Posted by Squiggles on October 23, 2002, at 20:34:11
In reply to Re: My Klonopin (Clonazepam) isnt working ?? » Squiggles, posted by Alan on October 23, 2002, at 12:11:30
Hi Alan and musil, viridis, hiba, whoever
else is interested in the WHO "Rational Use
of Benzos" document:My husband kindly printed it for me. I started
reading it tonight. It's rich. It is also
from 1996; nevertheless, i am amazed at how
many similarities i see (just skimming it) with
the knowledge acquired at the Benzo Group.1. General Introduction
I am glad that the target audience is both
psychiatrists and GPs as both use them.2. Epedimiology
2.1 Introduction
These drugs are prescribed in 3rd place, after
heart and circulatory drugs. Why is this? Is
it because anxiety is rampant, or backaches,
or insomnia; or is there some other reason, such
as dependence necessitating the continued prescription
of these drugs;2.2. Indications
The recent restriction of benzos to fewer
disorders is a goo move. The marked discrepancy
for which they are prescribed and the knowledge
or perception that the patient has, is a very good
point. In my case, i have no idea why I was prescribed
the anti-convulsant Clonazepam. I was certainly not
having convulsions. I have heard rumours that
bipolars are epileptics and have seizure-type electrical
activity in the brain, but i think this was at least
theoretical in my time (20 yrs. ago).The recommendation for short term prescription
is also something that the Benzo group was aware
of as the wisest course of action. I was taking
Xanax and Clonazepam for about 12 years, every day.2.4 Prescription Data
The statistics show a high propensity for
physicians to prescribe for non-psychiatric
reasons.2.5 Consumption of benzos
Some interesting hints of contradictory data
here:- "Difficulty in disontinuing the medication was
linked to age (over 45) and duration of use,
but not to the kind of benzodiazepine nor to the
sex of the use (Dunbar et al., 1989). Comparing
data with Balter, these researchers concluded that overall
prevalence use might have declined, but long-term
regular use of benzodiazepines had increased
substantially."- how do we interpret the above; may i suggest
that discontinuation was just unsuccessful and
continued use was the result? Also, i don't know
about the studies here (probably none) but for
some reason clonazepam is more difficult to withdraw
from than others. That was my experience and it
was also reported at the Benzo group.2.6 Conclusion
Benzo prescription and use is increasing.
3. PHARMACOLOGY
3.1 Introduction
A sentence that caught my attention points to
the significant pharmacological differences
between benzos (though of course there are mostly
similarities). Wonder what they are, besides
time and absorption.3.2 Benzo receptors
I notice that the mean duration of benzo treatment
for patients is 50 months. He he he.--- much which is techinical in these sections--
3.4 Clinical importance of pharmacokinetics3.4.1 Anxiolytic use of benzos
This is the main use of benzos. Withdrawal
problems are well described and well known here;
why don't the doctors read this stuff?3.4.3 Anticonvulsive use
They are used for epilepsy; i see no mention
of manic-depression;3.4 Clinical importance of pharmocokinetics
Mania:
This is an excellent and rational use of
benzos! The point is made here that benzos
are used in the initial phases of benzos and
in when in other psychiatric disorders for the
very good reason that they do not counteract
with the anti-psychotics such as lithium. Lithium
with neuroleptics instead of benzos, would
easily result in the truly undesired tardive
dyskinesia and neuroleptic malignant syndrome.But indefinitely? I guess.
-------------I am going to stop now and resume
tomorrow; as i said I am quite amazed at how
consistent the facts here are with the documents
collected at the Benzo group.--------
Squiggles
poster:Squiggles
thread:124171
URL: http://www.dr-bob.org/babble/20021019/msgs/124936.html