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The prolonged benzodiazepine withdrawal syndrome: anxiety or hysteria?


[Aj...]

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  :thumbsup:

 

Here is the abstract:

 

Abstract

 

In an attempt to establish whether prolonged withdrawal symptoms after stopping intake of benzodiazepines is caused by return of anxiety, hysteria, abnormal illness behaviour or the dependence process itself producing perhaps a prolonged neurotransmitter imbalance, a group of such patients suffering prolonged withdrawal symptoms (PWS) was compared on a range of psychophysiological measures with matched groups of anxious and conversion hysteria patients and normal controls. It was found that the psychophysiological markers of anxiety were not marked in the PWS group; nor were the averaged evoked response abnormalities found to be associated with cases of hysterical conversion in evidence. The PWS group were hard to distinguish from normal controls on the basis of psychophysiological measures and thus it was felt to be unlikely to be an affective disturbance. It was concluded that PWS is likely to be a genuine iatrogenic condition, a complication of long-term benzodiazepine treatment.

 

I know everyone is different but, my doctors concurred with the bolded text & we agreed that in my case it was better for me and my family for me to continue on a maintenance dosage of benzodiazepines rather than ruining our lives and livelihoods from prolonged withdrawal symptoms (PWS). Sincere best wishes to all who are suffering from PWS. 

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For others, it's the "long-term benzodiazepine treatment" itself that caused the problems. Mine started while I was on the various medications that I was prescribed. Had I been warned of the risks before that treatment by either the prescribing doctors or the pharmacists that repeatedly filled prescriptions, I would have been spared from these hellish experiences. When I did start to question the medications as the possible cause of my scary and horrific symptoms, I was told that I was taking "such a small dose" and that they couldn't be the culprit.

 

Bullshit. Medication metabolism is greatly affected by genetics, and a "small dose" for one person may be a much larger dose for another due to genetic differences -- among other factors.

 

Benzodiazepines are not meant for long-term use, and doctors and pharmacists should be aware the existing literature on this topic. Informed consent for such risky medications should be mandatory (i.e. by doctors and pharmacists) so that people can make appropriate decisions for themselves BEFORE they embark on such risky journeys.

 

 

 

 

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https://pubmed.ncbi.nlm.nih.gov/15762817/

 

Abstract

 

Although benzodiazepines are invaluable in the treatment of anxiety disorders, they have some potential for abuse and may cause dependence or addiction. It is important to distinguish between addiction to and normal physical dependence on benzodiazepines. Intentional abusers of benzodiazepines usually have other substance abuse problems. Benzodiazepines are usually a secondary drug of abuse-used mainly to augment the high received from another drug or to offset the adverse effects of other drugs. Few cases of addiction arise from legitimate use of benzodiazepines. Pharmacologic dependence, a predictable and natural adaptation of a body system long accustomed to the presence of a drug, may occur in patients taking therapeutic doses of benzodiazepines. However, this dependence, which generally manifests itself in withdrawal symptoms upon the abrupt discontinuation of the medication, may be controlled and ended through dose tapering, medication switching, and/or medication augmentation. Due to the chronic nature of anxiety, long-term low-dose benzodiazepine treatment may be necessary for some patients; this continuation of treatment should not be considered abuse or addiction.

 

I agree that long-term benzodiazepine treatment is likely the primary cause of benzodiazepine post withdrawal syndrome (PWS). As pointed out in the above article, "long-term low-dose benzodiazepine treatment may be NECESSARY for some patients". That observation is often overlooked by patients, doctors and too many others who write about this subject. In my case, my doctors & I agree that a maintenance dose of benzodiazepines is NECESSARY. In my opinion, and as supported by the above article, the necessity of continuing benzodiazepines after long-term use does not receive the attention it deserves. best wishes 

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In Saxon's study of treating PAWS with flumazenil, there's a comment on how it appears that sub-therapeutic doses of benzos that theoretically shouldn't do anything tend to alleviate PAWS.

 

Withdrawal symptoms are relieved by doses of benzodiazepines that are too small to be expected to be efficient in normal medication, whereas symptom* reemergence is not relieved (Smith and Wesson 1983).

* - Refers to the symptoms for which benzos were prescribed.

 

It's like receptors have been habituated to benzo presence and don't work without benzos. Flumazenil appears to break this habituation.

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I was fine on diazepam for 20 years.

Now re-tapering my current Clonazepam dose equivalent to 0.7mgs diazepam each dose  makes my muscles go weak to point my arches collapse and can’t hold head up.

I wish O was SI wine who could stay on low dose but each tiny dose is horrific.

But without it whole spine, neck, jaw etc is rigid and forced together.

