Posted by Squiggles on October 25, 2002, at 9:18:38
In reply to Re: RATIONAL USE OF BENZODIAZAPINES » Alan, posted by Squiggles on October 24, 2002, at 8:41:31
OK - back again and continuing remarks on the
WHO document at 4.1.2:4.1.2 Psychoses
Organic Psychoses
a) Acute organic brain syndrome
BTW, i like the title of that, it's very general
indeed---what does it mean and how many conditions
does it cover? Also, is there inorganic brain
syndrome?I remember the 60s, when it is mentioned here
that benzos are used for LSD or hallucinogenic-
induced psychosis or "freaking out". Yup, my
friends had mentioned something - Valium i think
and i recall thinking--yikes! they want to take
another drug too!As for neuroleptics, i have read so many awful
things about them and their ability to induce
neuroleptic malignant syndrome, that i hope a
new edition of this document would get rid of
them altogether.
b) Chronic organic brain syndromeFirst they define this as dementia, then they
say that benzos are not good for it; since the
definition is so general, what if includes
something like Parkinson's or Alzheimer's
or any of the myriad other CNS disorders?Too general. Benzos may infact be good for
Parkinson's if THAT particular brain syndrome
presents with anxiety.Schizophrenia and related disorders:
Well, i should hope that by now there may be
new drugs for schizophrenia. I find the use
of benzos for catatonia rather pardoxical but
i'm no doctor.Other psychoses
4.1.3 Mood Disorders
Depression
I think they've got this one right; antidepressant
for depression with the adjunct benzo for the
effects of the antidepressant. Once stabilized
thought, one wonder why these drugs are given
prophylactically.. is this really necesssary?Mania
They've got this right too-throw out the
neuroleptics.
Once stabilized
thought, one wonder why these drugs are given
prophylactically.. is this really necesssary?
4.1.4 Drug and alcohol withdrawal syndromesYes, yes, yes. I don't know about alcohol, but
I can tell you pesonally, that in the case of
benzos, withdrawal should be tapered not only
with time (which is what I tried to do with the
Chunk-0-Meter) but with another benzo--e.g. Valium
or anything longer-life than the one you are
addicted to. With Xanax time was enough and I have
been told the withdrawal is relatively easy
because i was covered by the Rivotril. But with
Rivotril, time did not work; i should have tapered
off with Valium as Dr. Heather Ashton recommends.BTW, we have taken off the Chunk-0-Meter from
the Benzo group, because of the stroke or aneurysm
or whatever I got after 1 and a half yrs w/drawing
from 1.0mg Rivtoril. I think that time is not
enough. Again I did not know chlormethiazole was
used.
4.1.5 Personality disorderIf there is one thing that curls my hair, it's
"dependent personality disorder" and "emotionally
unstable personality disorder", and "Dahli fan
personality disorder", thouth this last one may
be an organic brain disorder indeed. Sigh...
well, at least they do not recommend drugs
for character.4.1.6 Suicidal patients
I don't know about this; maybe cocaine first or
something like it along with a benzo... a
sucidal person may be very depressed as well
as agitated - problem is how to turn that around
fast.
4.2 Other medical disorders4.2.1 Seizures
What are dissociative convulsions?
Status epilepticus - obviously you need
an anti-convulsant; but is manic depression
a species of epilepsy? Or was it the fashion
to just give it for accompanying anxiety or
GAD as it is affectionately called;4.2.2 Tardive dykinesia and akathisia
--
4.2.3 Somatic presentations
What are these? Is this what one of the people
at Benzo has - complaining of the entire body
being in pain from withdrawal of benzos?4.2.4 Muscle spasm
I think it was the vogue in the 70's to give
benzos for muscle pain; infact i think a relative
of mine was given these and got addicted. This
may explain the effects of addcition which looked
like an inexplicable state of anxiety and
rage. Benzos unless taken properly and on a
rigid program, can present with truly psychotic
episodes and behaviour. And nobody would suspect
it unless they knew the effects of intermittent
withdrawal, underdose, overdose, discontinuation,
etc. Muscle spasm, unless something medically
serious, should be considered as a minor ailment
for which benzos should be prescribed short-term
and some physiological therapy following it.
4.2.5Other indications
---
4.3 Symptomatic use4.3.1 Sleep disorders
Insomnia
I think this is the worst reason for giving benzos;
first of all the REM is changed, and your sleep
is crappy, but most importantly, the reason for
insomnia is not examined. The person, i bet you
more often woman gets hooked; it inevitably escalates
into addiction and having the responsibilities of
work and family the person has no choice.
But I think they realize this here.Disorders of arousal
--
4.4. Other situationsYup, this is excellent. Benzos should be used
as psychological ban-aids until the wound is
treated and healed.The next section is 5. (ADVERSE EFFECTS) hee hee!
(sorry to have to break now--i hope you can
follow it); BTW I wonder if this is the latest
version of WHO or a next one is coming up;
Squiggles
poster:Squiggles
thread:124171
URL: http://www.dr-bob.org/babble/20021025/msgs/125175.html