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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Phillipa on February 10, 2005, at 20:47:50
I was just thinking. Years ago, when I experienced my first panic attack this drug was a miracle for me. Now they never use it. It seems to me, that it would be the drug of choice for someone who is going through extreme anxiety with muscle cramping and twitching. It does have muscle relaxing properties. What do you think? Fondly, Phillipa
Posted by jen2 on February 10, 2005, at 21:57:41
In reply to What Ever Happened To Valium?, posted by Phillipa on February 10, 2005, at 20:47:50
I was wondering the same thing recently. I used to take it many years ago too, but you never hear about it any more. Other anti-anxiolytics like Lorazepam are really horrible and just make me feel dead, whereas Valium always made me feel calm and relaxed.
Jen
Posted by Phillipa on February 10, 2005, at 22:06:26
In reply to Re: What Ever Happened To Valium?, posted by jen2 on February 10, 2005, at 21:57:41
Exactly! So, why don't they use it? Probably those drug companies again, and the more expensive drugs. Since the new pdoc is probably in her late 60's, and is an expert on addiction, I'm definitely going to ask her. I really think this what I need to slow down the racing thoughts, and the muscle twitching, spasms, etc. I have been thinking about it all day. Fondly, Phillipa
Posted by jen2 on February 10, 2005, at 22:43:21
In reply to Re: What Ever Happened To Valium? » jen2, posted by Phillipa on February 10, 2005, at 22:06:26
I think you're right - the pharmaceutical companies have an obvious interest in promoting "the latest and newest and best" pill on the market, since the old ones - that work just as well, mind, if not better - don't generate as much profit after the patents run out because generics can be prescribed at much lower cost.
I'd be interested to hear what the pdoc says. Hope it goes well.
Jen
Posted by cubbybear on February 11, 2005, at 3:04:11
In reply to Re: What Ever Happened To Valium? » Phillipa, posted by jen2 on February 10, 2005, at 22:43:21
I agree totallyabout the drug companies looking for profits
More to the point, I asked for and easily got some Valium last year to substitute for Klonopin during the last stages of the tapering when I could no longer cut the Klonopin pills and had to go down in very small increments. The Valium was perfect for doing this. (see tapering charts on www.benzo.org)
Posted by alienatari on February 11, 2005, at 3:19:14
In reply to What Ever Happened To Valium?, posted by Phillipa on February 10, 2005, at 20:47:50
The first benzo i had ever used was valium and that was a few years ago. Maybe things are different here in Australia, but they seem to want to push Valium over othere benzo's here. Not sure.
Posted by ed_uk on February 11, 2005, at 7:17:06
In reply to Re: What Ever Happened To Valium?, posted by alienatari on February 11, 2005, at 3:19:14
Hi,
It's the same in the UK. Other anxiolytic benzos are rarely used, many doctors here only prescribe diazepam. Nitrazepam and temazepam are used for sleep. Lormetazepam is also occasionally used for sleep.
Ed.
Posted by med_empowered on February 11, 2005, at 8:40:37
In reply to Re: What Ever Happened To Valium? » alienatari, posted by ed_uk on February 11, 2005, at 7:17:06
I think here in the US valium just has a bad rep. Think about it: when the backlash against the benzos began in the later 70s (thanks for that, betty ford) , what name did you hear the most? Valium. What drug defined the term "Mother's Little Helpers"? Valium. Basically, I think a lot of shrinks either view benzos simplistically as bad, bad things or necessary evils OR, when they do prescribe them, tend to rx for ones that don't have the same rep as valium does, which is a shame. I mean, think about it; if Valium didn't have such a bad rep, do you really think Klonopin, which was originally made for epileptics and has fun side-effects like cognitive slowing and occasionally causing/worsening depression, would be such a big drug in the treatment of anxiety?
Posted by Buckeye Fan on February 12, 2005, at 5:33:22
In reply to Re: What Ever Happened To Valium?, posted by med_empowered on February 11, 2005, at 8:40:37
I think you are ALL correct.
