![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 51. Go back in thread:
Posted by Alan on December 5, 2002, at 9:48:21
In reply to Re: Social Anxiety in OZ (Damn Benzophobes) » Alan, posted by Squiggles on December 5, 2002, at 8:46:49
> I'm sorry I was unsuccessful posting yesterday,
> possibly I am banned for a week or something;
> Try again; Alan, and others, may i say please
> that unless you are a doctor you should not
> prescribe websites where drugs can be gotten.
> That is careless and maybe even illegal.
>
> Of course some benzos are necessary (i take
> K for example) and under the right circumstances
> and for the right duration - details which
> only your doctor should counsel.
>
> May i suggest that people interested should
> at least consult The Merck Physician's Manual
> before taking the advice of a poster.
>
> http://www.merck.com/pubs/mmanual/section15/chapter195/195d.htm
>
> take care
>
> Squiggles===============================================
Actually the bboard is not illegal and is quite informative. I was in no way recommending that a medicine be ordered without consultation with the OP doctor's prescription. THEN the GP or other local doc can help manage. If the govnm't guidelines inhibit the freedonm of choice for patients based on benzophobia, opioidphobia, etc then this is what will happen. Also the exhorbitant prices that are charged in the US for such drugs compared to foreign countries that there is no doubt as to the genesis of this type of bboard for US citizens especially.The Merck Manual is biased and confusing in my opinion. BZDS are in the lowest classification of "possible" risk for abuse and including them on a page with barbituates without quantifying the differences in the two drugs is irresponsible IMO. It gives the consumer the idea that they shouldn't go anywhere near THESE types of drugs if they are being compared to seconal and the like. It is incomplete and misleading in it's LACK of information and is part of the problem contributing to the undue overconcern about prescribing bzds.
alan
Posted by Dinah on December 5, 2002, at 10:06:54
In reply to Re: Social Anxiety in OZ (Damn Benzophobes) » Squiggles, posted by Alan on December 5, 2002, at 9:48:21
Forgive my ignorance, Alan. But what is an OP doctor?
Posted by Squiggles on December 5, 2002, at 10:09:03
In reply to Re: Social Anxiety in OZ (Damn Benzophobes) » Squiggles, posted by Alan on December 5, 2002, at 9:48:21
Good grief - i would say that your assessment
of The Merck is on the side of arrogance,
considering the caliber of doctors who have
contributed to this tome; not to mention the
similarities to other medical reference texts.Could you recommend a better, more 'pro-benzo'
or should i say 'pro-your perspective' medical
reference text, and point to the chapter you
have seen so we can share information?I'm afraid that a catchword like "benzophobic"--
though possibly suited to marketing persuasion
techniques and rhetoric, does not move me; not
in the light of evidence and what doctors are
aware of regarding this class of drugs, including
my own doctor. This does not imply that the
antidepressants, esp. the SSRIs (a glory drug if
i ever saw one) are not with similar problems
of "discontinuation syndrome" which has lately
come to light.As Ray Nimmo used to say (and i believe he
quoted me LOL - "the truth will out"). The truth
does come out after a generation of people taking
a certain class of drugs--it is just difficult
to do with the poor animals that the drugs are
tested on--their lives being nasty, brutish,
and short.
Squiggles
Posted by Alan on December 5, 2002, at 10:35:49
In reply to Re: Social Anxiety in OZ (Damn Benzophobes) » Alan, posted by Dinah on December 5, 2002, at 10:06:54
> Forgive my ignorance, Alan. But what is an OP doctor?
===========================================
Online Pharmacy Doctor...or more correctly, OP referral doctor. A doc that the OP will defer to in order to honor let's say a US script from a US doc for meds that are available only in, or perhaps cheaper in Canada. They Canadian doc just rewrites the script for the Canadian pharm to dispense since the system will not honor US scripts...It's a way around the overcharging in the US and gaining access to meds that a US doc want's to try off label because for instance the wait for FDA approval is so slow. It IS done.
Alan
Posted by Alan on December 5, 2002, at 11:07:58
In reply to Re: Social Anxiety in OZ (Damn Benzophobes) » Alan, posted by Squiggles on December 5, 2002, at 10:09:03
> Good grief - i would say that your assessment
> of The Merck is on the side of arrogance,
> considering the caliber of doctors who have
> contributed to this tome; not to mention the
> similarities to other medical reference texts.Sorry I was not clear enough in my explanation. It is the EDITING for common consumption that I am referring to. I have no problem with the part on bzds except that it is perhas incomplete, specifically:
"Withdrawal from benzodiazepines produces a similar withdrawal syndrome, although it is rarely as severe. The syndrome may be slow in onset because the drugs remain in the body a long time. A withdrawal syndrome of varying severity has been reported in persons who have taken therapeutic doses, although the prevalence of this unusual phenomenon is unknown. Withdrawal may be most severe in those who used drugs with rapid absorption and quick decline in serum levels (eg, alprazolam, lorazepam, triazolam). Many persons who misuse benzodiazepines have been or are heavy users of alcohol, and a delayed benzodiazepine withdrawal syndrome may complicate alcohol withdrawal. The benzodiazepine receptor antagonist flumazenil has been approved for treatment of severe sedation secondary to benzodiazepine overdose. Its clinical usefulness is not well defined because most persons who overdose on benzodiazepines recover without intervention. Occasionally, when used to reverse sedation, flumazenil precipitates seizures."
