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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 5 to 29 of 107. Go back in thread:
Posted by Phillipa on August 25, 2006, at 11:21:15
In reply to Re: What does taking a benzo actually feel like? » Meri-Tuuli, posted by Squiggles on August 25, 2006, at 9:52:19
Squiggles I took xanax for over l0 years inbetween valium and I never had to raise the dose. All I wanted was the horrific anxiety to go away and when it did I never went above two mg in a day. That's just me. Love Phillipa ps Merri just you and I both do. Sending you one now.
Posted by Squiggles on August 25, 2006, at 11:42:14
In reply to Re: What does taking a benzo actually feel like? » Squiggles, posted by Phillipa on August 25, 2006, at 11:21:15
Maybe that you took it WITH Valium made
a difference - covered by the Valium when
infact withdrawn on Xanax. Anyway, my
doctor agreed with me, so I rest assure
his judgement about the addicting nature
of most benzos. You might also look at the
APA, FDA, and other Gov. Health organizations.Squiggles
Posted by valene on August 25, 2006, at 11:43:15
In reply to Re: What does taking a benzo actually feel like? » Squiggles, posted by Phillipa on August 25, 2006, at 11:21:15
I have taken xanax for severe GAD for many years and have not increased the dose; in fact I have lowered it from 3mg. to 1.5mg. It works fine for me. That's my experience.
Val
Posted by Squiggles on August 25, 2006, at 11:54:57
In reply to Re: What does taking a benzo actually feel like?, posted by valene on August 25, 2006, at 11:43:15
With the exception of clonazepam (increase
every 7-10 yrs), my experience has been
that the other benzos I have tried (Xanax,
and Valium) are addicting.Period.
Over and out.
Squiggles
Posted by rjlockhart on August 25, 2006, at 11:57:18
In reply to Re: What does taking a benzo actually feel like?, posted by valene on August 25, 2006, at 11:43:15
Xanax feels as if you are calming, mellowing out, well if you have anxiety it almost causes, well it does bring relief.
Xanax is potent, it makes you want to sleep almost, i take a high dose for panic attacks.
It depends when you take it how it effects you.
I dont like taking Xanax when im doing something fun, it zones you out.
Thats my put.
Your doctor wont even put you Klonopin?
Matt
Posted by Meri-Tuuli on August 25, 2006, at 12:08:42
In reply to Re: What does taking a benzo actually feel like?, posted by rjlockhart on August 25, 2006, at 11:57:18
Hey folks,
Thanks for the descriptions. I'm after descriptions because I would like to know what it feels like when the benzo quells your anxiety.
Is it like having a glass of wine, I mean, in terms of anxiety reduction?
Matt:
> Your doctor wont even put you Klonopin?
No. I might try asking again, and being 'abit pushy' if you know what I mean.
I mean the thing is, they *know* I suffer from anxeity and depression and they *know* i get panic attacks (some so bad I end up in ER) but they won't even talk about benzos.
I know they are addictive. But then, SSRIs etc are sort of addicitive. I mean, its hard coming of those too, yet there isn't such a backlash.
I mean, what is better, drinking to reduce anxiety or taking benzos????????
Kind regards
Meri
Posted by UgottaHaveHope on August 25, 2006, at 13:05:27
In reply to Re: What does taking a benzo actually feel like?, posted by Meri-Tuuli on August 25, 2006, at 12:08:42
That's one good description I've heard about benzos.
Let me say TWO things: 1, every med affects everyone differently. 2, Benzos are great despite being possibly the most feared meds around. They are so feared because they garnered a bad reputation after so many ppl abused them for RECREATIONAL use. The TRUTH is, when used properly (i.e. strictly medicinal purposes) benzos are some of the safest and most effective meds out there. I am taking less Klonopin now than when I first started nine years ago. Good luck.