 

 

 

Lapis, if you want to read it just stick the Doi no.or URL in https://sci-hub.tw/

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I was fine on diazepam for 20 years.

Now re-tapering my current Clonazepam dose equivalent to 0.7mgs diazepam each dose  makes my muscles go weak to point my arches collapse and can’t hold head up.

I wish O was SI wine who could stay on low dose but each tiny dose is horrific.

But without it whole spine, neck, jaw etc is rigid and forced together.

 

 

 

Lapis, if you want to read it just stick the Doi no.or URL in https://sci-hub.tw/

 

Hi Ajusta,

I couldn't get the full study on Sci Hub for this one, unfortunately.

 

I'm just curious...In your case, were you told to get off the meds, or did you choose to do so? In my case, I had to get off them because they were creating all kinds of problems. I should never have  been on them in the first place.

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A physio suggested it and I had got off pf everything else.

I should not have done so and, when tried to reinstate in Dec 2017 (before the irreparable damage was fine to muscles and joints) and it helped I should have stayed on rather than listening to ppl on here about how dangerous the drugs are.

Ppl in dystonia groups are on the decades with no problems.

I was so wine for whom they were a good option for my problems.

 

 

It opens fine for me in Sci-hub?

 

Try this: https://dacemirror.sci-hub.tw/journal-article/ff9051da9e3e5b7642823181455c6cb5/higgitt1990.pdf

 

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A physio suggested it and I had got off pf everything else.

I should not have done so and, when tried to reinstate in Dec 2017 (before the irreparable damage was fine to muscles and joints) and it helped I should have stayed on rather than listening to ppl on here about how dangerous the drugs are.

Ppl in dystonia groups are on the decades with no problems.

I was so wine for whom they were a good option for my problems.

 

 

It opens fine for me in Sci-hub?

 

Try this: https://dacemirror.sci-hub.tw/journal-article/ff9051da9e3e5b7642823181455c6cb5/higgitt1990.pdf

 

Hi Ajusta,

Thanks for the link. It didn't work when I tried to find it yesterday. It's a bit finicky, I think.

 

Anyway, I think I misunderstood a few things in your note here, but I get the gist of it. I believe Baylissa Frederick had dystonia, but she got off her clonazepam and was eventually fine. It was her choice to get off it. So, I guess it's a very individual thing as to how it goes for people with dystonia.

 

Everyone has to make his/her own decisions on this thing. If people decide to stay on medications for long periods of time, they need to keep in mind that liver and kidney function might not be the same over time, and that may influence how well they do on meds. My 81-year-old mom recently had to have some of her meds adjusted downwards because it turned out that what she was taking was a bit too much. Thankfully, she worked with her doctor to figure out what needed to be changed.

 

Bottom line: It's a very individual thing. It's definitely not one size fits all. But people need to be given proper information up front so that can make informed decisions. Few of us around here got that.

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I was able to access and read the study, which as Lapis2 noted upthread, dates from 1990.  I wonder if the study has been replicated?  Also of note, quoting the authors: “The small samples contrasted in this study suggest caution in interpreting these results.”  (The prolonged withdrawal symptom group comprised 9 patients.)
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Libertas,

 

The study date of 1990 does not detract from the findings. "After more than 50 years of experience with benzodiazepines, the American health care system has a love-hate relationship with them. In 1955, Hoffmann-La Roche chemist Leo Sternbach serendipitously identified the first benzodiazepine, chlordiazepoxide (Librium). By 1960, Hoffmann-La Roche marketed it as Librium, and it pursued molecular modifications for enhanced activity. Valium (diazepam) followed in 1963. Hoffmann-La Roche's competitors also began looking for analogues. Initially, benzodiazepines appeared to be less toxic and less likely to cause dependence than older drugs. A specific improvement was their lack of respiratory depression, a safety concern with barbiturates. Medical professionals greeted benzodiazepines enthusiastically at first, skyrocketing their popularity and patient demand. In the mid-to-late 1970s, benzodiazepines topped all "most frequently prescribed" lists. (Note: I was initially prescribed diazepam during the mid 1970's for a non-psychological condition commonly called cluster headaches and is now called Trigeminal neuralgia: https://en.wikipedia.org/wiki/Cluster_headache.)  It took 15 years for researchers to associate benzodiazepines and their effect on gamma-aminobutyric acid as a mechanism of action. By the 1980s, clinicians' earlier enthusiasm and propensity to prescribe created a new concern: the specter of abuse and dependence. As information about benzodiazepines, both raising and damning, accumulated, medical leaders and legislators began to take action. The result: individual benzodiazepines and the entire class began to appear on guidelines and in legislation giving guidance on their use. Concurrently, clinicians began to raise concerns about benzodiazepine use by elderly patients, indicating that elders' lesser therapeutic response and heightened sensitivity to side effects demanded prescriber caution. The benzodiazepine story continues to evolve and includes modern-day issues and concerns beyond those ever anticipated." https://pubmed.ncbi.nlm.nih.gov/24007886/