But the CONTEXT in which it appears gives it nearly the same stigma and fear factor as the other more heavy-duty CNS depressants - especially to the med-phobic anxity sufferer. It's medically correct but incomplete but not put into context as to it's risk factor (for instance that it is in the lowest classifications of scheduled meds for abuse potential, class IV - "very low abuse potential".
>
> Could you recommend a better, more 'pro-benzo'
> or should i say 'pro-your perspective' medical
> reference text, and point to the chapter you
> have seen so we can share information?This is old ground. The WHO report prety much sums it up for me along with the more recent one about SSRI withdrawal.
>
> I'm afraid that a catchword like "benzophobic"--
> though possibly suited to marketing persuasion
> techniques and rhetoric, does not move me; not
> in the light of evidence and what doctors are
> aware of regarding this class of drugs, including
> my own doctor. This does not imply that the
> antidepressants, esp. the SSRIs (a glory drug if
> i ever saw one) are not with similar problems
> of "discontinuation syndrome" which has lately
> come to light.
>
> As Ray Nimmo used to say (and i believe he
> quoted me LOL - "the truth will out"). The truth
> does come out after a generation of people taking
> a certain class of drugs--it is just difficult
> to do with the poor animals that the drugs are
> tested on--their lives being nasty, brutish,
> and short.
>
>
> SquigglesBZDS have been aroud almost 50 years and have exhausted their life-cyle of overprescription and real life clinical testing and the key results are in (if 50 years means anything or everything to anybody or everybody, who knows?).
They are some of the most safe reliable anxiolytics on the planet WHEN PRESCRIBED AND MANAGED PROPERLY as implied in the WHO report. Even the title of the report, "The Rational Use of BZD's" implies this basic concept.
I don't believe that the present debate is a pro/anti one and think that this analysis misses the entire point. It's not as black and white as that. It actually muddles the issue.
It's the grey areas that are not being considered that does the individual in treatment the biggest disservice. Not offering bzds on equal footing with all other anxiety treatments is not a "PRO" benzo stance but is really the "compromise" or moderate position in light of all of the evidence.
The PRO bzd stance would be to say, "no therapy, no anthing, just bzds all of the time". In that context the persctive broadens quite a bit...because there are those biopsychiatrists that take this stance not only with the bzds but even moreso - to an appaling degree with the commercially driven AD's.The "truth" is not fact alone or is it purely "evidence" either. If an individual is to be administered to with respect and freedom of choice, this bias against the use of bzds should essentially be taken out of the picture.
More later..
alan
Posted by Squiggles on December 5, 2002, at 11:43:42
In reply to Re: Social Anxiety in OZ (Damn Benzophobes) » Squiggles, posted by Alan on December 5, 2002, at 11:07:58
Alan,
To do the issue justice, i could go back
to my notes and posts at "Benzoland" and
retrieve all the research I have done, as
well as the debated in The House of Lords
and the voluminous evidence Charles Medawar
and others have collected. There are books,
articles, doctors's testimonials, patients'
testimonials -- there is enough evidence
for the huge civil lawsuit that was started
in England some years ago, but dropped for
lack of funds.Please don't make me go through it again - you
can look for yourself.At the end of the day, I do believe that no
matter what contrary evidence i prsented (for
example it is 25 years that the benzos have
been used, the practice of giving them on
a daily basis for anxiety is presently being
dropped, the realization by the Brits and the
Canadians at least, that rage accidents, pilot
mistakes, domestic violence, car accidents,
rebound panic attacks, psychotic episodes, insomnia,
elderly falls and breaks of bones, etc.
can all result from habituation to these
drugs and do.When I got off the Xanax (which gave me years of
panic attacks) my doctor congratulated me. Why?
Because it is almost impossible to get off.
Also, your assertion that this habituation could
be managed and that i needed the drugs in the first
place is wrong on two counts: One, the anxiety
may have been percipiated by something else, e.g.
hyperthyroidism (in my case), and secondly, you
are proposing indirectly that someone started on
Xanax at the age of 16, should continue to take
them forever -- that would require the accumulation
of the dose. My own doctor, did not want to raise
the dose after it got high in his opinion. Why?
Because a high dose of benzos lead to a high
and more intense accumulation of side effects, not
to mention the interaction with other drugs. Case
in point, I had dyspnea at the higher levels of
benzos before I lowered them.As for the Rivotril, I am not so sure that I have
epilepsy just because i am bipolar. I think that
was a vogue 20 years ago to diagnose bipolars as
being a species of epileptics and therefore add
an anti-convulsant. I felt perfectly OK when i
was given Rivotril with just the lithium. I did not
know why i was given it. But i know, and my
doctor knows that after 15 years i cannot get off
with a seizure or a stroke or both.And one last point: these are not individual
guidelines that i have been treated under - these
are the medical and pharmacological state of the
art that has been practiced on everyone with
bipolar disorder or affective and anxiety disorders
in the past 25 years.But, as you said, or should I say, complained,
they are presently being changed on account
of the horrendous addiction and withdrawal
phenomena now cited in the medical literature
and legal records.As for WHO -- if any report i have read is
general - it is that one. But, as i said
the truth will out, especially if it is the
administrators, the doctors, and the health
professionals who take these drugs. There is
nothing like experience to provide conviction
in a theory of this type.Squiggles
Posted by Alan on December 5, 2002, at 13:34:55
In reply to Re: Social Anxiety in OZ (Damn Benzophobes) » Alan, posted by Squiggles on December 5, 2002, at 11:43:42
> Alan,
>
> To do the issue justice, i could go back
> to my notes and posts at "Benzoland" and
> retrieve all the research I have done, as
> well as the debated in The House of Lords
> and the voluminous evidence Charles Medawar
> and others have collected. There are books,
> articles, doctors's testimonials, patients'
> testimonials -- there is enough evidence
> for the huge civil lawsuit that was started
> in England some years ago, but dropped for
> lack of funds.Well then the movement wasn't so big and overriding a health issue after all then was it?
