Posted by mattdds on March 2, 2003, at 18:45:23
In reply to Re: KLONPIN daily for life? » jonh kimble, posted by KrissyP on March 2, 2003, at 17:42:05
Guys,
People routinely take benzos for decades, without loss of its ANTIANXIETY effect. This is an important distinction to make, as there are different effects of benzos (e.g. anxiolytic, anticonvulsant, and sedative). The tolerance you are all so freaked about is more to the sedative and anticonvulsant effects, and NOT so much to the antianxiety effects. Furthermore, the anxiolytic properties are what most of us are interested in, right? This is pretty well documented in the literature. I will look for some references, but did learn this in my pharmacology class in dental school.
Yes, if you take benzos for extended periods of time, you will likely become dependent on them. I don't understand why this is so disturbing. This doesn't mean they stop working, it just means you need to taper when you come off them. What is it that people don't get about this? If you come off of most psychoactive drugs (even the pristine and free of sin SSRI's and atypical neuroleptics that seem to be so en vogue these days) without a good slow taper, you are going to get withdrawals! This is true of Paxil, Celexa, Seroquel, and even with drugs that aren't psychoactive, like B-blockers and Coumadin. Why is this aspect, dependence requiring a SLOW taper, so magnified with only the benzos? Honestly, in my opinion, if you go off a benzo without a taper and experience withdrawals, you only have yourself to blame. These effects can be minimized or even eliminated with a good slow taper. Read about this in Goodman & Gilman's pharmacology, where they say that withdrawals from diazepam and clonazepam are virtually nonexistent in slow tapers (1-2 months, gradually).
In sum, I am not convinced that in the majority of people there is much tolerance to the antianxiety effects of benzos. This is obviously possible in some, but I think it's the exception, rather than the rule. There is, however substantial tolerance to their sedative and anticonvulsant effects, but in my opinion, benzos should not be taken for these purposes long-term, because there are drugs which are much better suited for these concerns (e.g. zolpidem for sleep, valproate et. al for seizures)
Finally, PLEASE explain why people have such a difficult time distinguishing between two simple words: ADDICTION and DEPENDENCE. These are two very different things. Addiction involves intense cravings and a compulsive need to take a substance, and antisocial behavior. Benzos do not do this, especially in people with diagnosed anxiety disorders. Please, why is this so difficult to use the appropriate language?Matt
poster:mattdds
thread:205179
URL: http://www.dr-bob.org/babble/20030301/msgs/205345.html