 

The relatively small sample size does not detract from the study's conclusion: "Despite the small size, it can be concluded that this distinctive group of patients who continue to suffer withdrawal symptoms for periods of months or years after stopping benzodiazepine intake do not resemble patients diagnosed as suffering either from conversion hysteria or generalized anxiety disorder when compared on a range psychophysiological measures." https://dacemirror.sci-hub.tw/journal-article/ff9051da9e3e5b7642823181455c6cb5/higgitt1990.pdf

 

Heather Ashton's manual which is still promoted widely on this forum indicates that none, I repeat NONE of her 50 patients which used benzodiazepines long-term truly and fully recovered from post withdrawal symptoms. See Tables 1 & 2 from "Benzodiazepine Withdrawal: Outcome in 50 Patients" First published: British Journal of Addiction (1987) https://www.benzo.org.uk/ashbzoc.htm

 

Of the 50 patients Ashton studied, she classified 24 patients as "Excellent & Fully Recovered" but if you read her definition of "Excellent &

Fully Recovered", she states: "- Minimal symptoms, leading normal life, full-time job, no regular medication, may still be 'highly strung')." Of the remaining 26 patients: 1 died from suicide, 4 relapsed or failed to withdraw from use within approximately 3 years of follow up, and for the other 21 patients, they still had post withdrawal symptoms (PWS) which hindered their quality of life to various and serious degrees, i.e. " - Some symptoms but able to lead normal life, full-time job - Coping but symptoms which interfere with life or require other drugs (e.g. betablockers, antidepressants) still present and - Off benzodiazepines but still polysymptomatic and/or needing other psychotropic medication (e.g. antidepressants, sedative/hypnotics). I repeat, of the 50 patients Ashton included in her study none truly fully recovered and about half of those 50 patients may still be 'highly strung' (not a very technical term but it denotes not being fully recovered).

 

As I previously stated, based upon my experience, my doctors' advice and the article I previously noted above (https://pubmed.ncbi.nlm.nih.gov/15762817/) "long-term low-dose benzodiazepine treatment may be NECESSARY for some patients". That observation is often overlooked by patients, doctors and too many others who write about this subject.

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Libertas,

 

The study date of 1990 does not detract from the findings. "After more than 50 years of experience with benzodiazepines, the American health care system has a love-hate relationship with them. In 1955, Hoffmann-La Roche chemist Leo Sternbach serendipitously identified the first benzodiazepine, chlordiazepoxide (Librium). By 1960, Hoffmann-La Roche marketed it as Librium, and it pursued molecular modifications for enhanced activity. Valium (diazepam) followed in 1963. Hoffmann-La Roche's competitors also began looking for analogues. Initially, benzodiazepines appeared to be less toxic and less likely to cause dependence than older drugs. A specific improvement was their lack of respiratory depression, a safety concern with barbiturates. Medical professionals greeted benzodiazepines enthusiastically at first, skyrocketing their popularity and patient demand. In the mid-to-late 1970s, benzodiazepines topped all "most frequently prescribed" lists. (Note: I was initially prescribed diazepam during the mid 1970's for a non-psychological condition commonly called cluster headaches and is now called Trigeminal neuralgia: https://en.wikipedia.org/wiki/Cluster_headache.)  It took 15 years for researchers to associate benzodiazepines and their effect on gamma-aminobutyric acid as a mechanism of action. By the 1980s, clinicians' earlier enthusiasm and propensity to prescribe created a new concern: the specter of abuse and dependence. As information about benzodiazepines, both raising and damning, accumulated, medical leaders and legislators began to take action. The result: individual benzodiazepines and the entire class began to appear on guidelines and in legislation giving guidance on their use. Concurrently, clinicians began to raise concerns about benzodiazepine use by elderly patients, indicating that elders' lesser therapeutic response and heightened sensitivity to side effects demanded prescriber caution. The benzodiazepine story continues to evolve and includes modern-day issues and concerns beyond those ever anticipated." https://pubmed.ncbi.nlm.nih.gov/24007886/

 

The relatively small sample size does not detract from the study's conclusion: "Despite the small size, it can be concluded that this distinctive group of patients who continue to suffer withdrawal symptoms for periods of months or years after stopping benzodiazepine intake do not resemble patients diagnosed as suffering either from conversion hysteria or generalized anxiety disorder when compared on a range psychophysiological measures." https://dacemirror.sci-hub.tw/journal-article/ff9051da9e3e5b7642823181455c6cb5/higgitt1990.pdf

