![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by lynny2 on April 12, 2000, at 19:24:25
What are the major differences between these 3. i know they belong to same category?
Posted by Cam W. on April 12, 2000, at 20:13:28
In reply to ativan vs. valium vs. xanax, posted by lynny2 on April 12, 2000, at 19:24:25
> What are the major differences between these 3. i know they belong to same category?
Lynny - These belong to the benzodiazepine family of drugs. They all bind to the GABA receptor complex and make it easier for GABA to open the receptor's chloride ion channel, hyperpolarizing the neuron, making it less excitable and less likely to fire. Benzodiazepines are used as sedative/huypnotics (sleeping pills), anti-anxiety meds (anxiolytics), anti-panic agents, and anticonvulsants (anti-epileptics). The primary differences between all benzodiazepines are in their pharmacokinetic properties (their absorption, distribution, metabolism and excretion).
V = Valium (diazepam); A = Ativan (lorazepam); X = Xanax (alprazolam)
Indications (Uses):
V - anxiolytic, preoperative sedative, anticonvulsant.
A - anxiolytic, preoperative sedative.
X - anxiolytic, panic disorder.Equivalent Doses:
V - 5mg
A - 1mg
X - 0.5mgApproximate Half-life:
V - 100h
A - 10-20h
X - 12-15hOnset of Action
V - < 1h
A - 1-3h
X - 1-3hAre Metabolites Active?
V - yes
A - no
X - yesMetabolism:
V - oxidation
A - conjugation
X - oxidationDid I miss anything you would like to know?
- Cam W.
Posted by kazoo on April 12, 2000, at 20:35:06
In reply to Re: ativan vs. valium vs. xanax, posted by Cam W. on April 12, 2000, at 20:13:28
> Did I miss anything you would like to know?
> - Cam W.^^^^^^^^^^^^^^^
Wonderful breakdown of these three drugs, but a few things were left out.
Abrupt cessation after extended use of any of these drugs, especially Valium, could land
you in a hospital, in a coma. Don't mix with alcohol or you'll do a "Karen Ann Quinlan."
Lastly, Xanax is a palindrome and imparts a mild antidepressant effect.Greetings to Cam W.
kazoo
Posted by Mark H. on April 13, 2000, at 16:34:38
In reply to ativan vs. valium vs. xanax, posted by lynny2 on April 12, 2000, at 19:24:25
Cam and Kazoo consistently make me smile! I wonder if palindromes in general are anxiolytic in nature? MedLib could probably help here.
To Cam and Kazoo's good observations, I would only add that the different benzodiazepines not only affect different people differently, but (at least for some of us) they also affect the same people differently at different times in their cycles.
For instance, during my "up" cycles, Xanax tends to have an anti-depressant effect for me. However, at the bottom of my cycle, it simply makes me more depressed. Valium is similar in that regard -- but it is still the "best" muscle relaxant if you are prone to back spasms from stress. Ativan, which I've only recently tried (in a low part of my cycle) seems to cheer me up and make me feel like I *remember* Valium making me feel in my 20s. However, if I take Ativan for even two days in a row, I have some withdrawal symptoms when I don't take it the third day, so I'm very careful not to use it much.
Another idiosyncratic quirk (is that like a needlessly redundant, repetitive tautology that is unnecessarily said over and over again?): while Valium is notorious for potentiating alcohol, for me it was just the opposite. I haven't consumed any alcohol for more than 18 years, but when I did drink, Valium had the effect of sobering me up -- but that was just me, so don't try this at home.
After being on Valium (15mg/day) for several months, it took me *weeks* before the withdrawal symptoms subsided. For the past 20 years, I've been very careful not to take any of the benzodiazepines every day (with the exception of clonazepam, which was surprisingly easy to stop and is used by some doctors to help people withdraw from the more addictive benzodiazepines).
I hope this additional information helps round out the picture some.
