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Author Topic: Is Robert DuPont's "lifetime steady dose of benzos" total nonsense?  (Read 666 times)

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Online NeverAgain2

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Re: Is Robert DuPont's "lifetime steady dose of benzos" total nonsense?
« Reply #15 on: August 15, 2014, 09:32:27 PM »
I knew a WWII vet who had serious anxiety problems, and he took 10mg Valium per day for 15 years, and he was just fine.  But.. he did not have an addictive personality.  Without the Valium, I don't believe he could have functioned.  He had had electric shock therapy, which restored him to "normal", and then the benzo kept him on a functioning path.  He was quite functional and drove and had a good live with his wife and kids and grandchildren, until he passed of natural causes several years ago.

I took Ativan at the worst of my anxiety and it helped.  Anti-depressants did not.  I had severe muscle pain, and I don't care what claims are made by any kind of doctor, no anti-depressant helped a bit -- for me. 

What I call "Med Madness" has gripped a good subsection of the population out there, usually those who have had some kind of dependency problem with a benzo,  and they lobby and get restrictions placed on perfectly good medications.  This has now gone to pain killers of all types and even anti-depressants, which do help some people.  These morons think that you can suck on a herb and it will do the trick.  Maybe, if the placebo works.

So, I had no withdrawal problems from the Ativan as I slowly tapered and that was that.  No craving to get back on or anything.

You hit on a good article.
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Online Frotob

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Re: Is Robert DuPont's "lifetime steady dose of benzos" total nonsense?
« Reply #16 on: August 16, 2014, 12:30:35 AM »
 
Thanks Frotob
So if I read you right, you're saying some (like one of your 3 aunts) can keep taking the benzo for life, without dose increase, and possibly even with a dose decrease, but they've probably long-since stopped getting the original anxiolytic (or sleep-inducing) effect, and it's only keeping them from bad w/d symptoms. That tolerance is indisputable, and they long-since hit "tolerance," but more of a body-dependence type of tolerance where their body's gotta have it, not a I-need-to-up-my-dose-to-get-the-same-effect type of tolerance.

Technically speaking, that would be called "dependence" but not "tolerance"

If your one aunt doesn't crave a higher dose, either she's gotten used to sleeping without a benzo (because, as you say, it's no longer having much effect,) or she's never hit tolerance. The other 2 definitely hit it 'cause they need more. And it sounds like you did too.

So 3 out of 4 in your family hit tolerance, 2 of whom are upping their doses and 1 (yourself) is tapering off (good going!) And only one (yourself) started with an "addictive profile."

That's a bad score for Dr DuPont, as well as earlier posters Shawn & Ian. That would tend to indicate only 1 out of 3 or 4 can count on not hitting tolerance, as opposed to DuPont's insistance that 90% will be cool.



Well they'd definitely have developed a dependence by now. . . They were all prescribed it for sleep, 2 of them stopped sleeping well at their beginning doses and got to the I-need-to-up-my-dose-to-get-the-same-effect point, which would be tolerance.

As for myself, I wouldn't say I ever got tolerant to the effects of benzos. . . I never had to increase my dose, and was stable as far as anxiety (for which it was prescribed). Which leads me to believe that A) I probably wasn't on that dose long enough to become tolerant to the anxiolytic effects, or B) You don't get tolerant to the anxiolytic effects of benzodiazepines. I'm not a Neurochemist, so I don't feel comfortable making the comparison - but alcoholics typically grow tolerant to the effects of alcohol, requiring they imbibe more to get to the desired level of drunkenness. . . I know that benzos work on similar receptors as alcohol, and that they're cross tolerant. So I'd imagine tolerance is definitely possible with BZDs. . . However, alcoholics typically push the boundaries on how much they drink, because. . . well. . they don't want to stop drinking. . . . I'd venture to say that a majority of people, addictive personality or not, don't approach benzos with that same attitude or behavior. So taking the same dose daily may not precipitate tolerance of anxiolytic effects, or at least not as quickly.

