Posted by Elizabeth on June 8, 2001, at 16:24:15
In reply to Re: Xanax use, posted by gilbert on June 8, 2001, at 12:27:19
> I find that I feel way more stoned on an ssri or like I am on speed on Wellbutrin than being on xanax.
I sympathise. I feel much more like myself on opioids than I do on typical ADs. Definitely not "stoned."
> The huge push for ssris for anxiety disorders did coincide with patents on benzos running out and new expensive drugs being pushed for panic that benzos were treating with a fair amount of success.
Antidepressants also tend to have more side effects, especially for people with panic disorder, than benzos do.
> All of the truly serious anxiety websites recommend benzo use and show it's efficacy superior to ssri treatment. I.E. Tapir, anxities.com, Dr Shipko and the Panic institute. The studies showing ssri efficacy on panic if you dig deep enough are usually sponsored by drug companies or paid for by drug companies with an interest in ssris.
I think this is plausible, but could you point me to some research showing benzos to be superior? They definitely work faster and without the initial period of increased anxiety; I'm thinking more of the long term (after the AD has had a chance to work). I have panic disorder and my experience has been that ADs work fine; when I was on them (I'm in the process of a switch right now) I never needed to resort to using my "emergency Xanax" for panic.
> The ssri school of thought that benzos are addictive and your brain will shrink and memory will go is scare tactics to sell more ssris.
I agree, although it is true that chronic benzo use (not necessarily abuse) causes long-lasting brain changes. It's *not* known whether these changes constitute "brain damage" or have any bad effects, though.
> I am not foolish enough to think that their are not those out there who abuse benzos...there are. There are people out ther abusing turpentine, there are people out there abusing ssris too.
Those are almost silly examples. But for kicks, try searching Medline for tranylcypromine and (abuse or addiction or dependence). Tranylcypromine *would* be a controlled substance under the Analogues Act if it hadn't already been in use when the Act was passed.
> But study after study proves otherwise it is a very small minority.
Yes. And furthermore, the very small minority consists almost exclusively of people who are abusing other drugs also.
Cam makes a good point that if you get into trouble with benzos, the doctor who prescribed them can get into trouble too. But you're right, doctors are overly benzophobic as a result.
> In my experience over the past 2 years of trying everthing and I mean everything the ssris have been the least cleanest drugs to get away from. The rebound depression and jones for some extra seratonin reminds me of my cocaine withdrawal and my jonesing days off the powder.
MAOI withdrawal is worse, but AD withdrawal is not generally associated with cravings. It's a pharmacological abstinence syndrome, not an addiction.
> I have detoxed off of vodka....cocaine....and other various substances and beilive me when I say this that coming off of antidepressants has mimicked those awful detox sysmtoms closer than any benzo withdrawal.
You're in the minority there, although this might have been because doctors didn't recognise AD withdrawal phenomena until relatively recently (so they just had their patients stop the SSRIs cold turkey). People who have experience with both often say that benzo withdrawal is worse than heroin withdrawal.
In most cases, there are ways to make drug discontinuation relatively painless. You can switch to a milder and longer acting drug (e.g., buprenorphine to get off of heroin, or Klonopin or Tranxene to get off of Xanax), for example. You can also try to treat the withdrawal symptoms with drugs like anticonvulsants (for benzos), or clonidine, propranolol, etc. (for opioids). This can work with AD withdrawal syndromes as well: switching from Effexor or Paxil to Prozac; using benzos, Benadryl or hydroxyzine, etc. to alleviate the withdrawal symptoms.
> I just think that the stigma surrounding benzo use actually forced me to try drugs that made my condtion worse.
That has happened to a lot of people: you're definitely not alone.
> I did not have the self esteem or fortitude to stand up for myself.
It's *hard* to stand up to doctors, AA members, friends, relatives, etc. when they're all pushing you to do something that you don't feel is right for you. Don't get down on yourself over it. There was a time when I was younger and feeling *very* demoralised I had a tough time standing up to doctors and psychologists, and it ended up making things worse for me too.
> My peers in AA and friends would say Gil get off xanax and try an antidepressant before the xanax leads you back to drinking.....what a joke.
What a joke indeed! Alcohol is a lame and toxic substitute for benzos -- if you have adequate doses of benzos, you don't *need* to drink. The idea that a history of alcoholism is cause to avoid benzos is just wrong -- morally as well as factually.
> Your body will tell you when it is right.
Amen.
> The doc said let's stick with what works stay on the xanax leave the rest alone see ya in 3 months so that is where I am today....
Stick with what works. Nice. I'm glad you've got a doc who understands that.
Oh yeah also that vet study on klonopin and impotence I went back and looked 46 % of the klonopin users experienced impotence but the dose was like enough to knock out an elephant. I think it was from 3 to 5 grams per day.
***GRAMS***????
I think this is the abstract of the study you mean:
Anxiety 1994-95;1(5):233-6
Clonazepam-related sexual dysfunction in male veterans with PTSD.
Fossey MD, Hamner MB.
Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC 29401, USA.Medication-induced sexual dysfunction can significantly interfere with patients' quality of life and lead to poor compliance. This retrospective study examined the records of 100 male veterans with post-traumatic stress disorder (PTSD) selected in alphabetical order from an active treatment file of 230 patients. Forty-two patients had received clonazepam (mean maximum dose: 3.4 +/- 1.6 mg/day) at some point during their treatment. Of these, 18 (42.9%) complained of significant sexual dysfunction (primarily erectile dysfunction). Eighty-four patients received diazepam (mean maximum dose: 52.1 +/- 29.7 mg/day), nine received alprazolam (mean maximum dose: 5.2 +/- 2.8 mg/day) and eight received lorazepam (mean maximum dose: 3.8 +/- 2.4 mg/day). None of these patients complained of sexual dysfunction during treatment with these three other benzodiazepines. Our findings suggest that benzodiazepines, particularly clonazepam in the current study, can be a cause of sexual dysfunction in many male patients. Prospective studies comparing the overall clinical utility of various benzodiazepines are indicated in this and other clinic populations.
Some of those doses are high-end, but not outrageous. Klonopin 1.8-5.0 mg/day isn't at all unreasonable. 50 mg of Valium and 5 mg of Xanax are a bit high, but not too bad. Like I said (different post, same thread), the dose range of Xanax for depression is around 8-12 mg/day.
-elizabeth
poster:Elizabeth
thread:65576
URL: http://www.dr-bob.org/babble/20010605/msgs/65815.html