Posted by Elizabeth on August 10, 2001, at 15:25:31
In reply to well, it depends....:) » Elizabeth, posted by Daveman on August 9, 2001, at 23:11:23
> I think it depends what is meant by "cross-tolerant."
Pharmacodynamic tolerance to one benzo will result in tolerance to other benzos. As you say, the principal mechanism.
> But each benzo has a different chemical profile and thus different side effects.
For the most part, it's not easy to predict the side effects of different benzos. For some people, Valium is more sedating than a supposedly "equivalent" dose of Xanax. For others the reverse is true. (I've taken as much as 40 mg of Valium -- with no tolerance -- and didn't feel a thing.)
> Thus, some experts utilize a valium-substitution method to wean off Xanax- not only does it cover withdrawal symptoms and have a longer half life, but is a much stronger hypnotic and can thus help with the insomnia that comes with benzo withdrawal.
Again, the sedative effects of benzos are highly variable from individual to individual. Valium isn't the best choice for substitution in benzo discontinuation; despite its relatively long elimination half-life, its action lasts only a few hours because of distribution factors. Klonopin and Tranxene are probably the longest-lived benzos.
> Of course, panic disorder patients report staying on the same doses of Xanax or klonopin for years without developing tolerance to the anti-panic effects (as opposed to the sedation). YMMV.
That's not just patient report; it's a pretty well established fact. Some people say they became tolerant to the antipanic effects of benzos, but that seems to be the exception rather than the rule.
-e
poster:Elizabeth
thread:72451
URL: http://www.dr-bob.org/babble/20010809/msgs/74503.html