Posted by medlib on April 14, 2000, at 2:55:18
In reply to Re: ativan vs. valium vs. xanax, posted by Mark H. on April 13, 2000, at 16:34:38
> Cam and Kazoo consistently make me smile! I wonder if palindromes in general are anxiolytic in nature? MedLib could probably help here.
>
> Another idiosyncratic quirk (is that like a needlessly redundant, repetitive tautology that is unnecessarily said over and over again?)
MarkH--Your post made *me* smile! Sure, palindromes are anxiolytic--to the extent they're recognized and make us smile (documented to lower BP and release endorphins).Lots of anxiolytic posts (and posters) on this board this time. Let's hear it for alternative "medicine"!
Guess I'd better close these "senile lines" and hit the sack.
medlib, aka "sum mus"
Posted by Mark H. on April 14, 2000, at 18:22:42
In reply to Re: Don't nod, posted by medlib on April 14, 2000, at 2:55:18
Hi MedLib,
Thank you, especially for Senile Lines, which seems particularly descriptive of my writing.
I've been meaning to ask if your delight in words is also part of your illness? Hypomanics and manics sometimes have a wonderful time with rapid word association.
Warm regards, Mark H.
(No hidden palindromes in the above message -- but here are a few of my borrowed favorites:)
Sex-aware era waxes.
Sex at noon taxes.
Lonely Tylenol.
Are we not drawn onward, we few, drawn onward to new era?
Yawn -- Madonna fan? No damn way!
Posted by Not Me on April 14, 2000, at 18:59:44
In reply to Re: Don't nod, posted by medlib on April 14, 2000, at 2:55:18
And how come that patient finally paid up?
MedLib bil'd 'em.
**GROAN** ;-)
MH
Posted by medlib on April 17, 2000, at 6:08:41
In reply to Re: Palindromes, posted by Mark H. on April 14, 2000, at 18:22:42
> Hi MedLib,
>
> Thank you, especially for Senile Lines, which seems particularly descriptive of my writing.
>
> I've been meaning to ask if your delight in words is also part of your illness? Hypomanics and manics sometimes have a wonderful time with rapid word association.
>
> Warm regards, Mark H.
>
> (No hidden palindromes in the above message -- but here are a few of my borrowed favorites:)
>
> Sex-aware era waxes.
>
> Sex at noon taxes.
>
> Lonely Tylenol.
>
> Are we not drawn onward, we few, drawn onward to new era?
>
> Yawn -- Madonna fan? No damn way!*******************************
Mark H--Thanks very much for your interest. Sorry I didn't reply sooner, but I've been busy extracting my feet from my virtual mouth re a couple of previous posts.
Interesting--I did not know of the connection between mania and word association. My brother is bipolar, but that was never one of his symptoms. I have no personal knowledge of hypomania or mania; I've never been that up, although I've always wanted to feel that good--just once. My dx is double dysthmia--symptom onset in my teens. I believe my wordiness was inherited from my mother (she did NY Times crossword puzzles and played "killer" Scrabble until a few months before her death at 86). I disappeared into books before I started kindergarden and had a wide-ranging (and undiscriminating) curiosity. My brother called me an "intellectual junk collector." People were the only subject I couldn't figure out, perhaps partly because they aren't logical; facts and vocabularies were always easier to acquire than friends. (I almost avoided the temptation to say, "I was a nerd before there was such a word."--but I couldn't resist the alliteration.)
So, yeah, my wordiness probably is related to my disease; although I never have been diagnosed with OCD, I likely have an atypical version of it. Certainly my drive to share my information far exceeds any sane person's desire to know it. My poor daughter once inquired plaintively, "Mother, how come when I ask one question I get six answers?" Kinda like this post, huh?
Your posts indicate that you're unusually perceptive about people; would that I could borrow some small chunk of that ability--I might at least be able to avoid such an intimate association with shoe leather.