In any sense, I wouldn't say that I'm currently struggling with getting off of Valium, as I'm going about it the right way for me. . . just that the entire process sucks balls, and I feel like crap for a week or two after every reduction in dose. . anxiety is actually the least common symptom when I reduce. I usually get 1-2 bad days of anxiety and the rest is just physical symptoms. I'm not against the use of benzos and I do believe they have their place, at least til something better comes along. I'll be the first to say that those who are having trouble tapering off of benzos are probably the minority, but they're an outspoken minority - because frankly, if you're having trouble . . . it sucks. My qualm isn't with the medication themselves, but the doctors who prescribe them so liberally and then meet you with a blank stare when you ask with help tapering off. If 90% of patients have no difficulty tapering, you're still responsible for the 10% that do. If you're not knowledgeable enough to help them, you shouldn't be prescribing that medication. . There are plenty of doctors that don't prescribe them for more than a couple of weeks (their indicated use for anxiety), for that reason alone. . . They don't know what to do when a patient has trouble stopping the medication.

That patient is then left to their own devices to figure out how to taper off of them, or met with unreasonable expectations from their doctors. . .  Which probably is why the majority of the people at the "other" forum are so distrusting of medications. Everyone is entitled to an opinion, and those on the other forum have had generally bad experiences with that class of drugs, it's easy to become suspicious of medications in general when you get blindsided by crap like that.

Pain meds aren't really comparable because there is a REAL problem with abuse, much more so than with BZDs. . . I imagine very few addicts consider benzos as their drug of choice. Restrictions do need to be made on certain medications. . . it's not necessarily fair to those suffering from real problems, but even after the crackdown on pain pills, I don't think those with serious pain problems are being refused medication regularly.

Also. . . Isn't inpatient detox usually not successful for benzos? I read someone was an addiction specialist . . . and as far as those who come to detox for benzos. . . are they typically abusing them or within the therapeutic dosage? Just curious

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Online NeverAgain2

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Re: Is Robert DuPont's "lifetime steady dose of benzos" total nonsense?
« Reply #17 on: August 16, 2014, 09:15:39 AM »
Frotob, I agree generally with what you are saying.  Many doctors have no idea that dependence can be created by the drugs they prescribe, but one can get dependent on anything, including coffee, tea, greasy food, sex and pain killers.

Pain killers and benzos have street value, but the "Med Madness" that is creeping -- racing-- across the main currents of thought, at least in the US, if frightening.

In the late 1960's, President Nixon started a "War on Drugs", and we can see now that it is another lost war for the US.  The attitude gains strength and wains.  In the late 1980's, my father was in a major teaching hospital in a coma and days from death due to lung cancer, and the was on a very low dose of morphine and was suffering terribly.  His pulse and respiration were off the charts and his face contorted in pain.  The doctors and the medical staff told me that they would not increase his dose of morphine, not because they were afraid of depressing his respiration and killing him, but because "they did not want him to become an addict".

The abuse of the percentage who have addictive personalities are having a horrible effect on those who need some of these meds.  I'm pretty Darwinistic about it: I really don't care if some of these addicts leave this planet because they are unintentionally making other people suffer and even die.

Up until the beginning of the 20th Century in the US, you could get any drug you wanted, and if you had no respect for yourself and lived your life in an opium den, then you died. 

Sorry, but I see the "Med Madness" as another politicization of medicine --here in the US, anyway.
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Offline sethman

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Re: Is Robert DuPont's "lifetime steady dose of benzos" total nonsense?
« Reply #18 on: August 16, 2014, 02:42:52 PM »
More good feedback in these posts, thanks NeverAgain & Frotob.
So far, there's more responders saying steady-dose long-term use of BZDs can be safe & not produce tolerance, than those insisting you're definitely going to encounter tolerance & withdrawal problems...on this forum. Obviously, on another forum where the main focus is withdrawal problems, the response will be heavily weighted the other way. Because as Frotob says, if you do encounter physical/mental side fx, it sucks, it's really tough, and the prescribing Drs are often no help, either in prescribing it properly or supporting with tapering off. So you naturally get on a 'help-this-is-awful' forum and become part of the med denouncers.

