatment on a scale of 1 to 10; 10 being most effective, 1 being least effective.
Reason for terminating.
Dose at termination.
Any withdrawal effects.
Any concurrent medication, if so, dose and duration of treatment.
Reason for restarting medication.
The dose of your first prescription.
The drug.
The duration of your first course of treatment.
Efficacy of this course of treatment on a scale of 1 to 10; 10 being most effective, 1 being least effective.
Reason for terminating.
Dose at termination.
Any withdrawal effects.
Any concurrent medication, if so, dose and duration of treatment.And so on for each course of treatment.
I also need to know how you rate the current efficacy of your benzodiazepines, again efficacy of this course of treatment on a scale of 1 to 10; 10 being most effective, 1 being least effective.
Cognitive impairment is harder to measure subjectively, and I'm not being rude, but I think I've seen substantial evidence of that in your posts over the years here. On the topic of withdrawal symptoms I remember you describing a scenario after the birth of your first daughter where your Valium was discontinued abruptly, and you suffered withdrawal symptoms as a result. I'll search the archives for that post while you're filing out my questionnaire, is that a fair deal?
Also, I have in my possession a few babblemails which run contrary to your claims here. Do you get receipts for your babblemails? I never post details in public that people have given me in confidence, but I'd like you to check your email inbox for a receipt of a babblemail you sent me on 6th April this year.
Q
Posted by Quintal on August 10, 2007, at 22:47:17
In reply to Re: beta carbolines to reverse benzo cognitive pro, posted by Phillipa on August 10, 2007, at 21:03:36
......and chronological order if possible. Thank you.
Q
Posted by Phillipa on August 10, 2007, at 22:57:07
In reply to Re: beta carbolines to reverse benzo cognitive pro » Phillipa, posted by Quintal on August 10, 2007, at 21:47:17
You'll have to find the one I just sent Squiggles as I have to go to bed now. Only thing on not on there is that they started at l0plus and now maybe an 8. When I had my Daughter at age 27 the ob-gyn had given me two seconals in labor false and he and the pdoc prescribed the type of wine I should drink each night while pregant. I think I was on placydil two and l0 or l5mg of valium and the booze and wanted to breast feed didn't work out and quit cold turkey for two weeks and then started back up on 5mg. No more sleeping pills for me or booze in llyears dry. Love Phillipa.
Posted by Phillipa on August 10, 2007, at 23:47:41
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by Phillipa on August 10, 2007, at 22:57:07
Quintal shower over going to bed but I never took a med til after two kids the third was the one. I was told I would have seizures if I cold turkeyed the meds didn't though just felt like on a rocking ship. Slept on the couch for the two weeks the baby was in the hospital then reseumed 5mg of valium. I don't keep copies of babblemails I send only if they pertain to something to do with the board or deputies. Love Phillipa
Posted by Quintal on August 11, 2007, at 1:18:36
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by Phillipa on August 10, 2007, at 22:57:07
Those rocking sensations are something I recognize from my own benzo withdrawals, so from that I think it's fair to conclude that you have suffered withdrawal symptoms at some point. The sensations and feelings you experienced in April this year, when the doctor prescribed huge doses of benzos then reduced the dose suddenly, were also very reminiscent of benzo withdrawal symptoms. I think they were withdrawal symptoms because although there was a strenuous attempt to attribute them to the thyroid problem at the time, the next thyroid test turned out to be normal. When you quit benzos cold turkey many years ago the withdrawal symptoms might have been mild because you were taking only small doses, and they would likely have been mitigated by the sleeping pills you were also taking at the time.
If the benzos are no longer as effective as they were then that would suggest tolerance, and tolerance would be entirely expected after such a long period of continuous use.
The problem with raising and lowering the dose again rapidly, as the doctor did with you, is that (as I posted on the other thread) the benzodiazepine receptors can get locked into an inverse agonist configuration. This means that you can get withdrawal symptoms even in the presence of the drug, and I think this may be one reason in addition to tolerance why you still have so much anxiety despite taking benzos. This can be corrected so that the benzos regain their original efficacy - in other words tolerance can be reversed. I'll explain in more detail when I get up as I'm going to bed now myself. Sleep well.
Q
Posted by linkadge on August 13, 2007, at 9:04:57
In reply to Re: beta carbolines to reverse benzo cognitive pro » linkadge, posted by Quintal on August 10, 2007, at 15:40:17
>I am not trying to prove a totality. I *am* >saying the overwhelming body of evidence >demonstrates significant cognitive and memory >impairment at typical therapeutic doses of >benzodiazepines in the majority of subjects.
Sure, in the majority of the subjects studied. I don't know what the argument is.
Linkadge
Posted by linkadge on August 13, 2007, at 9:16:32
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by linkadge on August 13, 2007, at 9:04:57
>Same again. None of this changes the fact that >therapeutic doses of benzos cause significant >amnesia and cognitive impairment.
I think this was the only statement I thought was a bit of a presumption.