>
> Please don't make me go through it again - you
> can look for yourself.
>
> At the end of the day, I do believe that no
> matter what contrary evidence i prsented (for
> example it is 25 years that the benzos have
> been used, the practice of giving them on
> a daily basis for anxiety is presently being
> dropped, the realization by the Brits and the
> Canadians at least, that rage accidents, pilot
> mistakes, domestic violence, car accidents,
> rebound panic attacks, psychotic episodes, insomnia,
> elderly falls and breaks of bones, etc.
> can all result from habituation to these
> drugs and do.Well then there are a lot of other drugs that can just as well lead to the same outcome but they aren't singled out by political bodies and scare tactics and half-truths put out by Benzo.org. This is simple catastophising for purely political purposes (House of Commons debate about the pushes and pulls regarding the commercialisation of the newest drugs such as AD's to treat anxiety) and the whole rationale of throwing the baby out with the bathwater is rediculous and an overreaction IMO and many doctors that specialise and use these medications in monotherapy know this as well.
Do Doctors consult benzo.org for their medical information? No. They assess individual needs if they are good ones - or alternatively if part of a big HMO or NHS, put the ssri flavor of the month in front of the patient after a 5 min consult after having waited 2 months to be referred to a psych that more often than not has an instinctive cookie-cutter corporate mentality because of their training influenced directly by the drug co's...even down to the medical school level in many cases.
>
> When I got off the Xanax (which gave me years of
> panic attacks) my doctor congratulated me. Why?
> Because it is almost impossible to get off.Impossible to get off FOR YOU.
> Also, your assertion that this habituation could
> be managed and that i needed the drugs in the first
> place is wrong on two counts: One, the anxiety
> may have been percipiated by something else, e.g.
> hyperthyroidism (in my case),Then that's simple misdiagnosis and misprescribing as many cases are. One doesn't just start throwing psychotropic meds unless a complete physical study is done first....especially thyroid!
>and secondly, you
> are proposing indirectly that someone started on
> Xanax at the age of 16, should continue to take
> them forever -- that would require the accumulation
> of the dose. My own doctor, did not want to raise
> the dose after it got high in his opinion. Why?
> Because a high dose of benzos lead to a high
> and more intense accumulation of side effects, not
> to mention the interaction with other drugs. Case
> in point, I had dyspnea at the higher levels of
> benzos before I lowered them.Well, I suppose if you weren't misprescribed in the first place there wouldn't have been this experience. But I really don't know and you seem to really not know. I don't know why I was prescribed AD's for 8 years for an anxiety disorder and suffered greatly because of it until I was prescribed without bias a bzd. I'm a victim of the system too.
A 16 year old needing an axiolytic most definitely stay on the drug if they are symptomatic. Lifetime? I never proposed such a thing. What are the alternatives if medication is in the end needed? To be habituated to an AD that DOESN'T treat symptoms adequately - and suffer worse withdrawals because that's what the latest reports worldwide are telling us via that meaningless organisation called the WHO. Should they go untreated and suffer the consequences both socially and medically of missing life's opportunities for fear of "possible" long term effects?
That's a PERSONAL decision and needs to be presented as such for individual assessment *in perspective*...not by governments, by pharm reps and their corporate docs with some of their anti bzd-babble, not by anyone.
It's all a cost/benefit assessment. That should be left up to doctors and their patients and no one else - not government run health care systems unduly influenced by political and moralistic organisations such as benzo.org with their extrapolations for what's good for society based on, at best, very limited reports of their lack of safety.
>
> As for the Rivotril, I am not so sure that I have
> epilepsy just because i am bipolar. I think that
> was a vogue 20 years ago to diagnose bipolars as
> being a species of epileptics and therefore add
> an anti-convulsant. I felt perfectly OK when i
> was given Rivotril with just the lithium. I did not
> know why i was given it. But i know, and my
> doctor knows that after 15 years i cannot get off
> with a seizure or a stroke or both.
>
> And one last point: these are not individual
> guidelines that i have been treated under - these
> are the medical and pharmacological state of the
> art that has been practiced on everyone with
> bipolar disorder or affective and anxiety disorders
> in the past 25 years.How could they be state of the art if they are 25 years old? Sorry but the contoversy is a limited one and no amount of exggeration based on individual cases as is the case on bzd.org is going to change the strident, vocal minority rhetoric that the site engages in.
>
> But, as you said, or should I say, complained,
> they are presently being changed on account
> of the horrendous addiction and withdrawal
> phenomena now cited in the medical literature
> and legal records.Huh? Maybe you complained about this but I haven't.
>
> As for WHO -- if any report i have read is
> general - it is that one. But, as i said
> the truth will out, especially if it is the
> administrators, the doctors, and the health
> professionals who take these drugs. There is
> nothing like experience to provide conviction
> in a theory of this type.
>
> SquigglesConviction isn't enough without evidence that shows truth. The WHO report which you cite as general would be more aptly described as broad and providing perspective based on the study of 40+ years of independent research by one of the most prestigious non-commercially influenced organisations in the world.