Posted by xbunny on August 25, 2006, at 13:08:10
In reply to Re: What does taking a benzo actually feel like?, posted by Meri-Tuuli on August 25, 2006, at 12:08:42
> Thanks for the descriptions. I'm after descriptions because I would like to know what it feels like when the benzo quells your anxiety.
>
> Is it like having a glass of wine, I mean, in terms of anxiety reduction?I find taking diazepam is nothing like a glass of wine. Its a bit weird, I take it and forget about it and then I notice an hour or so later that I feel less anxious. If my stomache was churning it has usually calmed down and I just feel less anxious. Alcohol feels totally different less 'smooth' less relaxed.
Im sorry you cant get your GP or pdoc to prescribe you a benzo, I know its no consolation but they do actually do it, my GP prescribes me diazepam and a pdoc has prescribed lorazepm, so maybe if you persevere you will get a result. I would stress to your GP that you only want it for the short term to get through the tough patch you are having. I think already being on a drugs they respect can help too. If you are already taking a drug they think works for anxiety like an SSRI and can say you still feel anxious then perhaps they are more likely to give you a benzo rather than prescribe an antidepressant which I gather you havent had much success with.
Best regards, Bunny
Posted by bassman on August 25, 2006, at 13:45:34
In reply to Re: What does taking a benzo actually feel like? » Meri-Tuuli, posted by xbunny on August 25, 2006, at 13:08:10
That's pretty much my expereince of what a benzo "feels like", too. It is more the absence of anxiety/depression than, say drinking, in which you know something is going on. Benzos just sort of remove anxiety without doing much else-if you didn't know you had taken one, you'd say you just "calmed down". Of course, different people have different reactions to benzos. I think sometimes people feel the benzo has stopped working because they no longer get sleepy-so they take more. That can cause problems...the only really difficult dependence problem is when a person takes more and more of a benzo until they are taking so much they show side effects-but they are at such a high dose, tapering is difficult AND they have to put up with side effects from the high dose.
Posted by willyee on August 25, 2006, at 13:53:02
In reply to What does taking a benzo actually feel like?, posted by Meri-Tuuli on August 25, 2006, at 9:13:32
A few have some unique chracteristics,however if you are dealing with some extreme anxiety,then most should be a welcoming delight.
Regardless of anxiety however they all can depress people,some more sensative than others,i personaly for general all day anxiety am a fan of klonopin,and using it as so....
In small increments,laying out a large dose cut up,time the increments,take a pieace and let your anxiety keep you busy,as you take each pieace you should slowy notice,usualy behind your neck first,your anxiety begin to settle,just remeber usualy a benzo doesent hold much mood elevation so more is definalty not better,if u can go for the least theraputic amount and try to let your body work its synergy with the drug,a lot of times for me too much of a benzo can bring on worse anxiety and depression,and oddly enough i am on my third time over choosing NOT to follow a docters advice on going high on my benzo,i dont feel it is the right choice,i dont like the calm over benzo-ing *i know that isnt a word* brings.
I prefer the just right or a tad under calm,so im instead continuing to take it as needed as i have been for 5 years,i followed her instructions for a week and took 3 times my normal dose and i felt totaly drugged and i hated it.
Sooooo my point is,after your initial response,if you were to obtain a benzo it might take some work to find the best dosing range as everyone works different.
Posted by laima on August 25, 2006, at 16:03:21
In reply to What does taking a benzo actually feel like?, posted by Meri-Tuuli on August 25, 2006, at 9:13:32
My experience with the different ones is that there are some subtle, and some substancial differences between them.When I took low dose xanax- I felt calm, still quite clear, and while worries were still worries, they didn't seem desperately unmanageable at all. I felt, "I can handle it"! Higher dose=getting groggier.
Ativan sort of worked for me for sleep- but each dose wore off very quickly. As a benzo wears off, I can detect a heightened anxiety as "withdrawal" effect. I didn't use it during the day- no reason other than I wasn't prescribed to use it during day.