Frotob says they're just an outspoken minority, and NeverAgain thinks it's devolving into Med Madness, where morons are lobbying against all kinds of beneficial drugs just cause a small portion has had a rough time with them.

I'm not ready to agree with either of those things...yet. Still would like to hear more personal histories from long-term BZD users, and I hope they post here. I try not to label people "morons," maybe just misguided people who jumped to wrong conclusions from a few bad experiences. And I'm still not certain long-term BZD users noticing their having tolerance or side f/x issues are in the minority.

What I do know is that these are very powerful drugs. They are definitely mind-altering, and they have a concentrated & cumulative effect on your GABA, serotonin & norepinephrine receptors. That's just measured & proven scientific fact, not opinion. Since the only thing most people "feel" from a BZD is a nice calming down of their mind & nerves, they're naturally gonna say, "Well that's harmless enough." They can't "feel" the changes taking place in their receptors or brain so they don't think about that. And they may not notice the longer-term effects, like emotional blunting, lack of creativity, changes in sleeping patterns, and vision or brain tics until 5, 10 or 15 years down the road...and by then it could be too late to stop if the decide they don't want those side fx.

So while I would agree with NeverAgain that their may be a bit too much overreaction on the part of anti-med crusaders, I do think it's important to tell the whole truth about just how concentrated and biochemistry-effecting these drugs are, and not just go, "Well, I'm taking them, they feel fine to me, and everything's cool  :nature-smiley-016:"

Hope to hear from more of you as this dialogue continues.
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Online NeverAgain2

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Re: Is Robert DuPont's "lifetime steady dose of benzos" total nonsense?
« Reply #19 on: August 16, 2014, 05:24:03 PM »
Sethman, I don't normally call people "morons" unless the label fits, and people who start crusades to ban things because of their own personal experiences with them, are, in fact, just that --morons.  But maybe you are right: maybe they aren't morons and misguided; maybe they should be thought of as something much more malevolent.  Some are motivated out if the hate of "Big Pharma" as well.  Because of my past I still get notices and newsletters of all sorts, and I do see a disturbing trend about once again denying people meds they need, for various reasons.

I watched my father die in agony because of mis-guided opinion, so the passion rises about this.  Also, I had my own trouble getting scripts for benzos when they were the only thing that loosened by hyper-tight muscles.  I tried every muscle relaxant out there, nerve meds, pain killers and a lot of anti-depressants, etc.  The only thing I would not try was Vicodin , because I knew Valium and Ativan worked enough to allow me to go to work and function.  Yet, doctors would insist I try this or that and I'd have more and more weeks of agony.  I'm talking like multiple and unending charlie horses up and down my back and around my entire trunk. 

So, I apologize for the passion, but the ill-informed people who are railing against prescription drugs of all sorts, need to take a step back and think of more than just their subjective experience.

If you are looking for other examples: a friend of mine was on Klonopin for years, large dozes, but it helped her pull her life back together, take care of things she had to, and tapered off and does not take anything.  I don't think she suffered mentally, as she has written several novels since. 

The people on the internet forums are self-selected and offer their horror stories on a ratio of probably 100:1.  I've read them.  Few people who are not suffering from addictive disorders or problems with a med will come back and endorse it, though it does happen.

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Re: Is Robert DuPont's "lifetime steady dose of benzos" total nonsense?
« Reply #20 on: August 16, 2014, 06:04:48 PM »
Also...

As far as effects five or ten or fifteen years later, some people are in such dire need -- I'm talking re benzos here-- that concern has to be the "now", because in some cases the end may come at their own hands, sooner rather than later.  I endured horrible pain for a long, long time, and thoughts of sui*cide were ever present (but I could not even express those, for the fear of social consequences), but fortunately, my current GP, and older doc, had long experience with Ativan,  and allowed it for me.  I then had to use CBT and ACT therapies on my own to learn how to finally extinguish the pain, because allopathic medicine and many in the psycho-therapy world do not allow for anxiety/depression/stress to be the causation of pain, only a cause for making it worse. 