Post whatever you feel you must but after awhile, the rhetoric comes awfully close to looking like crying fire in a crowded theatre.
Do you have a risk/benefit analysis formed of the 10 top AD's too, the same for Maoi's, the same for seroquel, neurontin, etc, etc, etc....all used to treat the symptoms of anxiety disorders?
That's the real issue.
Perspective and context. Otherwise it's just another boogey man agenda being carried out by those few that have gotten burned by the infrequent unexplainable bad reaction, misdiagnosis, misprescribing, or mismangement...all of the very same pitfalls that should be afforded to the other psychotropics, not just the lowly bzd.
Alan
Posted by Squiggles on December 5, 2002, at 13:48:59
In reply to Re: Social Anxiety in OZ (Damn Benzophobes), posted by Alan on December 5, 2002, at 13:34:55
You seem determined to put the onus on
any other cause BUT the benzodiazepine
addiction and withdrawal problem.So, it looks like I WILL have to rehash
and reserve the research. I will try
to prepare something that covers your
posts, but i want you to give me some
kind of proof first that you are not infact
cognizant of part of this party or knowledge
is you like; that is that you are not infact
using me for devil's advocacy. Cause i'm
really tired of this... hope you understand;Squiggles
Posted by Squiggles on December 5, 2002, at 15:17:55
In reply to Re: Social Anxiety in OZ (Damn Benzophobes) » Alan, posted by Squiggles on December 5, 2002, at 13:48:59
One primary point i forgot to make
about all this Alan: the impact of
benzos on my life.I believe, as Ray Nimmo explained to me,
and as i now see in retrospect, i would
never have been diagnosed as bipolar if
i had not taken Valium for exam jitters.
The withdrawals may have mimicked manic
depression. Consequently, i would never
have lost my thyroid function, never taken
Klonopin, never taken Xanax, never had
panic attacks, never ruined my academic
career, never lost my final job, and basically
never have ruined my life.Squiggles
Posted by Alan on December 5, 2002, at 16:36:52
In reply to Re: Social Anxiety in OZ (Damn Benzophobes) » Squiggles, posted by Squiggles on December 5, 2002, at 15:17:55
> One primary point i forgot to make
> about all this Alan: the impact of
> benzos on my life.
>
> I believe, as Ray Nimmo explained to me,
> and as i now see in retrospect, i would
> never have been diagnosed as bipolar if
> i had not taken Valium for exam jitters.
> The withdrawals may have mimicked manic
> depression. Consequently, i would never
> have lost my thyroid function, never taken
> Klonopin, never taken Xanax, never had
> panic attacks, never ruined my academic
> career, never lost my final job, and basically
> never have ruined my life.
>
> Squiggles
============================================And this is exactly what is wrong with Ray Nimo's ideology - ANY idealogy. Anyone can make an argument for what one specific thing ruined their life if they choose to blame the drug (which in your individual case and a RELATIVELY few others, it perhaps may have been) but to extrapolate as he has that because this thing happened to you that bzds are the spawn of the devil exclusive of all other possibilities - and therefore for everyone else - is pure nonsense.
You were misdiagnosed and mismanaged. If I took seroquel because I was misdiagnosed with something and sufferered greatly for it, would I more likely find fault with the drug or the doctor? If valium withdrawal was misdignosed as Bi polar then why blame the valium? As you've described it, you were mismanaged, misdiagnosed AND misprescribed...a literal "hat trick".
I could do the same for AD's. Sure they've caused a lot of loss in my life and I could therefore blame the entire class of drug itself. OR I could find out why I was misprescribed, misdiagnosed and mismanaged. That I finally did...commercial interests trumping medicine.
Perhaps you won't be as fortunate as I, not finding a personally satisfying, conclusive answer and I suppose therefore you may always wonder. It's a terrible bind to be in and I'm not saying this to patronise but out of compassion.
We share a lot I suppose. Moreso than perhaps we understand through this sterile medium of the internet. But I see no meaningful purpose, no positivism, no hope, in universalising for all others via personal stories and exploiting them for their own political zeal as benzo.com does. It's zealotry, it's a crusade...I'm reminded of the rotating symbol at the bottom of the home page of benzo.org with the symbols of the fish and cross.
On top of everything else I've read and seen done with the information used on that site to scare people by exaggerating overall risk, that symbol seems to sum it's approach up for me.
I am not interested in "using" you as a devil's advocate. I only assert from what I know in response to the misunderstandings about the medication and it's usage.
Are there cases of the drug causing harm? Sure? Any more than any other drug - even when prescribed and managed properly? NO. And that's my point. The jury of 50 years is in and it looks good for those in the general population that take bzds short or long term. Its the quality, not quantity of life in your years. Why suffer needlessly when there are choices.
The problem is that if the choices are witheld there is an inherent loss of freedom for the patient to choose their own destiny.
That is if they are even aware there are choices in the first place. Anti-benzo zealotry as practiced by these kinds of organisations take away choice for the doctor and patient either via political pressure or on purely moral grounds. The claims to scientific or medical authenticity are so overwhelmingly in favor of using bzds on an equal footing with other medications that it's not even close.
Hence the title of this thread and the impetus for this discussion to even exist.
Best,
Alan
Posted by Alan on December 5, 2002, at 16:48:58
In reply to Regarding Benzophobia, posted by Alan on December 5, 2002, at 16:36:52
Doctors have little or no knowledge about how to use the BDZs, even as they explore a new psychiatric drug every month that claims to treat anxiety diorders/panic.
