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Re: Benzo Monotherapy or Antidepressants ? » utopizen

Posted by viridis on December 15, 2002, at 23:09:28

In reply to Re: Benzo Monotherapy or Antidepressants ?, posted by utopizen on December 15, 2002, at 9:31:04

I think the real point is that when you take these meds (benzos, ADs, etc.) they change the signaling pathways in your brain. That's what they're supposed to do -- make your brain work in a more normal way. So, this isn't necessarily a bad thing, if it improves your quality of life. And of course, the longer you take them, the more dependent your system becomes on having them, just like it would for a diabetic using insulin replacement.

I don't think it's fair to equate dependency with "addiction". Some people do become addicted to benzos (I've known a couple of people who continually escalated their doses of Xanax or Valium way beyond what was prescribed). That's where you get into trouble. But the available evidence indicates that people who take benzos for serious anxiety conditions don't tend to do this.

I discussed the issue at some length with my psychiatrist when I started on benzos. He's very cautious with them, because he says he's occasionally seen addictive/abusive behavior with these drugs, and if this happens, he insists on shifting to a different med regimen. But he also told me that long-term benzo therapy can be appropriate for some people (like me), and that withdrawal for those who use benzos responsibly is pretty straightforward -- it just has to be done gradually. I trust his experience; he's very direct, is much more knowledgeable than any other pdoc or GP I've seen, and has dealt with many patients using benzos for varying lengths of time.

Many others on this board have reported little difficulty in withdrawing from benzos (although a few have had serious problems). I've never done it (and don't plan to if I can avoid it). So far I've done well on a low dose of Klonopin that hasn't needed any adjustment, but I certainly wouldn't stop it suddenly. Reports of serious withdrawal from ADs are abundant, and I've had major trouble coming off Prozac in past (probably the longest half-life SSRI). I know others who have had severe withdrawal problems with ADs that range from Prozac to Serzone. So, these drugs aren't benign relative to benzos when it comes to discontinuation.

My impression is that both benzos and ADs are very useful meds, and their efficacy is highly individual-specific. But whatever route you choose, it seems that almost any med that provides relief from psychiatric problems is likely to be difficult to come off suddenly. Again, these drugs rewire your brain (often in a positive way) and it's not surprising that stopping them suddenly will have serious consequences. I don't think that benzos are unique in this respect.

My original point was that at least with benzos, we have decades of experience to work with when it comes to withdrawal, whereas with the newer ADs methods for managing withdrawal are only beginning to be understood.


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poster:viridis thread:131769
URL: http://www.dr-bob.org/babble/20021210/msgs/131949.html