Posted by mattw84 on April 29, 2005, at 22:37:45
In reply to Re: how long do benzos work? - chemist, posted by lgmg on April 29, 2005, at 6:30:57
lgmg,
Name is EmDubya, I'm an MS2 med student. From my perspective there is little to no *subjective* difference between the two -- aside from a general preference towards Ativan(Lorazepam) in US institutions. The most significant difference is only in what the FDA has approved respective uses thereof. Ativan is usual the first line anxiolytic because:
1) ...it is extremely fast acting.
2) ...has superior anticonvulsant properties compared to Xanax.
3) ...likely is more profitable in clinical practice.
4) ...is more retro/anteroamnestic than Xanax. (Useful in a clinical setting, but let's not get into that.)
5) ...has a lower equipotent maximum dosage to that of Xanax.Those might not all seem like significant reasons as to why lorazepam is preferable, but they is what they be...
Alprazolam is *indicated* for anxiety with concomitant depression. Even though no evidence suggests that Lorazepam is any less likely to induce depressive states.
They are both short-acting, with T to 1/2 plasma concentrates occurring <8 hours post administration. So is there really any superiority between the two? Alprazolam likely has a slight edge on Lorazepam, only because it does act *very* mildy as 5HT agonist, whereas the former shows no evidence thereof. That aside -- outside of an inpatient setting, profit margins are much greater than with Lorazepam, especially with the advent of Xanax XR.
With equal respect, both produce rapid physiological dependence and tolerance. Alike, approximately 50% of those administered either are likely to be long-term customers.
My personal opinion is to simply use either pro re nata, or not at all. Though they both illustrate long-term efficacy, the choice is yours... I'll leave the rest of this up to the chem, assuming he'll break it down in terms more appeasing.
Best of luck with whatever you choose to do.
Regards,
M.W.
poster:mattw84
thread:488862
URL: http://www.dr-bob.org/babble/20050428/msgs/491726.html