![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by SadDoggie on February 2, 2005, at 3:47:03
Hello everyone, this is my very first post. Thank you.
I was wondering if anyone knew of anything that prevented tolerance to benzodiazepines. I've taken them before and find they work great except they stop working in a few days or weeks for me. It seems this is kind of rare and doesn't happen to most people. Rather than keep raising the dose till I'm addicted I just stop them. When I give them a long break I go back to them and they work again, but then they poop out again. So I was wondering if there was something like memantine that they use for opiates and amphetamines, but for benzodiazepines?Thanks.
SadDoggie
Posted by med_empowered on February 2, 2005, at 4:02:03
In reply to Preventing tolerance to benzodiazepines, posted by SadDoggie on February 2, 2005, at 3:47:03
Hi! I've never heard of anything that's been proven to prevent tolerance to benzos. Sorry. That said, you may be able to have your shrink work with you on this w/o coprescribing something to prevent tolerance. What benzos have you used, and which have been most successful? If one is taking them for a while, every day, the general consensus seems to be that long-acting benzos such as Klonopin are best used, whenever possible. Short-acting benzos such as Ativan and the original xansx (there's an xr version of that now) are now used mostly for sleep or on a relatively infrequent, as-needed (PRN) basis. That said, many perfectly capable psychiatrists still prescribe xanax or ativan for regular use b/c they work quite well, and some people have problems with Klonopin (depression with long-term use is a big one). If you drink regularly, take other sedatives, or even use sedating antihistamines on a regular basis, try taking your benzo(s) without these additional agents; if you potentiate your meds with additional sedatives, future doses will seem less effective/powerful. Prescription benzo "boosters" might help as well; propranolol and other beta-blockers, for instance, are believed to boost the effect of the benzodiazepens. Add-ons such as gabitril, neurontin, and sometimes, BuSpar (usually NOT coprescribed with benzos, but I've known a few people on the combo) can help with anxiety, too, and prevent a dosage increase. Good luck!
Posted by SadDoggie on February 2, 2005, at 6:22:26
In reply to benzo tolerance, posted by med_empowered on February 2, 2005, at 4:02:03
Hi, I took Valium a long time ago which worked well but it poops out in a few days for me. I can raise the dose a little and get a good effect again but there's a limit to doing that, I don't like going to high doses. Klonopin, I've used recently and doesn't do that much for me, but it does help a little. Ativan is what I'm using right now and has been very good for a few weeks(I was surprised it worked this long) but is now going dead on me.
My psychiatrist didn't even want to go beyond the minimal dose with Ativan because he's a scared a**hole. Doesn't want to prescribe anything anymore. I told him I felt better at 1mg but he didn't want to give it to me until finally he said ok. I've never been an addict and haven't shown him anything that would make him think I would abuse them. So if I even *think* about wanting to try another benzo, I have to get a hold of them myself now, unless I want to beg for it and get turned down on repeated occasions. It's like pulling teeth from a whale.
I am now getting a hold of Xanax XR, some more Klonopin, and plan on rotating them, including Ativan. (Seems like I'm abusing them a little know though :) And I'll cross my fingers my little plan works(it probably won't). I should add Valium too later on, and am going to see what else I can add(this is to give the other meds more holiday time, I don't want to sound like a junkie :)
I would like to rotate them every 2 days, (or 4 days if I raise the dose of each one time). Believe it or not this is how fast they last, only a few days. What do you think about my little rotating plan? Is it dangerous? I don't plan on combining them together on the same days.
This is what I'll have to try if there really is nothing that can prevent tolerance to benzos, as they help me a lot when they're working. I will try the suggestions you gave me too. Thanks.
> Hi! I've never heard of anything that's been proven to prevent tolerance to benzos. Sorry. That said, you may be able to have your shrink work with you on this w/o coprescribing something to prevent tolerance. What benzos have you used, and which have been most successful? If one is taking them for a while, every day, the general consensus seems to be that long-acting benzos such as Klonopin are best used, whenever possible. Short-acting benzos such as Ativan and the original xansx (there's an xr version of that now) are now used mostly for sleep or on a relatively infrequent, as-needed (PRN) basis. That said, many perfectly capable psychiatrists still prescribe xanax or ativan for regular use b/c they work quite well, and some people have problems with Klonopin (depression with long-term use is a big one). If you drink regularly, take other sedatives, or even use sedating antihistamines on a regular basis, try taking your benzo(s) without these additional agents; if you potentiate your meds with additional sedatives, future doses will seem less effective/powerful. Prescription benzo "boosters" might help as well; propranolol and other beta-blockers, for instance, are believed to boost the effect of the benzodiazepens. Add-ons such as gabitril, neurontin, and sometimes, BuSpar (usually NOT coprescribed with benzos, but I've known a few people on the combo) can help with anxiety, too, and prevent a dosage increase. Good luck!
Posted by med_empowered on February 2, 2005, at 14:09:17
In reply to Preventing tolerance to benzodiazepines, posted by SadDoggie on February 2, 2005, at 6:22:26
hi! I personally don't see anything wrong with a rotation...just keep in mind they're in the same family, so cross-tolerance can easily occur. In addition, you might want a shrink who will actually USE the medicines available instead of acting in fear. A skillful doctor can prescribe useful but not oversedating doses of benzos for the short or long-term without any major consequences. Some docs I've had oppose benzos b/c of "addiction" but then hand out adderall like candy....its a ridiculous stance based on fear and ignorance, not science. If possible, find somebody better.
