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Chronic benzos, mood + memory. Hoover + experts?

Posted by mattdds on April 17, 2009, at 3:48:14

Hi all,

It's nice to see some of the same genius posters still here (you're a legend Larry Hoover).

It's been a while since I posted. Excuses: I went to war (seriously), then back to school, started a long stressful long residency in a surgical subspecialty. Yeah, that stuff is awesome for anxiety and depression!

Background: I've taken clonazepam for 8 years. Overall it has been a tremendous med. Seven years on 1.0 mg bid, over the last year I decreased to 0.5 mg bid. Everything else didn't work or had unacceptable side-effects. (e.g. SSRIs --> tremor, sweating, both very bad in my trade)

To my questions:

1. How well do you think cognitive impairment (memory) and depression secondary to chronic benzodiazepines is supported by the literature. I've seen some small n studies involving older folks cited to back this claim but not much else (I'm young(er), and I want to know about me :) ).

It's hard to judge yourself. Maybe there has been a slow memory decline that I'm not aware of. Perhaps some of my lingering depression could be from long-term benzos.

2. What about the risk of *chronic anxiety itself* on memory and depression? I find it odd that the studies I looked at didn't consider this. It would be hard if not impossible to say whether my memory and persistent low-grade depression would have been better or worse without benzos. I am quite certain that my depression improved significanly in the short term from where I originally was in 2001. Some of my attention might have even been freed up when my anxiety and ruminating thoughts decreased. I'm positive unchecked anxiety precipitates severe depression for me. It almost seems like meds like clonazepam should be neuroprotective in the same way SSRIs and ADs have been shown to be.

3. I worry that some of the literature sort of suggests that memory loss from chronic benzos doesn't come back, or comes back slowly and incompletely. This makes me wonder why Ashton and her followers have developed these beautiful protocols to withdraw. What's the point of a hellish prolonged withdrawal if it doesn't get that much better? I don't believe in extra cool points for being "drug free" for the hell of it (although it would be nice not to have to see a psychiatrist periodically and re-explain my whole situation).

I remember the hope I had years ago for novel medications like Lyrica and the novel CRH antagonists. But Lyrica is not what we hoped and CRH antagonists...what happened there? I hoped clonazepam would bridge the gap while they developed the good stuff, haha.

Please weigh in if you can!






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