Klonopin- stronger, and more likely to make me feel "drug is in my body". Fuzzier-but not bad on lower dose. This one is a mild muscle relaxant, too. Very high doses- as I tend to gulp too many of these on plane trips-leave me stumbley, clumsy, fading in and out, with trouble keeping my eyes open. Then that wears off into "drained and mellow."
Restoril (for sleep, and it is either part hypnotic or related to hypnotics) was like a knock out. I even read that militaries have used it to put fighters to sleep during their brief "breaks" (sorry- I got no references to prove or disprove- but it wouldn't surprise me. The idea was that it can "knock one out" that effectively and quickly.) To me it felt like a depressing bludgeon.
They all feel different from ambien, too- ambien for me=weird, bizarre behavior as I still resist going to bed, and while it can groggify me, oddly it never calmed anxiety whatsoever, in my experience.
Benedryl for me=plain dullness.
With the possible exeption of excessive klonopin stumbliness, none of them felt "drunk" at all to me- "drunk" to me has more giddiness, disinhibition, extroversion, goofiness, loudness, and fuzziness, and losing awareness, losing memory....
Also, "drunk" can turn into emotionality, crying, hysterics, drama, whatever- note people stumbling out of bars totally trashed at closing time. Never got any of that sort of an effect with a benzo.And "high" isn't even in the same ballpark, in my opinion- utterly different.
Posted by laima on August 25, 2006, at 16:05:07
In reply to Re: What does taking a benzo actually feel like?, posted by Meri-Tuuli on August 25, 2006, at 12:08:42
I'd say better- no "can't sleep" effect later, for one thing.
> Hey folks,
>
> Thanks for the descriptions. I'm after descriptions because I would like to know what it feels like when the benzo quells your anxiety.
>
> Is it like having a glass of wine, I mean, in terms of anxiety reduction?
>
> Matt:
>
> > Your doctor wont even put you Klonopin?
>
> No. I might try asking again, and being 'abit pushy' if you know what I mean.
>
> I mean the thing is, they *know* I suffer from anxeity and depression and they *know* i get panic attacks (some so bad I end up in ER) but they won't even talk about benzos.
>
> I know they are addictive. But then, SSRIs etc are sort of addicitive. I mean, its hard coming of those too, yet there isn't such a backlash.
>
> I mean, what is better, drinking to reduce anxiety or taking benzos????????
>
> Kind regards
>
> Meri
>
>
Posted by laima on August 25, 2006, at 16:10:17
In reply to Re: What does taking a benzo actually feel like?, posted by bassman on August 25, 2006, at 13:45:34
I'd like to agree, but add, alas, they are technically generally "addictive", and many people find they need to take higher and higher dose to keep up the effect. So long term use can have a dark side- for many- not for all- but for many. And that's when you start to hear about the "withdrawal stories"...I thought my doctor had good advice: "use benzos as more of a tool than as a final and sole solution for your anxiety, if at all possible."
> That's pretty much my expereince of what a benzo "feels like", too. It is more the absence of anxiety/depression than, say drinking, in which you know something is going on. Benzos just sort of remove anxiety without doing much else-if you didn't know you had taken one, you'd say you just "calmed down". Of course, different people have different reactions to benzos. I think sometimes people feel the benzo has stopped working because they no longer get sleepy-so they take more. That can cause problems...the only really difficult dependence problem is when a person takes more and more of a benzo until they are taking so much they show side effects-but they are at such a high dose, tapering is difficult AND they have to put up with side effects from the high dose.