Posted by SadDoggie on February 2, 2005, at 18:00:41
In reply to Re: Preventing tolerance to benzodiazepines, posted by med_empowered on February 2, 2005, at 14:09:17
I'm glad someone says there's nothing wrong with it. And yes I agree, I will be looking for a better doctor.
SadDoggie> hi! I personally don't see anything wrong with a rotation...just keep in mind they're in the same family, so cross-tolerance can easily occur. In addition, you might want a shrink who will actually USE the medicines available instead of acting in fear. A skillful doctor can prescribe useful but not oversedating doses of benzos for the short or long-term without any major consequences. Some docs I've had oppose benzos b/c of "addiction" but then hand out adderall like candy....its a ridiculous stance based on fear and ignorance, not science. If possible, find somebody better.
Posted by Phillipa on February 2, 2005, at 18:08:57
In reply to Re: Preventing tolerance to benzodiazepines, posted by SadDoggie on February 2, 2005, at 18:00:41
I'm on a tappering down of benzos right now. My new pdoc will not raise them even for the twitching of my muscles in fingers, shoulder, and leg. How long do you think this will last? I've been on benzos for over 30yrs. Phillipa
Posted by Fred23 on February 2, 2005, at 18:29:59
In reply to Preventing tolerance to benzodiazepines, posted by SadDoggie on February 2, 2005, at 6:22:26
> My psychiatrist didn't even want to go beyond the minimal dose with Ativan because he's a scared a**hole. Doesn't want to prescribe anything anymore. I told him I felt better at 1mg but he didn't want to give it to me until finally he said ok.
Wyeth's own prescribing info for Ativan says that 2 - 3 mg per day is the initial dose, and gives a high range from 6 - 10 mg per day, so what is he looking at as a reference?
(In other words, he may be giving you a sub-therapeutic dose.)
Posted by linkadge on February 2, 2005, at 18:51:34
In reply to Re: Preventing tolerance to benzodiazepines » SadDoggie, posted by Fred23 on February 2, 2005, at 18:29:59
Chronic inositol administration increases the sensitivity of GABA, serotonin and dopamine receptors.
I've heard that inositol supplementation can help some aspects of benzo tollerance.
Linkadge
Posted by SadDoggie on February 2, 2005, at 19:06:33
In reply to Re: Preventing tolerance to benzodiazepines, posted by Phillipa on February 2, 2005, at 18:08:57
Why is he tapering down your benzos? Because of the twitching? If it's withdrawals then it'll probably go away with some time.
SadDoggie> I'm on a tappering down of benzos right now. My new pdoc will not raise them even for the twitching of my muscles in fingers, shoulder, and leg. How long do you think this will last? I've been on benzos for over 30yrs. Phillipa
Posted by Phillipa on February 2, 2005, at 19:55:37
In reply to Re: Preventing tolerance to benzodiazepines, posted by SadDoggie on February 2, 2005, at 19:06:33
No the twitching is due to the "down regulation" of the tapering of benzos according to the pharmacist. I don't know what this means do you?Fondly, Phillipa
Posted by SadDoggie on February 2, 2005, at 20:18:41
In reply to Re: Preventing tolerance to benzodiazepines » SadDoggie, posted by Fred23 on February 2, 2005, at 18:29:59
He's looking at his *ss for a reference. Actually it's 1mg twice a day that I take. I might be raising it a little, I have more pills now. I know it's a low dose. Believe it or not he wanted to give me just 0.5mg once a day at first!
SadDoggie
> > My psychiatrist didn't even want to go beyond the minimal dose with Ativan because he's a scared a**hole. Doesn't want to prescribe anything anymore. I told him I felt better at 1mg but he didn't want to give it to me until finally he said ok.
>
> Wyeth's own prescribing info for Ativan says that 2 - 3 mg per day is the initial dose, and gives a high range from 6 - 10 mg per day, so what is he looking at as a reference?
>
> (In other words, he may be giving you a sub-therapeutic dose.)
>
Posted by SadDoggie on February 2, 2005, at 20:25:09
In reply to Re: Preventing tolerance to benzodiazepines » SadDoggie, posted by Phillipa on February 2, 2005, at 19:55:37
Yes it's probably due to that(or something like that). It just means the number of receptors that were involved with the drug are going down, so it causes this effect. But do you want to taper off the benzos? 30 years is a long time, it seems like you need em. Unless your psychiatrist is planning to put you on something better.
SadDoggie
> No the twitching is due to the "down regulation" of the tapering of benzos according to the pharmacist. I don't know what this means do you?Fondly, Phillipa
Posted by SadDoggie on February 2, 2005, at 20:26:24
In reply to inositol, posted by linkadge on February 2, 2005, at 18:51:34
Thanks for this tip, I will try it out. How are you doing?
SadDoggie
> Chronic inositol administration increases the sensitivity of GABA, serotonin and dopamine receptors.
>
> I've heard that inositol supplementation can help some aspects of benzo tollerance.
>
>
> Linkadge
>
Posted by Phillipa on February 2, 2005, at 20:42:52
In reply to Re: inositol, posted by SadDoggie on February 2, 2005, at 20:26:24
I know this is a long time. But, unfortunately the new generation of MD's do not want to RX benzos, my alternative was seroquel at bedtime. Read my new Post and you'll see what happened to my low dose regime. Fondly, Phillipa
Posted by platinumbride on February 4, 2005, at 15:10:47
In reply to Re: Preventing tolerance to benzodiazepines, posted by med_empowered on February 2, 2005, at 14:09:17
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.