Linkadge
Posted by Quintal on August 13, 2007, at 9:17:29
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by linkadge on August 13, 2007, at 9:04:57
>I don't know what the argument is.
The good thing about opiates, link, is that they give you resilience, for which I am very grateful.
Q
Posted by linkadge on August 13, 2007, at 21:55:27
In reply to Re: beta carbolines to reverse benzo cognitive pro, posted by linkadge on August 9, 2007, at 9:00:13
I read the thread in which I was admittedly less than completly coherant.
http://www.dr-bob.org/babble/20070808/msgs/775011.html
Sometimes, I am responding to too many thoughts at once, which is as you suggest may be realted to my condition.
When I said that you are presuming to "read minds", this was not meant to be taken literally. I was really only responding to what appeared to be some generalizations about the way that medications affect people. While I agree with you about the possability of aformentioned side effects, I don't think it is fair to presume that everbody is effected (equally) by such side effects.I also tried to make an analogy with SSRI's. I said that while they can cause sexual side effects not everbody is affected by them.
I was not presuming that you implied that SSRI's cause sexual side effects in all users, I was only indending to reinforce my point that it is not fair to assume all individuals taking a particular drug are destined to experinece a particular side effects.
I should have been more clear, and I hope this adds clarity. Please feel free to ask about any other issues that were less than clear.
My appolgies,
Linkadge
Posted by Phillipa on August 13, 2007, at 22:03:06
In reply to Re: beta carbolines to reverse benzo cognitive pro » Phillipa, posted by Quintal on August 11, 2007, at 1:18:36
Quintal where did you get this personal info about me which happened years ago today is today tomorrow is tomorrow. Please do not discuss my past as I did not disclose this to you either on the board or in private. If you read something said to someone else does this allow you to bring it up? I don't know. Love Phillipa
Posted by Phillipa on August 13, 2007, at 22:15:13
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by Phillipa on August 13, 2007, at 22:03:06
Quintal my apologies you switched threads my mistake yes that happened when I was 27 many moons ago and I cold turkeyed valium, booze as I drank then, and placydyl as I was prescribed them by my OB-GYN before they knew they affected fetuses. I was determined to breast feed and knew I needed them out of my system before my child came home from the hospital. At the time they kept them for quite a while after hernia surgery. Well I no longer drink ll years ago was my last drink, no sleeping pills and the same dose of valium as then so according to my pdoc I'm well within the limit. And on the other thread my therapist agrees with that pdoc and wants me to see a rheumatologist from the chronic lymes and elevated ANA which of course leads to the hasimotos which she feels strongly is the reason for the anxiety. Hope I cleared it up and my deepest most sincere apolgies for the post of mine above as I am also tired and am heading to bed myself. Nighty night. Love Phillipa
Posted by Quintal on August 14, 2007, at 4:45:03
In reply to Re: beta carbolines to reverse benzo cognitive pro » Quintal, posted by Phillipa on August 13, 2007, at 22:03:06
How could I know about this if you did not disclose it to me? You posted this information to the board some time last year. That's how I know.
Q
Posted by Quintal on August 14, 2007, at 4:48:33
In reply to Re: responce to misunderstanding, posted by linkadge on August 13, 2007, at 21:55:27
No problem link. I'll connect the two threads since what I posted to you on the opiate thread is much the same as what I'd like to say in response to your post here.
http://www.dr-bob.org/babble/20070808/msgs/776148.htmlQ
Posted by FredPotter on August 14, 2007, at 15:30:08
In reply to Re: responce to misunderstanding » linkadge, posted by Quintal on August 14, 2007, at 4:48:33
Right so how do we manage this? In this country they mix codeine and paracetomol in a cunning ploy to prevent the codeine doing anything, since paracetomol is dangerous, but codeine not particularly. I think there needs to be a shift away from the notion that the greatest harm a Dr can do is make a patient an addict. In my view there is greater harm, viz removing one's sex life, causing weight gain and even diabetes, and worst of all allowing a hypocampus-shrinking condition like depression to continue
Fred
Posted by Quintal on August 14, 2007, at 18:57:02
In reply to Getting Doctors to prescribe opiates » Quintal, posted by FredPotter on August 14, 2007, at 15:30:08
I'm not sure how you'd go about asking a doctor to prescribe you opiates for depression. I suppose you could take along one of those bupe studies if you think that would help. I think you'd need to have a pretty good relationship with your doctor for them to seriously consider something like this, obviously. I have a feeling that by far the majority would still refuse though.
In your country there is a high-strength preparation of dihydrocodeine and paracetamol called Panadeine, more info here: http://forum.opiophile.org/showthread.php?p=152432#post152432. I use a similar one called Paramol. I combine it with an ibuprofen-based codeine preparation called Nurofen Plus, I don't know if you can get it where you live. You need to use high-strength preparations because those 8mg tablets are useless for most people, though personally I can detect the effect of 16mg codeine.
You could always try for some real grown-up strength ones by developing the old bad back, or arthritis pain. Tramadol is an interesting opiate having SNRI-like action, and I prefer it to codeine.
Q
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