It was no joy ride or academic exercise for me.
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Offline insights

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Re: Is Robert DuPont's "lifetime steady dose of benzos" total nonsense?
« Reply #21 on: August 16, 2014, 06:10:42 PM »
More good feedback in these posts, thanks NeverAgain & Frotob.
What I do know is that these are very powerful drugs. They are definitely mind-altering, and they have a concentrated & cumulative effect on your GABA, serotonin & norepinephrine receptors.

...They can't "feel" the changes taking place in their receptors or brain so they don't think about that. And they may not notice the longer-term effects, like emotional blunting, lack of creativity, changes in sleeping patterns, and vision or brain tics until 5, 10 or 15 years down the road...and by then it could be too late to stop if the decide they don't want those side fx.

All of which applies equally to antidepressants. So where does that leave you. You could go down the therapy route. It can be very effective. But it just isn't either a financial option for many, and qualified therapists can be rarer than hen's teeth outside the major cities. Bottom line: Meds, and I would argue antidepressants more so than BZDs, are awful drugs that no one in his right mind would take, no pun intended, but given the current state of the art they are all we have and for the majority they work well enough to make their lives livable again.

Final point: the fact these meds change receptor densities isn't that significant. Anxiety disorders themselves reduce the numbers and sensitivity of BZD receptors, they also kill large numbers of brain cells. Receptors are not permanent brain structures, but simple proteins studded through the fatty walls of cells. They have a very limited 'lifespan' with half-lives measures in seconds, minutes or a few hours depending on the receptor type and its location. Your brain today contains not a single receptor from the beginning of this week. The nonsense you may have read about them in anti benzo sites is just that, nonsense.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Online NeverAgain2

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Re: Is Robert DuPont's "lifetime steady dose of benzos" total nonsense?
« Reply #22 on: August 16, 2014, 06:51:03 PM »
More good feedback in these posts, thanks NeverAgain & Frotob.
What I do know is that these are very powerful drugs. They are definitely mind-altering, and they have a concentrated & cumulative effect on your GABA, serotonin & norepinephrine receptors.

...They can't "feel" the changes taking place in their receptors or brain so they don't think about that. And they may not notice the longer-term effects, like emotional blunting, lack of creativity, changes in sleeping patterns, and vision or brain tics until 5, 10 or 15 years down the road...and by then it could be too late to stop if the decide they don't want those side fx.

All of which applies equally to antidepressants. So where does that leave you. You could go down the therapy route. It can be very effective. But it just isn't either a financial option for many, and qualified therapists can be rarer than hen's teeth outside the major cities. Bottom line: Meds, and I would argue antidepressants more so than BZDs, are awful drugs that no one in his right mind would take, no pun intended, but given the current state of the art they are all we have and for the majority they work well enough to make their lives livable again.

Final point: the fact these meds change receptor densities isn't that significant. Anxiety disorders themselves reduce the numbers and sensitivity of BZD receptors, they also kill large numbers of brain cells. Receptors are not permanent brain structures, but simple proteins studded through the fatty walls of cells. They have a very limited 'lifespan' with half-lives measures in seconds, minutes or a few hours depending on the receptor type and its location. Your brain today contains not a single receptor from the beginning of this week. The nonsense you may have read about them in anti benzo sites is just that, nonsense.

Ian

Thanks, Ian.  I don't have enough knowledge to defend benzos except on an observational level. 
Nonsense prevails everywhere, and politics has entered heavily into medicine.  I was once given Cypro for a festering surgical incision, and I had a horrible allergic reaction to it.  Would I ever try to get it banned because of the small percentage --including me-- who had a reaction to it?  Never.  But there are whole treads on many sites attacking Cypro by those who had a bad effect and think it causes long term damage  and believe it should be banned (who the heck knows? But how many lives has it saved in turn? )  Yeah, you don't become physically addicted to Cypro, but I would argue some people get a psychological dependence on antibiotics and run to their doctor for every sniffle.  Cause to ban it?  No.  Cause for common sense on the part of the doctor?  Yes.