Posted by bassman on August 25, 2006, at 17:23:34
In reply to Re: What does taking a benzo actually feel like? » bassman, posted by laima on August 25, 2006, at 16:10:17
There are many who would agree with your opinion. Here is research that support the opposite opinion, namely, that benzos very seldom cause addiction (as opposed to dependence) and dose escalation is unusual:
Schweizer et al. (58) have conducted an 8-month, placebo-controlled study of continuation therapy for panic disorder with alprazolam and imipramine that found sustained efficacy for both compounds with no dose escalation, suggesting an absence of tolerance to the therapeutic effect
Preliminary evidence for the efficacy of continuation therapy of GAD comes from two studies (43, 47). In both studies the benzodiazepine therapy achieved sustained remission of anxious symptomatology with no tolerance and no dose escalation over a 6-month period.
http://www.acnp.org/G4/GN401000129/CH127.html
A total of 136 patients received clonazepam nightly for a mean 3.5 (+/- 2.4) years, with no significant difference in initial versus final mean dose: 0.77 mg (+/- 0.46) versus 1.10 mg (+/- 0.96). Similar results were obtained with chronic alprazolam treatment and with other benzodiazepine treatments. CONCLUSION: Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep resulted in sustained efficacy in most cases, with low risk of dosage tolerance, adverse effects, or abuse.
Fifty-nine panic disorder patients originally randomized to treatment in a controlled trial comparing alprazolam, clonazepam, and placebo were reevaluated in a follow-up study. At a mean follow-up of 1.5 years, 78% of patients remained on medication and the mean dosage of alprazolam and clonazepam did not increase.A 15 year study:
Maintenance medication was common. No benzodiazepine abuse was reported. CONCLUSION: PD has a favourable outcome in a substantial proportion of patients. However, the illness is chronic and needs treatment. The short-term treatment given in the drug trial had no influence on the long-term outcome.I think this is interesting because it basically says the physicians are quite prejudiced concerning benzo use, even when it comes to outcome. Who knows the benefits better, the physician or the patient? That’ s easy.
The participants were 93 patients over 60 years of age using a benzodiazepine for insomnia and 25 physicians comprising sleep specialists, family physicians, and family medicine residents. The main outcome measure was perception of benefit and risk scores calculated from the mean of responses (on a Likert scale of 1 to 5) to various items on the survey. RESULTS: The mean perception of benefit score was significantly higher in patients than physicians (3.85 vs. 2.84, p < 0.001, 95% CI 0.69, 1.32). The mean perception of risk score was significantly lower in patients than physicians (2.21 vs. 3.63, p < 0.001, 95% CI 1.07, 1.77). CONCLUSIONS: There is a significant discordance between older patients and their physicians regarding the perceptions of benefits and risks of using benzodiazepines for insomnia on a long term basis. The challenge is to openly discuss these perceptions in the context of the available evidence to make collaborative and informed decisions.
The Task Force Report, although over 10 years old, is still a standard reference for benzodiazepine use. Its points—that there is undue reluctance to use minor tranquillizers, and that many people are under treated—still hold, and are borne out by the Roy-Byrne study. Other relevant literature includes a review of 2719 adult out-patient charts2 (medical and psychiatric) for evidence of benzodiazepine abuse that found no patients meeting the criteria. Another study, of long-term alprazolam users, found no dose escalation with long-term use.3 Tyrer’s 19884 paper on minor tranquillizers notes an absence of evidence that benzodiazepine dependence leads to dangerous long-term sequellae, and blames "excessive media attention" for distortion of scientific attitudes.
http://fampra.oxfordjournals.org/cgi/content/full/20/3/347
Benzodiazepines are relatively safe drugs that are probably under- rather than overprescribed. Periodic reassessment of chronic users is appropriate, although generalized anxiety disorder and panic disorder are chronic conditions for which long-term treatment may be necessary. In the more recent era of safer antidepressants, these agents may be able to supplant minor tranquillizers for the control of chronic anxiety in many patients. Long-term benzodiazepine use is appropriate for some patients.
http://fampra.oxfordjournals.org/cgi/content/full/20/3/347
Tolerance is the need to increase the dose of a drug to maintain the desired effects. Tolerance to the anxiety-relieving effects of benzodiazepines is uncommon and most individuals do not increase their benzodiazepine dose
Posted by Squiggles on August 25, 2006, at 17:39:18
In reply to Re: What does taking a benzo actually feel like?, posted by bassman on August 25, 2006, at 17:23:34
If it weren't for faith in authority
we must just doubt our own experience.Squiggles
Posted by Colleen D. on August 25, 2006, at 18:05:41
In reply to What does taking a benzo actually feel like?, posted by Meri-Tuuli on August 25, 2006, at 9:13:32
Hi!