MD'S & PD'S are under constant pressure to prescribe the "newest" and "safest" medicines available.
I see more pharmacutical Reps waiting to see my MD than patients some days lol!I had a minor outpatient procedure Thur and I was given Valium for the first time to help relax me before the procedure.....I loved it!
I dont know what its half-life is...( they only gave me 5mg) but I was relaxed and sleepy the rest of the day.
Buckeye Fan
Posted by medhed on February 12, 2005, at 6:07:23
In reply to Re: What Ever Happened To Valium?, posted by Buckeye Fan on February 12, 2005, at 5:33:22
I'D RATHER HAVE A PROMOTIONAL PEN FOR VALIUM THAN ANY OTHER BENZO. MY PDOC HAS A STRATTERA PEN- WHAT A SELLOUT SHE IS. SHE ALSO HAS A XANAX XR CLOCK! ALL HER POST ITS ARE FROM EFFEXOR...
IF I HAD A PEN WITH 'ROCHE 10MG. VALIUM' I'D REPLACE THE REFILL WHEN IT RAN OUT OF INK, INSTEAD OF CHUCKING IT.
Posted by Buckeye Fan on February 12, 2005, at 8:02:54
In reply to Re: What Ever Happened To Valium?, posted by medhed on February 12, 2005, at 6:07:23
LOL! Good one Medhead....
Thanks for the chuckle.....AND for the truth in your post.BF
Posted by Lazarus on February 12, 2005, at 20:45:01
In reply to What Ever Happened To Valium?, posted by Phillipa on February 10, 2005, at 20:47:50
My pdoc frequently gives me Valium during extremely stressful times in my life (during a restraining order, etc.). It has a calming, muscle relaxant effect, and is very long lasting. Compared to other benzos I think it is one of the safer ones (tolerance potential is low). So don't be afraid to ask your pdoc for it.
Lazarus
Posted by jen2 on February 12, 2005, at 22:22:23
In reply to What Ever Happened To Valium?, posted by Phillipa on February 10, 2005, at 20:47:50
So Phillipa, did you see the pdoc and, if so, what did she say about Valium? I know that you're having computer problems so I'll just wait to hear back from you.
Jen
Posted by Kon on February 13, 2005, at 10:49:04
In reply to What Ever Happened To Valium?, posted by Phillipa on February 10, 2005, at 20:47:50
In the 1980s there were many studies (see below for a sample)comparing valium to the then newer "high-potency" benzos (lorazepam, xanax, clonazepam) and most of the studies suggested somewhat greater efficacy and better side-effect profile of the latter group compared to valium. Much of this research was company-sponsored and some publication bias is likely but I think this is also a reason (among many others)that most usually prescribe the "high potency benzos".
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Neuropsychobiology. 1983;9(2-3):139-41.
Intramuscular lorazepam. A double-blind comparison with diazepam and placebo.Ananth J, Van den Steen N.
In this double-blind, placebo-controlled study, 24 anxiety neurotic patients were randomly assigned equally into the intramuscular placebo, lorazepam or diazepam groups. The results indicated that lorazepam was as effective as diazepam in overall efficacy and was superior to diazepam in certain cluster scores including the Obsessive Compulsive Phobic Cluser of the Wittenborn Psychiatric Rating Scale.
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Acta Psychiatr Belg. 1978 Jul-Aug;78(4):619-34.
Time-blind videotaped evaluation of injectable diazepam, lorazepam and placebo.Bobon DP, Fanielle J, Mormont C, Breulet M, Bobon J.