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Offline Never-Quit

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Re: Is Robert DuPont's "lifetime steady dose of benzos" total nonsense?
« Reply #23 on: August 16, 2014, 07:32:34 PM »


More good feedback in these posts, thanks NeverAgain & Frotob.
What I do know is that these are very powerful drugs. They are definitely mind-altering, and they have a concentrated & cumulative effect on your GABA, serotonin & norepinephrine receptors.

...They can't "feel" the changes taking place in their receptors or brain so they don't think about that. And they may not notice the longer-term effects, like emotional blunting, lack of creativity, changes in sleeping patterns, and vision or brain tics until 5, 10 or 15 years down the road...and by then it could be too late to stop if the decide they don't want those side fx.

All of which applies equally to antidepressants. So where does that leave you. You could go down the therapy route. It can be very effective. But it just isn't either a financial option for many, and qualified therapists can be rarer than hen's teeth outside the major cities. Bottom line: Meds, and I would argue antidepressants more so than BZDs, are awful drugs that no one in his right mind would take, no pun intended, but given the current state of the art they are all we have and for the majority they work well enough to make their lives livable again.

Final point: the fact these meds change receptor densities isn't that significant. Anxiety disorders themselves reduce the numbers and sensitivity of BZD receptors, they also kill large numbers of brain cells. Receptors are not permanent brain structures, but simple proteins studded through the fatty walls of cells. They have a very limited 'lifespan' with half-lives measures in seconds, minutes or a few hours depending on the receptor type and its location. Your brain today contains not a single receptor from the beginning of this week. The nonsense you may have read about them in anti benzo sites is just that, nonsense.

Ian



Thanks again Ian,  :action-smiley-065:

For your solid information and knowledge base! - Helping us understand the more complex underpinnings of these discussions!

(This is a big Rec's +1 on your excellent post, from me)

You are truly a great asset to this Forum!  :grinning-smiley-003:



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Online Frotob

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Re: Is Robert DuPont's "lifetime steady dose of benzos" total nonsense?
« Reply #24 on: August 16, 2014, 07:40:29 PM »
More good feedback in these posts, thanks NeverAgain & Frotob.
What I do know is that these are very powerful drugs. They are definitely mind-altering, and they have a concentrated & cumulative effect on your GABA, serotonin & norepinephrine receptors.

...They can't "feel" the changes taking place in their receptors or brain so they don't think about that. And they may not notice the longer-term effects, like emotional blunting, lack of creativity, changes in sleeping patterns, and vision or brain tics until 5, 10 or 15 years down the road...and by then it could be too late to stop if the decide they don't want those side fx.

All of which applies equally to antidepressants. So where does that leave you. You could go down the therapy route. It can be very effective. But it just isn't either a financial option for many, and qualified therapists can be rarer than hen's teeth outside the major cities. Bottom line: Meds, and I would argue antidepressants more so than BZDs, are awful drugs that no one in his right mind would take, no pun intended, but given the current state of the art they are all we have and for the majority they work well enough to make their lives livable again.

Final point: the fact these meds change receptor densities isn't that significant. Anxiety disorders themselves reduce the numbers and sensitivity of BZD receptors, they also kill large numbers of brain cells. Receptors are not permanent brain structures, but simple proteins studded through the fatty walls of cells. They have a very limited 'lifespan' with half-lives measures in seconds, minutes or a few hours depending on the receptor type and its location. Your brain today contains not a single receptor from the beginning of this week. The nonsense you may have read about them in anti benzo sites is just that, nonsense.

