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Re: Same med for SA for more than 3 years? » breakman

Posted by myco on March 15, 2009, at 12:39:29

In reply to Re: Same med for SA for more than 3 years?, posted by breakman on March 15, 2009, at 12:26:37

What I am suggesting is that "tolerance" may not exist as how you think of it...there is a stabilization point in many benzos (particularly valium and restoril - no/low tolerance shown in studies - also ask phillipa - she has lowered valium dose after decades on it). Many benzos will lose that "peak" that happens in the beginning but the real effect is subtle...that slow decline that happens after peak. I cant remember the exact wording here but my old pdoc was explaining it...she didnt believe in tolerance to benzos. She said most people on them dont understand how they work...they chase after that initial peak of effect that knocks you out or relaxes you very fast then the peak dies and the dose stabilizes and declines slow - that slow decline, very subtle for low doses, is the actual benzo effect. She says thats how you use them properly, you adjust dosage correctly so that slow descent is enough to maintain a therapeutic "background" effect - the peak, in her mind, is merely a side effect than diminishes over time....making people think aww it stopped working when it hasnt, it's just gone "subtle". This is what scares gp's...patient comes back thinking its stopped working (no more peak) - dose is raised - again back - raised again - back again - no more. The benzo should be adjusted with a plan from the start and dosage escalation until you reach that stabilization (slow gradual descent) is expected and how you use it properly.

myco

> Are you suggesting that people have taken
> benzos _continuously_ for decades? My
> impression was that tolerance builds up
> and the dose keeps escalating.
>
> Maybe the dose escalation stops at some point.
>
>


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