It took me several years on my own (and with guidance from a doc that knows them as well as anyone) to really learn how to work with my bzds, and I am still learning more. It is completely unrealistic to expect that a busy family doctor is going to get intimate with a new psychotropic a month -- with many of them being used for panic disorder.
There is no real scientific literature on drugs as it is almost always biased by financial interests. This was always the case, but doctors did make up their own minds after a while and a sort of collective wisdom emerged...as is now being seen with the bzds and the bias against them. They've been the whipping boy of the competeing AD's for over 12 years now, the AD promotions starting just in time as the backlash of overprescribing bzds was finally easing and the drug was being understood for what it could do for many.
Practicing proper medicine it seems seeks to achieve the standard of care in our communities as the baseline. So there is a tendency towards a herd mentality. In depth understanding seems to have given way to a more shallow familiarity with trends. I just seem to keep digging deeper into just what bzds will and won't do and how best to use them in my individual case.
Posted by Alan on December 5, 2002, at 16:59:13
In reply to Re: Social Anxiety in OZ (Damn Benzophobes) » Alan, posted by Squiggles on December 5, 2002, at 13:48:59
> You seem determined to put the onus on
> any other cause BUT the benzodiazepine
> addiction and withdrawal problem.
>
> So, it looks like I WILL have to rehash
> and reserve the research. I will try
> to prepare something that covers your
> posts, but i want you to give me some
> kind of proof first that you are not infact
> cognizant of part of this party or knowledge
> is you like; that is that you are not infact
> using me for devil's advocacy. Cause i'm
> really tired of this... hope you understand;
>
> Squiggles
=============================================I am not exactly sure what is meant by this but I'll dance with you as long as you like. I'll let you know when I give up.
Better yet, why don't we just agree to disagree? It's all there for people to read from before. Let the readers of this bboard decide for themselves. I'm not here to talk only AT you (no offense) but to relate my understanding of the situation as I perceive it in the hopes of providing some form of positivism where there is some. Some hope-giving for those that I find in similar situations as I in the past.
If I had (as many others have similarly experienced) been still duking it out on AD's and everything else BUT bzds at this point, I would have lost everything: my job, my relationships, my life possibly.
Alan
Posted by Squiggles on December 5, 2002, at 17:10:10
In reply to Regarding Benzophobia, posted by Alan on December 5, 2002, at 16:36:52
I see your point. Nothing is certain
of course, but your perspective as you
describe it has certainly plagued my
thoughts; part of the problem in these
gray area cases, is that you can't test
for the diagnosis; indeed, you can't (in
my case and many others) even take the
person off the drugs to see the result.So, inadvertenlty, in cases of doubt,
the manic depressive must remain so;
the unipolar may be switched to another
AD, but certainly cannot be taken off
after many years of taking the drug.
And in the case of schizophrenia or
psychoses, i wonder how many women for
example, have not had post-pratum depression
mistaken for something else.A wrong diagnosis which goes on treated
as such for a long time can be devastating.
Once a schizophrenic, always a schizophrenic.These are practical problems with pretty
severe life-long consequences. I cannot
blame Ray for being so ideological; as
for his swirling fish -- i never could
take it seriously. He has such a great
sense of humour, that i think he put it there
to do a one-upmanship on Rand's. I think
Ray's is a lot more frisky. LOLThanks for your kind words.
Squiggles
Posted by Squiggles on December 5, 2002, at 17:39:14
In reply to Re: Social Anxiety in OZ (Damn Benzophobes) » Squiggles, posted by Alan on December 5, 2002, at 16:59:13
OK. But I'm always ready for the next match.
You have a very sincere and soothing tone --
i don't mean that you have put me to sleep,
but i do feel like letting my end go for a
while.Squiggles
Posted by bluedog on December 6, 2002, at 3:23:10
In reply to Re: Regarding Benzophobia - PS., posted by Alan on December 5, 2002, at 16:48:58
> Doctors have little or no knowledge about how to use the BDZs, even as they explore a new psychiatric drug every month that claims to treat anxiety diorders/panic.
>
> It took me several years on my own (and with guidance from a doc that knows them as well as anyone) to really learn how to work with my bzds, and I am still learning more. It is completely unrealistic to expect that a busy family doctor is going to get intimate with a new psychotropic a month -- with many of them being used for panic disorder.
>
> There is no real scientific literature on drugs as it is almost always biased by financial interests. This was always the case, but doctors did make up their own minds after a while and a sort of collective wisdom emerged...as is now being seen with the bzds and the bias against them. They've been the whipping boy of the competeing AD's for over 12 years now, the AD promotions starting just in time as the backlash of overprescribing bzds was finally easing and the drug was being understood for what it could do for many.
>
> Practicing proper medicine it seems seeks to achieve the standard of care in our communities as the baseline. So there is a tendency towards a herd mentality. In depth understanding seems to have given way to a more shallow familiarity with trends. I just seem to keep digging deeper into just what bzds will and won't do and how best to use them in my individual case.
>
>
>Hi Alan
Thankyou for your views on this topic. I'm just wondering whether you could share some of your experience as how to properly work with the benzo's? I would really appreciate this.
What Benzo's have you taken during the years?
I am currently on Diazepam for social anxiety? I am in the experimental stage as to how to get this drug to work best for me.
I currently take 2.5mg Diazepam at night and another 2.5mg in the morning.