Ian

What would lead you to make that argument? I'm just curious what part of antidepressants could be considered worse? Particularly SSRIs. .  I know some of the TCAs and MAO Inhibitors are bad news, what with TCAs having cardiovascular side effects and MAOIs interacting with everything. . But I cold turkey'd Buspar/Trazodone . . and dropped remeron from 30mg to 7.5mg without any trouble at all, whereas I'm in the weeds with this Valium crap.

I know as far as overdose and side effect profile BZD's are pretty safe, provided you don't drink on them. . . but other than that I feel as though they're pretty bad news. . .

Essentially I'm just asking if you know something I don't about SSRIs, particularly Lexapro as that's all that applies specifically to me.


 I have read horror stories of SSRI withdrawal, but I've also read stories of Buspar and Remeron withdrawal, the former I didn't experience at all and the latter was relatively minor compared to what I experience reducing Valium, so I kinda wrote them off as people making a fuss. Everything I've read about SSRI's has made them seem relatively safe. All drugs have downsides for the most part, even Tylenol. . . maybe especially tylenol lol.
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Offline sethman

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Re: Is Robert DuPont's "lifetime steady dose of benzos" total nonsense?
« Reply #25 on: August 16, 2014, 08:39:03 PM »
Bottom line: Meds, and I would argue antidepressants more so than BZDs, are awful drugs that no one in his right mind would take, no pun intended, but given the current state of the art they are all we have and for the majority they work well enough to make their lives livable again.

Good bottom line, Ian, and hard to argue. They're powerful drugs with perhaps a 50-50 chance of producing tolerance, dependence and disturbing side fx, but they're what we have and certainly help make some people's lives livable again when nothing else (including therapy) works. You are saying majority, which echoes what Frotob & others have stated above, and it may really be a small minority of people who get problems with 'em. I'm OK with finding out that's true...and I'm still listening...

Quote from: insights
Final point: the fact these meds change receptor densities isn't that significant. Anxiety disorders themselves reduce the numbers and sensitivity of BZD receptors, they also kill large numbers of brain cells. Receptors are not permanent brain structures, but simple proteins studded through the fatty walls of cells. They have a very limited 'lifespan' with half-lives measures in seconds, minutes or a few hours depending on the receptor type and its location. Your brain today contains not a single receptor from the beginning of this week. The nonsense you may have read about them in anti benzo sites is just that, nonsense.

Your receptor explanation sounds very real & scientific, but it's so diametrically opposed to what Ashton & others have said that it just blows my mind (no pun intended  :laugh3:) Ashton & others clearly state that GABA and other receptors will get down-regulated through regular BZD use, so when you stop - 2, 5 or 10 years later - those GABA  receptors will be "offline" and you'll go through crazy anxiety till they "re-learn" and come back online...which could take 6, 12 or 24 months. If, as you say, those GABA receptors are replaced w/new ones every week, that long-term receptor turn-off & rebuild would be total crap! Where is Ashton & others getting this long-term receptor down-regulation info...are they just making this stuff up?? Or do they have some published clinical proof of long-term receptor effects?
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Offline ShawnW

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Re: Is Robert DuPont's "lifetime steady dose of benzos" total nonsense?
« Reply #26 on: August 17, 2014, 12:30:39 AM »
Seth...for clarification I made no statements on BZD tolerance.  I mentioned DuPont's reputation.  Top addiction specialists learn from him.  There is no bigger name in the field.  With that said, I believe blanket black white statements are rarely accurate.  For instance, BZDs don't give people euphoria.  In general I would agree.  Most people do not seek out BZDs in isolation as they don't give that high many are looking for in therapeutic doses.  But, some of us especially those with addictive personalities are wired a bit different.  I can tell you from personal experience 2 mg of Klonopin is euphora producing in myself.  It didn't make me sleepy but made me feel invincible...like Super Man.  Being a physician in recovery...treating addicts I have noticed that black and white statements don't apply to everyone.  I have seen people lose effectiveness and develop tolerance to BZDs.  I know many primary Xanax abusers who indeed get euphoria from BZDs.  But, this is a small subset of the population.  Most users do well with BZDs...don't need higher doses and can be weaned without much difficulty.