Taking Xanax for me is like having a glass or two of wine, but without the feeling of overall relaxation of the muscles throughout my body. Drinking alcohol gives me a rubbery feeling and a definite lack of coordination.
I currently take less clonazepam than was originally prescribed. .5mg at bedtime and .5mg in the morning. It's been a miracle for my symptoms of OCD, GAD and SP.
I'm sad to hear it is not more easily available for you. After researching benzos and deciding clonazepam was probably the med for me, I asked my doctor and he didn't balk at prescribing it. So, perhaps you could do some more reading on them, take some notes and and go in as if you have made an informed decision on what you want and maybe...
Good luck!
Colleen
p.s. Where in the UK are you? My mom is Irish and all of our relatives are in Yorkshire.
Posted by valene on August 25, 2006, at 18:45:42
In reply to Re: What does taking a benzo actually feel like? » valene, posted by Squiggles on August 25, 2006, at 11:54:57
A benzo is a benzo - they all reduce the amount of GABA that the brain naturally produces because they are now supplying GABA to your brain. Klonopin is also extremely "addictive" to many people, also many find it quite depressing. I do not find that with Xanax, and the half life for me is perfectly fine on xanax- I can go 12-14 hours between doses before noticing any w/d symptoms.
Xanax has been the only benzo I can take that does not add to my depression. In fact, it is a mild anti-depressant for me. Valium was a complete nightmare when I switched to it from xanax - horribly depressing.Val
Posted by bassman on August 25, 2006, at 19:01:11
In reply to Re: What does taking a benzo actually feel like?, posted by valene on August 25, 2006, at 18:45:42
Exactly my experience with benzos: Klonopin and Valium depressing, Xanax has a distinct antidepressant effect on me and no "breakthough" anxiety even 20 hours after I've taken a dose. Ativan does little (actually, in terms of anti-anxiety, Valium does nothing for me at all-I can take 30 mg and not know I've taken anything).
Posted by Squiggles on August 25, 2006, at 19:29:06
In reply to Re: What does taking a benzo actually feel like?, posted by bassman on August 25, 2006, at 19:01:11
There are many perspectives to this topic:
http://psychmedaware.org/links.html
Squiggles
Posted by bassman on August 25, 2006, at 19:58:16
In reply to Re: What does taking a benzo actually feel like? » bassman, posted by Squiggles on August 25, 2006, at 19:29:06
From the home page of this link:
Psychiatric Medication Awareness Group is a small group of British Columbia citizens concerned about the increasing use of psychiatric drugs in B.C. and Canada, and the potential harm associated with these drugs. PMAG is also concerned about the dramatic increase in the prescribing of psychiatric drugs to the general population in Canada, particularly to women. This massive health crisis has been largely ignored, and its social and human costs are inadequately researched and largely unquantified.
Posted by finelinebob on August 25, 2006, at 20:38:20
In reply to Re: What does taking a benzo actually feel like?, posted by bassman on August 25, 2006, at 19:58:16
First of all, I must disagree with the "a benzo is a benzo" comment. If that were true, there would only be one. They may have similar pharmacodynamics (yep, had to look that one up!) but that hardly means they are the same. Anyway...
Have you ever been in a room with a lot of fluorescent lights? Like a classroom or something. Everyone leaves but you, and it gets very quiet, and then you can hear it -- the hum of the transformers for all the lights. It gets lost in the background noise unless there isn't any noise to cover it.