Is this enough to treat my social anxiety?
Would 5mg at night and 5mg in the morning be a better combination?
Or perhaps 5mg at night, 2.5mg in the morning and 2.5mg in the afternoon?
Is it best to take it with food or better to take it on an empty stomach between meals?I definitely found the 1st couple of weeks of taking Diazepam the hardest and I had to exercise discipline not to take more because it initially gave me a bit of euphoria but fortunately that has settled down and now and this so called addictive craving effect has passed and I now consider the drug as helpful and as healing for my condition as my generic Prozac at 20mg per day and I no longer give it a second thought. I find the Diazepam and the Prozac very complimentary as the Prozac is activating whilst the Diazepam reduces my anxiety giving my mind sufficient rest to start the healing process. This includes giving me restful and healing sleep! I do NOT believe that the Diazepam interferes with my natural sleep cycle because I am still dreaming (and recalling my dreams) and I am waking up refreshed and without any drowsiness! In fact since starting the Diazepam I am actually MORE alert during the day with HEAPS more stamina and concentration!
I noticed that Benzo's are also now used to treat chronic fatigue syndrome which as I mentioned above I am also suffering from. See the attached link as an example http://www.immunesupport.com/library/showarticle.cfm/id/3154/searchtext/klonopin/
I fully agree with you that proper treatment means getting the right diagnosis and then the doctors practicing responsible medicine by using the right medications for the right illnesses. In other words it boils down to professional and competent medical management which unfortunately is in rather short supply in western society.
Looking forward to your response to my questions
regards
bluedog
Posted by joy on December 6, 2002, at 9:50:54
In reply to Re: Social Anxiety in OZ (Damn Benzophobes) » Alan, posted by Squiggles on December 5, 2002, at 8:46:49
Squiggles,
Please abstain from the holier than thou attitude. Many doctors will not prescribe benzos, and they do help most people. I have a life now because of Xanax, and I take less than when I started. My family doc won't prescribe it, I have to go to a shrink to get it. Alan is entitled to post what he did. Everyone has to do what they think is right; we all have doctors. He was not telling people what to do. I'm sorry you had problems with the benzos, but I've had problems with the ADs that are frequently prescribed and handed out like candy. You should try to see the other point of view. I am trying to understand yours.
Joy
Posted by Squiggles on December 6, 2002, at 12:16:57
In reply to Re: Social Anxiety in OZ (Damn Benzophobes) » Squiggles, posted by joy on December 6, 2002, at 9:50:54
Joy,
I don't know why you consider my attitude
as such; whatever i report about benzos
is from my experience, which does coincide
with the experience of some other people;
but to be fair, i don't have any statistics.As for ADs, i have a friend whom i have seen
has had trouble getting off one AD for another,
but nothing in comparison to benzos -- again,
it would take more than just a few people
to answer Alan's retort 'FOR YOU PERHAPS';
There are other variables to any drug state,
but when you take the intervening variables
away, a clearer picture may emerge.Squiggles
Posted by Alan on December 6, 2002, at 16:57:55
In reply to Re: Regarding Benzophobia - PS. » Alan, posted by bluedog on December 6, 2002, at 3:23:10
> Hi Alan
>
> Thankyou for your views on this topic. I'm just wondering whether you could share some of your experience as how to properly work with the benzo's? I would really appreciate this.
>
> What Benzo's have you taken during the years?
Over the last 20 years I've undergone clinical trials with Klonopin, Valium, Ativan, and Xanax. Presently on klonopin maintainence at .5mg 3X's a day and ativan 1mg 3X's a day.
>
> I am currently on Diazepam for social anxiety? I am in the experimental stage as to how to get this drug to work best for me.
>
> I currently take 2.5mg Diazepam at night and another 2.5mg in the morning.
> Is this enough to treat my social anxiety?
> Would 5mg at night and 5mg in the morning be a better combination?
> Or perhaps 5mg at night, 2.5mg in the morning and 2.5mg in the afternoon?
> Is it best to take it with food or better to take it on an empty stomach between meals?According to dosing instructions you are at the relatively LOW end of the spectrum since the range is 2 - 10mg's, 2 - 4 times daily. That's between 4 and 40 mgs sum total.
The only way to know what works best for you is to perform your own clinical trial. No one can tell you how you will do based on a preconcieved template for what is given as a "statistical average". You are not a statistic afterall.
You will have to be able to distinguish between the feelings of withdrawal and the return of your orginal symptoms (both being anxiety but slightly different types - one will be distinguishable as drug induced with a little experience). Knowing this will tell you when the drug has or is beginning to lose it's theraputic effect. Only then will you know when and how much to titrate your dosage. This is what mixes many up.
I've tried klonopin 2, 3, and 4X's a day and found a level that felt comfortable to treat my GAD symptoms.
The caveat being, anxiety fluctuates, waxes and wanes, at varying degrees and speeds over time. So three times a day may be fine but you may find some weeks or months needing to add a little before bed or in the middle of the day. That is alright. Only if the dose suddenly escalates rapidly from 10 to let's say 40 -50 mgs in a few days would I become concerneed that the med is not right for you.
