Posted by Elizabeth on June 26, 2001, at 2:56:27
In reply to Re: Linky-link » Elizabeth, posted by paulk on June 16, 2001, at 15:45:00
> Our neuro-chemistry is probably much more variable than the shapes of our faces – YMMV.
That's for sure. The human brain is one of the most complicated objects in nature.
> Also the effects at high dosages may not at all the same as what I get out of the drug.
Maybe, but I wonder if in this case there might be a difference of metabolism involved. 4 mg/day of Klonopin is a pretty typical dose for panic disorder (and the upper end of the recommended dose range for epilepsy is 20 mg/day).
> > I haven't. But I have seen people take the same dose for years without problems and without needing to increase it.
>
> It isn’t pretty. I went to a funeral of a friend who had lost his hygiene habits after too many bezo over 15 years. He died choking to death on a hotdog. (this is not a joke)That's terrible, but I do hope your example doesn't scare people unnecessarily! I really would be interested to know the details, if you're comfortable discussing them -- like the individual's age, why he was taking the benzos (and which ones and how much), whether he had other medical conditions that could have contributed, etc.
Some people abuse benzos, and they can develop truly massive tolerance. The worst case of this I've heard of involved a guy who was using more than 100 mg of Xanax a *day*. Some people have general sedative abuse problems, and they often combine benzos with other CNS depressants, such as alcohol, barbiturates, meprobamate, industrial solvents (inhalants), etc. As I mentioned, most people who abuse benzos also abuse other drugs.
However, most anxiety patients who take therapeutic doses (which can mean up to around 6 mg/day of Xanax or Klonopin) do not have problems with them. They certianly don't become demented or unable to care for themselves; on the contrary, benzos can eliminate crippling anxiety. It is true that some people suffer cognitive impairment (slowed thinking, memory problems) from benzos; these people usually end up taking alternative anxiolytics (such as antidepressants) instead (although most people I know who take ADs for panic disorder still occasionally need to take benzos).
> I guess I’ve seen too many people who got in trouble with benzos when I was in hospital. That dosen’t mean everyone will, but some do.
That's rather surprising. Anxiety patients tend to use medication as directed or, if anything, to use *less* than the prescribed amount, not more.
> I would humbly disagree; the short half-life of Xanex causes withdrawal symptoms of ‘panic and anxiety’ in some patients with a single dose.
Some people might experience rebound anxiety (just as people who use short-acting benzos such as Halcion for insomnia may be subject to waking up in the middle of the night when the med wears off), but if they are truly taking the drug only on an occasional basis, rebound effects (if any) are unlikely to be serious. Also, people who have continuous anxiety (rather than, or in addition to, short-lived anxiety or panic attacks) will become anxious again after a benzo wears off: that's not a rebound reaction. Single, isolated doses of benzos do not cause dependence, by any definition you use.
> When I took Xanex – I would get quite irritable as the drug wore off. This makes a drug spiral – take Xanex for anxiety – it works, but as it wears off anxiety is there, but worse – take more – and more. Now, this doesn’t happen to everyone – but it sure happens to some folks.
Ahh. Irritability isn't an indication for benzos, and they have been known (and documented) to cause bad reactions in some people who had preexisting mood-regulation disorders (which often tend to manifest as irritability or atypical/mood-reactive depression). I don't know all the details, just that the disinhibiting effects of benzos can cause serious problems for some people. It would be interesting to read these reports in more detail; it might turn out that the patients described were suffering from a sort of rebound effect. Xanax has a particularly bad reputation for this compared to other benzos, incidentally. (I haven't ever read, or even heard, of such a rebound effect in people who take benzos on an ad-lib basis for anxiety or panic attacks.)
People do vary widely in their tendency to adapt to drug effects. Some people rapidly develop tolerance and dependence to a particular class of drugs, or to drugs in general. I wouldn't rule out the possibility that certain identified patient populations are unusually liable to become tolerant to drugs. (Tolerance and dependence are both due to adaptations: some people may adapt very rapidly to drugs.)
> They tapered – the anxiety returned – only treatment was CWSP.
"CWSP?" (Is there something I'm supposed to know about here?)
> This was a hospital that was down on drug therapy and thought they could talk away everyone’s problems (sadly some who had thyroid disease)
< groan >
-elizabeth
poster:Elizabeth
thread:65795
URL: http://www.dr-bob.org/babble/20010625/msgs/67917.html