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Re: Questions for Larry Hoover KellyD

Posted by Larry Hoover on July 12, 2003, at 7:58:13

In reply to Questions for Larry Hoover, posted by KellyD on July 8, 2003, at 10:34:53

> Larry,
> I appreciate your knowledge and would appreciate if you would indulge me and answer some questions about Klonopin, if you are able. I was wondering------

It is my pleasure. Seriously. Win-win, ya know?

> 1. As a CNS depressant, I assumed (gasp) neurochemicals circulating would be decreased also. Is this true?

First off, neurochemicals would not normally be thought of as circulating. Let me use an example. Trees and grass throw massive amounts of pollen into the air in hopes that circulating air will bring a tiny amount to its proper destination, another tree or grass plant of the same species. Mammals, on the other hand, are quite specific in the need to have the elements of procreation brought together in a specific place. There's quite a difference, spreading stuff far and wide, compared to very localized release.

Your brain does not circulate neurochemicals, it releases them in a very controlled manner. They are released from one neuron, from a very tiny area of that neuron, into a very tiny gap (the synaptic cleft) which separates two neurons. The receiving neuron has receptors designed to receive the sending signal. Any neurotransmitters that "leak out" of that tiny volume of space are quickly "mopped up" by reuptake pumps and enzymes designed specifically to destroy them (e.g. mono-amine oxidase, or MAO).

A CNS depressant reduces the general activity of the brain, so there will be less release of neurotransmitters. I just wouldn't call that circulation.

>What is the effect specifically on circulating seritonin? Does it increase circulating S, if so, why is depression a side effect in some users? (current theories of depression causes being used)

A CNS depressant has kind of a global effect, but it is more effective in suppressing release of some neurotransmitters when compared to others. In someone with a vulnerability to depression (I'm thinking genetic differences), it may be that the suppressing effect is large enough in particular chemicals to affect mood. Because depression is not a global result (i.e. not everybody gets it), we would think of depression as an idiosyncratic result (person-specific).

> 2. Is there basis for the "once a benzo user" theory for permanent changes to the brain's wiring? I've read accounts of persons who kicked the "habit", choose not to use them, etc. and still felt they had not REALLY recovered and continued to struggled with anxiety, just not treating it or using other meds to treat. They were just proud they didn't use a dreaded benzo.

My opinion on this issue.....

I don't believe that benzos (or antidepressants, either) cause permanent changes in brain function. Your brain has an astounding ability to rewire itself, and regulate receptor activity (the concept is known as neuroplasticity).

The idea that using benzos is a sign of a weak character seems to be embedded in the idea that anyone would need to "kick the habit". How sad, that even those who have been treated for anxiety would internalize the judgmental attitudes of the people suffering from chronic pain having to endure the criticisms that they are opiate addicts. Walk a mile in their shoes.....

People who have used benzos did so for a reason. They didn't just start using them because they were feeling normal and well, did they? No. They had symptoms which led them to seek treatment. During the time they used benzos, their bodies continued to change. Whatever pathology was taking place would continue to progress. Going off benzos won't fix the underlying disorder, or eliminate the symptoms. An anxious person will still be prone to anxiety after going off benzos. You ought not to blame the benzos for that.

It has been shown that there are genetic defects in certain receptors in some people with GAD. If you want to, you can "tough it out" and avoid benzos, or you can use them for some symptomatic relief. I think the decision is very personal, and I wouldn't worry about what other people think.

> I do consider myself a benzo "it was a blessing for me" person. I continue to use low dose Klonopin. It works for me and I do plan to continue.

Bravo! Count your blessings, and ignore the critics.

> I did want some info that's difficult to find on some hard questions. I thought maybe you could help or give me some resources to find the answers myself. Although, I will admit, the neuropharm stuff buzzes over my head. I would really appreciate your responses. Thanks in advance.

You're welcome. I hope I've answered your questions. If not, or if there are more, come back at me.

Take care,




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