>
> I definitely found the 1st couple of weeks of taking Diazepam the hardest and I had to exercise discipline not to take more because it initially gave me a bit of euphoria but fortunately that has settled down and now and this so called addictive craving effect has passed and I now consider the drug as helpful and as healing for my condition as my generic Prozac at 20mg per day and I no longer give it a second thought. I find the Diazepam and the Prozac very complimentary as the Prozac is activating whilst the Diazepam reduces my anxiety giving my mind sufficient rest to start the healing process. This includes giving me restful and healing sleep! I do NOT believe that the Diazepam interferes with my natural sleep cycle because I am still dreaming (and recalling my dreams) and I am waking up refreshed and without any drowsiness! In fact since starting the Diazepam I am actually MORE alert during the day with HEAPS more stamina and concentration!This "euphoric" effect is usually not a craving per se but a relief of symptoms. There's a HUGE distinction that needs to be made, usually is not, and the fear of "addiction" suddenly becomes the boogeyman. I hope that you understand the difference between "addiction" and sustained medical dependence.
If you are fine at your current dose then stay there. But if the anxiety waxes and wanes you may need to titrate your dosage.
The different bzds act differently for different individuals - just like any other psychotropic. Here is a bzd eqiv. chart for you:
http://www.dr-bob.org/tips/bzd.html
If you want to "exchange out" one for the other there is a system to follow that many docs also do not know how to use. But it's too involved to go into here...
Best,
Alan
>
> I noticed that Benzo's are also now used to treat chronic fatigue syndrome which as I mentioned above I am also suffering from. See the attached link as an example http://www.immunesupport.com/library/showarticle.cfm/id/3154/searchtext/klonopin/
>
> I fully agree with you that proper treatment means getting the right diagnosis and then the doctors practicing responsible medicine by using the right medications for the right illnesses. In other words it boils down to professional and competent medical management which unfortunately is in rather short supply in western society.
>
> Looking forward to your response to my questions
>
> regards
> bluedog
>
>
Posted by Squiggles on December 6, 2002, at 17:18:06
In reply to Re: Regarding Benzophobia - PS. » bluedog, posted by Alan on December 6, 2002, at 16:57:55
Re: Benzo Equivalence Chart
http://www.dr-bob.org/tips/bzd.html
I don't mean to be too intrusive here, but
i recognize the benzo equivalence chart.
That's because i worked on such charts with
Ray Nimmo and David Woolfe and Jan. I recall
that we were struggling with a number of
equivalence presentations and had queries
over how they differed from one medical text
to another. If I remember correctly, we
finally settled on Dr. Heather Ashton's
equivalence chart as the fairest, on account
of the clonazepam being given a higher
value than alprazolam. Of course, the
comparison is arbitrary from a pharmarcological
point view, as the effect on the state to
be corrected or reversed is what counts - and
that varies with individuals.It's quite a coincidence to find it here
and it makes me wonder if you people weren't
working there all along (Benzoland that is).Squiggles
Posted by Alan on December 6, 2002, at 18:25:27
In reply to Re: Regarding Benzophobia - PS. » Alan, posted by Squiggles on December 6, 2002, at 17:18:06
> Re: Benzo Equivalence Chart
>
> http://www.dr-bob.org/tips/bzd.html
>
> I don't mean to be too intrusive here, but
> i recognize the benzo equivalence chart.
> Of course, the
> comparison is arbitrary from a pharmarcological
> point view, as the effect on the state to
> be corrected or reversed is what counts - and
> that varies with individuals.
>
> It's quite a coincidence to find it here
> and it makes me wonder if you people weren't
> working there all along (Benzoland that is).
>
> Squiggles
================================================
Very dry wit there Squiggles!I doubt that the authors, Mssrs Plunkett and also the staff at "Clinical Handbook of Psychotropic Drugs, 4th revised edition, Bezchlibnyk-Butler et al. editors (Clarke Insitute of Psychiatry, Toronto), Hogrefe & Huber", ever thought of consulting with or have ever looked at the benzo.org website - but WHO knows (no pun intended).
IMHO the reality of these anti-benzo websites are that they are practicing fear-mongering (the intentional creating of fear).If these types of sites are where people with a problem come and find a solution, then that would not be fear-mongering.
The fear-mongering I see is when that relationship gets turned on its head -- it's not a problem in search of a solution, it's a solution in search of a problem.
That would be when anyone goes out and changes or steers the topic of just about every discussion about benzodiazapines into past, present, or imminent addiction to benzodiazepines. That would be when people receive scary messages telling them that benzodiazepines will ruin their health and their sanity and make them "drug addicts". The implication is clear with the "A" word freely used in the pejorative with heroin and cocaine - with no mention of the distinction between addiction and sustained medical dependence and the dumbing down of the distinction of drug classifications from schedule IV to schedule I.
Say what you want about my frequent harping on the neglected role of doctors to know their stuff - esp. regarding bzds. I don't claim it applies to everyone because it doesn't. And at least it's an inherently positive message that offers hope rather than dread. In fact, it's a message that has led some people to blessed relief of thier symptoms after being denied the very medication that was desiged specifically to treat anxiety disorders.
Alan
Posted by Squiggles on December 6, 2002, at 19:21:44
In reply to About Benzo's and positivism:, posted by Alan on December 6, 2002, at 18:25:27
Well,
just in case you guys want to peak and
you are too busy to go there, here is a
good sample on the benzos at least:
http://www.benzo.org.uk/profash.htm
btw, i notice your use of the term "positivism"
-- are you using it in a philosophical sense
or just trying to cheer us up?Squiggles
Posted by Alan on December 6, 2002, at 19:38:11
In reply to Re: About Benzo's and positivism: » Alan, posted by Squiggles on December 6, 2002, at 19:21:44
> Well,
>
> just in case you guys want to peak and
> you are too busy to go there, here is a
> good sample on the benzos at least:
>
>
> http://www.benzo.org.uk/profash.htm
>
>
> btw, i notice your use of the term "positivism"
> -- are you using it in a philosophical sense
> or just trying to cheer us up?