That's what clonazepam did for me -- it flipped the switch to "off". It wasn't that I was feeling something new or different, it's that something HUGE but subtle was all of a sudden gone. It's as if all my life, my entire nervous system had been vibrating and humming, producing this low-level of ever-present anxiety. And clonazepam turned it off.
Posted by Phillipa on August 25, 2006, at 21:06:00
In reply to Re: What does taking a benzo actually feel like? » valene, posted by Squiggles on August 25, 2006, at 11:54:57
To each his own but all the pdocs I've ever had have no problem with benzos . And Squggles I've just plain stopped xanax when life stresses were down. And gone for months at a time without any. Just my experience. Love Phillipa
Posted by Squiggles on August 25, 2006, at 21:11:54
In reply to Re: What does taking a benzo actually feel like? » Squiggles, posted by Phillipa on August 25, 2006, at 21:06:00
> To each his own but all the pdocs I've ever had have no problem with benzos . And Squggles I've just plain stopped xanax when life stresses were down. And gone for months at a time without any. Just my experience. Love Phillipa
It's easier to stop Xanax early; but the longer
you take it and the more continuously you take
it, the harder its. Glad you used it when you
needed it.I think part of the problem might be that
these drugs are prescribed, and then you are
shown the door. So, if you are not supervised,
and you forget one or take them erratically
or too long or just stop -- unexpected things
start to happen that are hard to connect to
the initial causes. This is especially so
when other drugs and other health conditions
are involved.Medicine has become very complicated and
short-staffed to do the right job, it seems
to me.Squiggles
Posted by Phillipa on August 25, 2006, at 22:06:29
In reply to Re: What does taking a benzo actually feel like? » Phillipa, posted by Squiggles on August 25, 2006, at 21:11:54
Sqiggles what counry are you in. In the US if you use a mail order pharmacy I believe three months is what you get. I don't have one so each 30days my pdoc sees me and gives me another prescription based on my stress level. Funny if you go to the withdrawal board is it benzos or Antidepressants that people seem to have problems withdrawing off of? I prefer a med that has been around for years and there are no known side effects. I think klonopin is depressing at least for me, xanax quick acting for panic attacks, valium long acting not depressing for me. I finally just stopped xanax as it was making me tired and I like to be on the go. Funny last time I saw my pdoc she said you should either take xanax during the day with valium at night or small bits of valium during the day. Oh her specialty is addictions. She writes for Jama and other medical journals. Love Phillipa she's seen it all she's in her 70's. Now I not being argumentive here. This is just my experience and that of other members of my family. See somehow we inheritated a panic gene.
Posted by laima on August 25, 2006, at 23:28:03
In reply to Re: What does taking a benzo actually feel like?, posted by bassman on August 25, 2006, at 17:23:34
Very interesting- and note- I have used benzodiazapines on and off for a good 5-6 ywears myself, and agree they seem safe and fairly effective when used per instructions. Breaks do help preserve their effectiveness, in my own body. Also did NOT claim everyone gets "addicted"- but maintain it can and does happen- it's a real risk for some people. I've caught myself slipping that way a few times myself, but managed to pull back up, a little painfully, each time.
> There are many who would agree with your opinion. Here is research that support the opposite opinion, namely, that benzos very seldom cause addiction (as opposed to dependence) and dose escalation is unusual:
>
> Schweizer et al. (58) have conducted an 8-month, placebo-controlled study of continuation therapy for panic disorder with alprazolam and imipramine that found sustained efficacy for both compounds with no dose escalation, suggesting an absence of tolerance to the therapeutic effect
>
> Preliminary evidence for the efficacy of continuation therapy of GAD comes from two studies (43, 47). In both studies the benzodiazepine therapy achieved sustained remission of anxious symptomatology with no tolerance and no dose escalation over a 6-month period.