Eighteen inpatients suffering from a severe anxiety received in double-blind and crossover conditions iv and im injections of 10 mg diazepam, 5 mg lorazepam or saline t.i.d. during 5 days. The morning injections was made iv in a CCTV studio. Before injection and 20 mn after it, the patient filled out a 100 mm Visual Analogue Scale; his doctor-in-charge proceeded to a standard interview and to physiological measurements (tremor of hand, patellar reflexes, blood pressure, pulse rate). The videotaped interviews were randomly, i.e. time-blind, rated by two independent observers on 3 scales: the VAS, the Hamilton Anxiety Scale and an ad hoc Verbal and Non-Verbal Anxiety Scale (VNVA). The statistical analysis was completed by a logical analysis according to Lewis Carroll. The results demonstrate the superiority of lorazepam over diazepam on psychic anxiety, somatic anxiety, sleep and blood pressure, the only significant side-effect being drowsiness.
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Dis Nerv Syst. 1976 Feb;37(2):58-61.
Lorazepam and diazepam in the treatment of neurotic anxiety: a double-blind trial.Valarino F, Perez-Lopez R.
Fifty-eight neurotic patients with intense anxiety were treated with either lorazepam or diazepam in a double blind between-patients trial. Statistical analysis indicated that the two groups were homogeneous before treatment and that the results of treatment were similar for both drugs. According to the global rating of illness week after week, after four weeks of treatment more patients on lorazepam than on diazepam were normal or had mild illness (82.1% vs. 70.8%). In the investigators' judgment, 71.9% of the patients treated with lorazepam had an excellent or good response compared with 56.7+ of those treated with diazepam. The mean reduction in score on the Hamilton Anxiety Scale was 17.7 for lorazepam and 16.5 for diazepam. However, none of the above differences in results were statistically significant. The largest dose of lorazepam required in treatment was 6 mg, compared with 30 mg of diazepam. Two patients treated with lorazepam had side effects, against six with diazepam. Six patients in the diazepam group did not complete the trial, including three who discontinued because of side effects (rash, tremors, agitation); no patients in the lorazepam group dropped out.
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J Clin Psychiatry. 1981 Sep;42(9):347-51.
Multicenter double-blind efficacy and safety study comparing alprazolam, diazepam and placebo in clinically anxious patients.Cohn JB.
Both alprazolam and diazepam were superior to placebo for the treatment of the clinical anxiety syndrome throughout a four-week double-blind multiclinic trial in 976 outpatients. At the fourth-week evaluation of the 845 patients completing the study, the 326 patients receiving alprazolam showed significantly more improvement than the 344 patients receiving diazepam on all 4 anxiety rating scales utilized (Hamilton Anxiety Rating Scale, Physician's Global Assessment, Patient's Global Assessment, and Target Symptoms).
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J Int Med Res. 1980;8(2):139-43.
Anxiolytic efficacy of alprazolam compared to diazepam and placebo.Maletzky BM.
The anxiolytic effects of alpraxolam (0.5--3.0 mg), diazepam (5--60 mg) and placebo were evaluated in eighty-six out-patients suffering from moderate to severe psychoneurotic anxiety in this 28-day, double-blind study. Efficacy was evaluated using five rating instruments, three rated by the physician (Hamilton Anxiety Rating Scale, Physician's Global Impressions and Target Symptoms) and two by the patients (Self-Rating Symptom Scale and Patient's Global Impressions). Alprazolam was more effective than placebo on all five measures of efficacy and, on several parameters, more effective than diazepam as well. The incidence of side-effects was lowest in the alprazolam group and decreased steadily over the course of the study, whereas the incidence in the diazepam and placebo groups remained relatively unchanged.
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Br J Clin Pharmacol. 1985;19 Suppl 1:37S-43S.
A double-blind comparison of alprazolam, diazepam and placebo in the treatment of anxious out-patients.Davison K, Farquharson RG, Khan MC, Majid A.
In a double-blind 28-day comparison of alprazolam, diazepam and placebo, alprazolam 1.5-3 mg/day was of equivalent anxiolytic effect to 15-30 mg diazepam/day and there was some evidence of antidepressant activity by alprazolam, but not diazepam, in neurotic depression. No serious side-effects or laboratory abnormalities were encountered.
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J Clin Psychiatry. 1980 Jul;41(7):245-8.
Alprazolam compared to diazepam and placebo in the treatment of anxiety.Aden GC, Thein SG Jr.