>
> Squiggles
===============================================I would guess that the two are not mutually exclusive.
If you want to see how most that visit the website are greeted, you may want to try the homepage too:
Posted by bluedog on December 6, 2002, at 20:35:52
In reply to Re: Regarding Benzophobia - PS. » bluedog, posted by Alan on December 6, 2002, at 16:57:55
>
> > I am currently on Diazepam for social anxiety? I am in the experimental stage as to how to get this drug to work best for me.
> >
> > I currently take 2.5mg Diazepam at night and another 2.5mg in the morning.
> > Is this enough to treat my social anxiety?
> > Would 5mg at night and 5mg in the morning be a better combination?
> > Or perhaps 5mg at night, 2.5mg in the morning and 2.5mg in the afternoon?
> > Is it best to take it with food or better to take it on an empty stomach between meals?
>
> According to dosing instructions you are at the relatively LOW end of the spectrum since the range is 2 - 10mg's, 2 - 4 times daily. That's between 4 and 40 mgs sum total.
>
> The only way to know what works best for you is to perform your own clinical trial. No one can tell you how you will do based on a preconcieved template for what is given as a "statistical average". You are not a statistic afterall.
>Thankyou very much for your advice Alan. I really appreciate it.
>
> This "euphoric" effect is usually not a craving per se but a relief of symptoms. There's a HUGE distinction that needs to be made, usually is not, and the fear of "addiction" suddenly becomes the boogeyman. I hope that you understand the difference between "addiction" and sustained medical dependence.
>
> >Yes!!! I definitely know the difference. I used to be addicted to alcohol. If there is a substance that has the potential to be "evil" then alcohol is it (I don't really believe that alcohol is evil as such but just that when someone is addicted to it "evil" things can occur with it's (ab)use). Whats more, alcohol is completeley legal and you don't even need a prescription to obtain it. At the height of my addiction, even after just one or two drinks I would desperateley drive around town trying to find a "bottle shop" that was open so that I could get some more (this could be at 2am or 3am in the morning). At parties I used to be completeley pre-occupied about where the next drink was coming from and I used to get frustrateted when the host didn't offer the next drink fast enough for my liking.
The Diazepam does cause me to behave in such an innappropriate way. Yes, I was initially reluctant to try Diazepam because it had taken me a lot of effort to break my alcohol addiction and I was frightened that I would be substititing one addiction for another especially having heard all the "horror" stories about the benzo's. However once I started researching this issue and looked at balanced, reasonable information on the issue my views changed rather rapidly. I realised that benzo "addiction" really only occured due to medical mis-management and especially because benzo's have been handed out like candy by doctors in the past for completeley innapropriate illness or conditions. It's exactly the same problem that has been created by doctors handing out antibiotics like candy for every little sniff or cough that patients present with. And we all know the results of this medical mismanagement with immune systems being devastated and bacterial organisms mutating into superbugs because of chronic over-prescription of the antibiotics. This is ALL because it's much easier and much more profitable for doctors to write out a prescription than to actually spend time and effort finding out what is truly wrong with a patient.
Anyway the end result of my research is that I decided to give the benzos a try and I am glad that I did. In fact since commencing with Diazepam I can have a couple of drinks again and not even give the matter another thought. It is such an absolute relief to be able to focus on the conversations at a party rather than obsessing about the next drink. I DEFINITELY attribute this to the Diazepam relieving my social anxiety symptoms. In other words I believe it causes a true THERAPEUTIC effect in my system.
As for the sustained medical dependance. Well I also know exactly what this is. I experienced this in it's full glory when I tapered off effexor.
Thanks again for your input Alan. I really appreciate it.
best wishes
bluedog
> > I noticed that Benzo's are also now used to treat chronic fatigue syndrome which as I mentioned above I am also suffering from. See the attached link as an example http://www.immunesupport.com/library/showarticle.cfm/id/3154/searchtext/klonopin/
> >
> > I fully agree with you that proper treatment means getting the right diagnosis and then the doctors practicing responsible medicine by using the right medications for the right illnesses. In other words it boils down to professional and competent medical management which unfortunately is in rather short supply in western society.
> >
> > Looking forward to your response to my questions
> >
> > regards
> > bluedog
> >
> >
>
>
Posted by bluedog on December 6, 2002, at 20:40:46
In reply to Re: Regarding Benzophobia - PS. » Alan, posted by bluedog on December 6, 2002, at 20:35:52
Woops, I wrote the following:
> The Diazepam does cause me to behave in such an innappropriate way.
What I meant to say was that Diazepam does NOT cause me to behave in such an innapropriate way :)
bluedog
Posted by Squiggles on December 6, 2002, at 21:03:03
In reply to Re: About Benzo's and positivism:, posted by Alan on December 6, 2002, at 19:38:11
Cute -- but it won't fly; i have many problems
in my life and i don't expect your advice to
do me any good; nor do i believe that you have
any particular interest in benefitting anybody's
health here. My doctor, who is sympathetic
with the Ashton school, and who teaches at the
best university in Canada, provides adequate
assistance; i'm sorry that it does not fit
into your school of thought. I suggest you
find someone else to set up for your cause.Squiggles
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