>
> http://www.acnp.org/G4/GN401000129/CH127.html
>
> A total of 136 patients received clonazepam nightly for a mean 3.5 (+/- 2.4) years, with no significant difference in initial versus final mean dose: 0.77 mg (+/- 0.46) versus 1.10 mg (+/- 0.96). Similar results were obtained with chronic alprazolam treatment and with other benzodiazepine treatments. CONCLUSION: Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep resulted in sustained efficacy in most cases, with low risk of dosage tolerance, adverse effects, or abuse.
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8629680&query_hl=1&itool=pubmed_docsum
>
>
> Fifty-nine panic disorder patients originally randomized to treatment in a controlled trial comparing alprazolam, clonazepam, and placebo were reevaluated in a follow-up study. At a mean follow-up of 1.5 years, 78% of patients remained on medication and the mean dosage of alprazolam and clonazepam did not increase.
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8376613&query_hl=1&itool=pubmed_docsum
>
> A 15 year study:
> Maintenance medication was common. No benzodiazepine abuse was reported. CONCLUSION: PD has a favourable outcome in a substantial proportion of patients. However, the illness is chronic and needs treatment. The short-term treatment given in the drug trial had no influence on the long-term outcome.
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14680716&query_hl=1&itool=pubmed_docsum
>
> I think this is interesting because it basically says the physicians are quite prejudiced concerning benzo use, even when it comes to outcome. Who knows the benefits better, the physician or the patient? That’ s easy.
>
> The participants were 93 patients over 60 years of age using a benzodiazepine for insomnia and 25 physicians comprising sleep specialists, family physicians, and family medicine residents. The main outcome measure was perception of benefit and risk scores calculated from the mean of responses (on a Likert scale of 1 to 5) to various items on the survey. RESULTS: The mean perception of benefit score was significantly higher in patients than physicians (3.85 vs. 2.84, p < 0.001, 95% CI 0.69, 1.32). The mean perception of risk score was significantly lower in patients than physicians (2.21 vs. 3.63, p < 0.001, 95% CI 1.07, 1.77). CONCLUSIONS: There is a significant discordance between older patients and their physicians regarding the perceptions of benefits and risks of using benzodiazepines for insomnia on a long term basis. The challenge is to openly discuss these perceptions in the context of the available evidence to make collaborative and informed decisions.
>
> . http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12019038&query_hl=11&itool=pubmed_docsum
>
> The Task Force Report, although over 10 years old, is still a standard reference for benzodiazepine use. Its points—that there is undue reluctance to use minor tranquillizers, and that many people are under treated—still hold, and are borne out by the Roy-Byrne study. Other relevant literature includes a review of 2719 adult out-patient charts2 (medical and psychiatric) for evidence of benzodiazepine abuse that found no patients meeting the criteria. Another study, of long-term alprazolam users, found no dose escalation with long-term use.3 Tyrer’s 19884 paper on minor tranquillizers notes an absence of evidence that benzodiazepine dependence leads to dangerous long-term sequellae, and blames "excessive media attention" for distortion of scientific attitudes.
>
> http://fampra.oxfordjournals.org/cgi/content/full/20/3/347
>
> Benzodiazepines are relatively safe drugs that are probably under- rather than overprescribed. Periodic reassessment of chronic users is appropriate, although generalized anxiety disorder and panic disorder are chronic conditions for which long-term treatment may be necessary. In the more recent era of safer antidepressants, these agents may be able to supplant minor tranquillizers for the control of chronic anxiety in many patients. Long-term benzodiazepine use is appropriate for some patients.
>
> http://fampra.oxfordjournals.org/cgi/content/full/20/3/347
>
> Tolerance is the need to increase the dose of a drug to maintain the desired effects. Tolerance to the anxiety-relieving effects of benzodiazepines is uncommon and most individuals do not increase their benzodiazepine dose
>
> http://www.daap.ca/factsonbenzodiazepines.html
>
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