All drugs have risks...BZDs are no exception.  They can be lifesaving medications in many with severe anxiety.  But, they do present a risk in certain populations.  I think everyone should weigh risk vs reward and make an educated decision.
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My insight, thoughts, experiences or advice that may be posted in this forum are not meant as a substitution for the advice of your physician.

Want to know how to address your anxiety?
http://www.anxietyzone.com/index.php/topic,93402.msg521266.html#msg521266

Offline ShawnW

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Re: Is Robert DuPont's "lifetime steady dose of benzos" total nonsense?
« Reply #27 on: August 17, 2014, 12:40:41 AM »
And Seth to answer your question...if you are 60 yrs old, have been exposed to klonopin or other mood altering substances and have never abused them...I think it's safe to say you are in a low risk group for addiction.  For clarification, dependency is much different than addiction.  If you take klonopin long enough some dependency will develop.  But, addiction is when the mood altering substance triggers intense craving...it's all you can think about.  Addiction is progressive and fatal.  It would look something like a doctor prescribing Klonopin...then you take more than prescribed...run out early...ask doc for more...he declines...you buy from friends...then maybe you decide to start drinking with it...or mixing in new pills because you are not getting the effect you once were...so on and so forth.

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My insight, thoughts, experiences or advice that may be posted in this forum are not meant as a substitution for the advice of your physician.

Want to know how to address your anxiety?
http://www.anxietyzone.com/index.php/topic,93402.msg521266.html#msg521266

Offline insights

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Re: Is Robert DuPont's "lifetime steady dose of benzos" total nonsense?
« Reply #28 on: August 17, 2014, 02:21:24 AM »
Where is Ashton & others getting this long-term receptor down-regulation info...are they just making this stuff up?? Or do they have some published clinical proof of long-term receptor effects?

I am unaware of any studies which support their assertion. Again, receptors are simple protein molecules, not permanent structures, and the density and sensitivity of receptors is in continual flux. This variability is one of the cornerstones of brain plasticity and it is difficult to see how BZD withdrawal would apparently 'freeze' that mechanism for prolonged periods of time. It is also difficult to see how one would test for it. Sure, it would be easy to detect GABA-benzodiazepine complex binding site densities over time, but how do you determine whether a prolonged drop is due to some long lasting BZD withdrawal effect, or merely a return of low density and sensitivity due to anxiety. As per my previous post, it has long been known that those with anxiety disorders have fewer binding sites than normal and the sites which do exist are less sensitive1.

Drug withdrawal is not purely a biological phenomenon. It is psycho-social-biological in nature and the biology component may be the least important. This is probably best illustrated by the differing experiences of epileptic and anxiety patient cohorts. BZD withdrawal is much less an issue among epileptics despite the fact that they are often prescribed far higher BZD doses than those usually used for anxiety. Even Ashton, who supposedly ran the world's first BZD detox clinic for 12 years (or 15, depending on which of her supporters you believe), appears not to have treated a single epileptic even though it ran in the very years that epileptics were being switched to the then new non BZD antileptics. Why, probably mostly because neurologists are better at planning the discontinuation and preparing their patients for it, and possibly even more importantly, not all epileptics have an anxiety disorder and thus lack some of the psychological triggers.

Ian

Reference:

[1]
Hasler G, Nugent AC, Carlson PJ, et al. (2008)
Altered cerebral gamma-aminobutyric acid type A-benzodiazepine receptor binding in panic disorder determined by [11C]flumazenil positron emission tomography.
Arch Gen Psychiatry. Oct;65(10):1166-75 (Abstract)

Geuze E, van Berckel BN, Lammertsma AA, et al. (2007)
Reduced GABAA benzodiazepine receptor binding in veterans with post-traumatic stress disorder.
Mol Psychiatry. 2008 Jan;13(1):74-83 (Abstract)

