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Psychiatry journal commentary, 2012: "Why benzodiazepines are not going away"


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There are so many aspects of this article that irk me, but I'm going to post it as an example of how wide-ranging the viewpoints are on the topic of prescribing benzodiazepines to anxious people. The author uses many 20- and 30-year-old references to back up his statements that it takes away credibility from his arguments. He minimizes the concerns that many of us have about dependence, tolerance and withdrawal, and in so doing, negates the reasons why so many of us here are suffering so badly.

 

In his perfect world, anxious people only take benzos a few times a week. They never need more than three doses a week, so they never become dependent and the drugs never lose their effectiveness. He never refers to risks to the elderly despite the fact that the elderly are prescribed these drugs all the time. He never refers to the vast legions of people who are currently physiologically dependent at the present time, and who are suffering terrible effects from them, e.g. dizziness, falls, fractures, rebound anxiety, rebound insomnia.  When he does talk about the estimated number of people who experience withdrawal, he writes, "It is sometimes not fully appreciated that withdrawal problems occur in only approximately 40% of those who take benzodiazepines regularly (Tyrer 1981)." ONLY?? 40% is almost half. That's significant. And again, he uses data that's from 1981. Is it currently accurate? We don't know.

 

There is zero discussion of any other treatment options for anxiety. It's as if there are no other options aside from benzodiazepines.

 

The only thing I really agree with this author on is the need to fully inform the patient and to give them choice. He writes, "The second strategy is to explain the risks of dependence and the possibility of this happening if dosage is taken long term, but to explain this in detail and to ask the patient to come to a personal decision."

 

I look forward to hearing others' comments on this article:

 

http://apt.rcpsych.org/content/aptrcpsych/18/4/259.full.pdf

 

 

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Overall I thought this article was pretty reasonable. The only thing that skeeves me out is the unwritten implication that drugs are the front-line and only tool for behavior/experience modification, but that's what I'd expect from an article in a psychiatry journal. It's great when people buck orthodoxy to have more complicated or nuanced ideas about things, but most scientific writing reflects the prevailing views of the era that's created it.
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Low-dose  dependence  is  not  associated  with  an 

escalation of dosage and there is relatively little

evidence  of  tolerance.

 

Yea right. What about me? Am I the only one? :idiot:

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He seems to be more of an academic, rather than a practising doctor. The other article I posted yesterday refers to tolerance, and it's a guideline document for use in the UK. I'd have to say that most of us here on BB experienced tolerance. So, no benzogirl, you're not the only one!
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