Alprazolam was compared to diazepam and placebo in 235 outpatients suffering from manifest anxiety. In this 28-day double-blind study, alprazolam was more effective than placebo and essentially equivalent to diazepam in alleviating the symptoms of anxiety. However, alprazolam produced a markedly lower incidence of side effects than either diazepam or placebo. Of particular note, drowsiness was reported less than half as frequently by alprazolam patients than by diazepam patients. These results were achieved with an average daily dose of 1.5 mg alprazolam compared to 18.6 mg diazepam.
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Psychopharmacology (Berl). 1983;80(4):308-10.
A double blind comparison of alprazolam, diazepam and placebo in the treatment of anxious out-patients.Davison K, Farquharson RG, Khan MC, Majid A.
The anxiolytic effects of alprazolam, a triazolobenzodiazepine, were evaluated in a double-blind 28-day comparison with diazepam and placebo in 46 out-patients suffering from anxiety states of moderate to severe intensity. Alprazolam 1.5-3 mg per day was found to be of at least equivalent anxiolytic effect to 15-30 mg diazepam per day, and there was evidence of antidepressant activity by alprazolam, but not diazepam, in neurotic depression. Side-effects occurred least often with alprazolam and were minor in nature. Laboratory data showed no changes attributable to alprazolam even in a patient who swallowed 15 capsules (7.5 mg). It was concluded that alprazolam is a safe and effective anxiolytic which is well-tolerated and also shows some antidepressant activity.
Posted by ed_uk on February 13, 2005, at 11:09:38
In reply to Re: What Ever Happened To Valium?, posted by Kon on February 13, 2005, at 10:49:04
Hi,
>most of the studies suggested somewhat greater efficacy
In many cases, the alleged superiority of high-potency benzodiazepines was probably just an artefact of the fact that non-equivalent doses were used.
For example....
>Eighteen inpatients suffering from a severe anxiety received in double-blind and crossover conditions iv and im injections of 10 mg diazepam, 5 mg lorazepam or saline t.i.d. during 5 days.
>The results demonstrate the superiority of lorazepam over diazepam on psychic anxiety, somatic anxiety, sleep and blood pressure, the only significant side-effect being drowsiness5mg lorazepam is a much higher dose than 10mg diazepam.
Regards,
Ed.
Posted by Tedar on February 13, 2005, at 11:58:14
In reply to Re: What Ever Happened To Valium? » Kon, posted by ed_uk on February 13, 2005, at 11:09:38
I wonder all of the time about the negative vibes toward Valium from docs. Years ago when my anxiety reached its first crisis, Valium is what was given to me. It worked tremendously well, without the paradoxical, funny,goofy, effects that Xanax has given me. No doubt about it, Pharma hype has a big role in the false perception of Valium as being dirtier and less effective than the other benzos. But Xanax is a triazolo Benzo, and all I know is that it messes with my moods, and does not help give me predictable calming. The Xanax XR that my current Psych is in love with, is even worse. I still have to take it a couple of times a day, and at higher daily doses than regular xanax. The Valium would be so much easier. I just felt more natural and like myself on it. Anyone with similar experiences?
Posted by Phillipa on February 13, 2005, at 19:46:36
In reply to Re: What Ever Happened To Valium?, posted by Tedar on February 13, 2005, at 11:58:14
How I wish I had never gone off valium and switched to the newer anti-anxiety meds, especially xanax and klonopin. When I used to take 5mg of valium, I could sit back and say "Ah, yes, now I'm relaxed! Never abused it, and it was the only thing that made me feel "normal". Just thought of something. The veterinarians are using valium for dogs to calm them. My l7yr old llapso-poo was dying and valium made him so much better. They also still use it for some non-invasive surgeries. I had Lasik surgery on my eyes last spring so I wouldn't need glasses for distance. They gave me 5mg of valium to take before. I noticed that it didn't affect me. Probably because I have been on all the others. Again I say, "They turned me into an addict!" Fondly, Phillipa
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