Cameron OG, Huang GC, Nichols T, et al. (2007)
Reduced gamma-aminobutyric acid(A)-benzodiazepine binding sites in insular cortex of individuals with panic disorder.
Arch Gen Psychiatry. Jul;64(7):793-800. (Abstract)

Bremner JD, Innis RB, Southwick SM, et al. (2000)
"Decreased benzodiazepine receptor binding in prefrontal cortex in combat-related posttraumatic stress disorder."
Am J Psychiatry Jul; vol 157(7):1120-6 (Abstract)

Bremner JD, Innis RB, White T, et al (2000)
"SPECT [I-123]iomazenil measurement of the benzodiazepine receptor in panic disorder."
Biol Psychiatry  Jan 15; vol 47(2):96-106 (Abstract)

Malizia AL.  (1999)
"What do brain imaging studies tell us about anxiety disorders? "
J Psychopharmacol Dec; vol 13(4):372-8 (Abstract)

Morimoto K. 1999
Benzodiazepine receptor imaging in the brain: recent developments and clinical validity
Kaku Igaku. May;36(4):307-13. (Abstract)

Malizia AL, Cunningham VJ, Bell CJ, et al. (1998)
"Decreased brain GABA(A)-benzodiazepine receptor binding in panic disorder: preliminary results from a quantitative PET study."
Arch Gen Psychiatry Aug; vol 55(8):715-20 (Abstract)

Tokunaga M, Ida I, Higuchi T, Mikuni M. (1997)
"Alterations of benzodiazepine receptor binding potential in anxiety and somatoform disorders measured by 123I-iomazenil SPECT."
Radiat Med May-Jun; vol 15(3):163-9 (Abstract)

Uchiyama M, Sue H, Fukumitsu N, et al. (1997)
"Assessment of cerebral benzodiazepine receptor distribution in anxiety disorders by 123I-iomazenil-SPECT: comparison to cerebral perfusion scintigraphy by 123I-IMP."
Nippon Igaku Hoshasen Gakkai Zasshi Jan; vol 57(1):41-6 (Abstract)
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline sethman

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Re: Is Robert DuPont's "lifetime steady dose of benzos" total nonsense?
« Reply #29 on: August 17, 2014, 12:41:12 PM »
Thanks Ian, for this deeply referenced & deeply scientific response. I admit to knowing nothing about biochemistry & receptors (I'm a musician and craftsman who did poorly in high-school of chemistry & biology  :-*,) but it appears you and all these other referenced people are clear about the temporary/changing nature of receptors and their inability to assume one frozen form due to prolonged BZD use.

It's just that there's so much talk about BZDS down-regulating GABA receptors, and that biological action being the main reason for anxiety-based dependence on them, not only in benzo-scared forums like the one I alluded to and Ahston's own manual, but all across the Internet. If you type in a phrase like "benzodiazepines turn-off GABA receptors," or something like that, you get hundreds of pages attesting to some way in which the GABA you need your body to produce, to have less anxiety, is somehow switched off for as much as a year or two after BZD use.

Based on your information, that's just patent nonsense. It makes me wonder how such a rich & prolific lie ever got started or sustained, and it makes me want to go back on the "other" forum and say, "Hey guys, all that stuff about BZDs blowing out your GABA receptors is crap, and here's the science behind it!"

But benzo-users & benzo-withdrawers have real, felt bodily symptoms and side fx beyond just rebound anxiety. Many develop insomnia, loss of creativity or emotion, memory problems, tinnitus & hearing issues, body pains, depression, depersonalization, the list goes on...so BZDs must be screwing with some part of the brain or perhaps the thousands of receptors not in the brain. I sure you are aware there are GABA/BZ receptors throughout the gastrointestinal tract and most other organs in the body.

So it's good to see scientific proof that tolerance & rebound anxiety is not a simple case of the benzos knocking out some permanent receptors that then need to "relearn" how to operate properly. But it still leaves much unexplained, and seems to leave BZDs in the category of drugs that could give many people some real bad problems, not the "quite safe" category.
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