Your resident word "nut"--medlib
Posted by Max Id on August 15, 2002, at 15:20:37
In reply to Re: Palindromes, posted by Mark H. on April 14, 2000, at 18:22:42
mark - your points are salient and entertaining. you seem to have a warm relationship with the written word. although, i have anyways found i tolerate xanax better than valium and valium better than klonopin and klonopin better than oxazepam and oxazepam better than librium. so naturally i am very curious about ativan. strictly in the therapeutic sense, of course.
max id
Posted by Lindsay Rae on January 25, 2005, at 11:23:36
In reply to Re: Palindromes, posted by Mark H. on April 14, 2000, at 18:22:42
This thread is really old, but I found it in a search regarding the differences between Valium and Xanax, for personal use, and after hundreds of thousands of "hits" on the web, all of which consisted of ONE website advertising drugs and free delivery, I found this educational post.
Posted by ed_uk on January 25, 2005, at 11:35:58
In reply to Re: Palindromes, posted by Lindsay Rae on January 25, 2005, at 11:23:36
Why doesn't Cam W come on p-babble anymore?
Ed.
Posted by Lindsay Rae on January 25, 2005, at 17:29:54
In reply to Re: Palindromes, posted by ed_uk on January 25, 2005, at 11:35:58
> Why doesn't Cam W come on p-babble anymore?
>
> Ed.I don't know her, nor do I know you, but maybe this old post will bring her back.
Are the two of you Pharmacologists, or just well-versed on the topic from personal research?
I'm 28 years old, going on ninety; at least, my back is, according to the Orthopoedic surgeon who assessed my 'friend's' MRI results five years ago. So I suppose my friend's back would be post-mortum by now, considering the fact that my 'friend' listened to his seedy advice about thinking of my back as a 'rusty hinge,' deeming me fit for only a nursing home following graduation, a diagnosis my 'friend' was happy to accept as long as I could keep getting 30 Darvocet per month called in to the pharmacy (thirty!).
So how do you suppose my 'friend' would wind up one 160 mg Methadone, 4mg Xanax, 37.5 Phentermine, and 100mg Lexapro daily?
Self talk, that's how.
Any advice on how to effectively taper, sans clinic, and lose all the weight and anxiety that came with the medication? My 'friend' missed just being able to enjoy a beer. Now it's nauseating. There is a two year old involved as well, whose daddy died a year ago due to illegal drug overdose.
All that aside, my main question was whether it would be comfortable to switch from Xanax to Valium given the half life difference and lack of antidepressant effects of Valium? Your friend's breakdown of the drug makes total sense.
My thought is that whatever benzo you're taking, it loses effect after awhile, so switching from one to another would most likely be a positive experience regardless of the other benzo. I'm not so sure now, though, after being off of Xanax a week and on Diazapam. I'm surprised, though, that the onset for Valium is quicker than that of Xanax.
Thanks,
L Rae
Posted by ed_uk on January 26, 2005, at 13:37:47
In reply to Re: Palindromes, posted by Lindsay Rae on January 25, 2005, at 17:29:54
Hi,
>Are the two of you Pharmacologists, or just well-versed on the topic from personal research?
I'm a pharmacy student. I think CamW is a pharmacist but I'm not sure.
>All that aside, my main question was whether it would be comfortable to switch from Xanax to Valium given the half life difference and lack of antidepressant effects of Valium?
Although switching to Valium should ease the withdrawal, mild withdrawal symptoms may still occur- particularly during the early stages of the switch.
In general,
1mg Xanax is approximately equivalent to 10-20mg Valium.
So,
4mg/day of Xanax would need to be replaced by 40-80mg/day of Valium. A certain amount of trial and error is usually required to find a suitable dose of Valium to prevent withdrawal symptoms.
Once the withdrawal symptoms have been controlled by the Valium, the daily dose of Valium can be reduced by approximately one-tenth every two weeks.
Ed.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.