 

Heather Ashton's manual which is still promoted widely on this forum indicates that none, I repeat NONE of her 50 patients which used benzodiazepines long-term truly and fully recovered from post withdrawal symptoms. See Tables 1 & 2 from "Benzodiazepine Withdrawal: Outcome in 50 Patients" First published: British Journal of Addiction (1987) https://www.benzo.org.uk/ashbzoc.htm

 

Of the 50 patients Ashton studied, she classified 24 patients as "Excellent & Fully Recovered" but if you read her definition of "Excellent &

Fully Recovered", she states: "- Minimal symptoms, leading normal life, full-time job, no regular medication, may still be 'highly strung')." Of the remaining 26 patients: 1 died from suicide, 4 relapsed or failed to withdraw from use within approximately 3 years of follow up, and for the other 21 patients, they still had post withdrawal symptoms (PWS) which hindered their quality of life to various and serious degrees, i.e. " - Some symptoms but able to lead normal life, full-time job - Coping but symptoms which interfere with life or require other drugs (e.g. betablockers, antidepressants) still present and - Off benzodiazepines but still polysymptomatic and/or needing other psychotropic medication (e.g. antidepressants, sedative/hypnotics). I repeat, of the 50 patients Ashton included in her study none truly fully recovered and about half of those 50 patients may still be 'highly strung' (not a very technical term but it denotes not being fully recovered).

 

As I previously stated, based upon my experience, my doctors' advice and the article I previously noted above (https://pubmed.ncbi.nlm.nih.gov/15762817/) "long-term low-dose benzodiazepine treatment may be NECESSARY for some patients". That observation is often overlooked by patients, doctors and too many others who write about this subject.

 

I agree with Libertas, this is just one study and a small one at that. Also, the overwhelming consensus is that most people who taper will recover.

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Libertas,

 

The study date of 1990 does not detract from the findings. "After more than 50 years of experience with benzodiazepines, the American health care system has a love-hate relationship with them. In 1955, Hoffmann-La Roche chemist Leo Sternbach serendipitously identified the first benzodiazepine, chlordiazepoxide (Librium). By 1960, Hoffmann-La Roche marketed it as Librium, and it pursued molecular modifications for enhanced activity. Valium (diazepam) followed in 1963. Hoffmann-La Roche's competitors also began looking for analogues. Initially, benzodiazepines appeared to be less toxic and less likely to cause dependence than older drugs. A specific improvement was their lack of respiratory depression, a safety concern with barbiturates. Medical professionals greeted benzodiazepines enthusiastically at first, skyrocketing their popularity and patient demand. In the mid-to-late 1970s, benzodiazepines topped all "most frequently prescribed" lists. (Note: I was initially prescribed diazepam during the mid 1970's for a non-psychological condition commonly called cluster headaches and is now called Trigeminal neuralgia: https://en.wikipedia.org/wiki/Cluster_headache.)  It took 15 years for researchers to associate benzodiazepines and their effect on gamma-aminobutyric acid as a mechanism of action. By the 1980s, clinicians' earlier enthusiasm and propensity to prescribe created a new concern: the specter of abuse and dependence. As information about benzodiazepines, both raising and damning, accumulated, medical leaders and legislators began to take action. The result: individual benzodiazepines and the entire class began to appear on guidelines and in legislation giving guidance on their use. Concurrently, clinicians began to raise concerns about benzodiazepine use by elderly patients, indicating that elders' lesser therapeutic response and heightened sensitivity to side effects demanded prescriber caution. The benzodiazepine story continues to evolve and includes modern-day issues and concerns beyond those ever anticipated." https://pubmed.ncbi.nlm.nih.gov/24007886/

 

The relatively small sample size does not detract from the study's conclusion: "Despite the small size, it can be concluded that this distinctive group of patients who continue to suffer withdrawal symptoms for periods of months or years after stopping benzodiazepine intake do not resemble patients diagnosed as suffering either from conversion hysteria or generalized anxiety disorder when compared on a range psychophysiological measures." https://dacemirror.sci-hub.tw/journal-article/ff9051da9e3e5b7642823181455c6cb5/higgitt1990.pdf

 

Heather Ashton's manual which is still promoted widely on this forum indicates that none, I repeat NONE of her 50 patients which used benzodiazepines long-term truly and fully recovered from post withdrawal symptoms. See Tables 1 & 2 from "Benzodiazepine Withdrawal: Outcome in 50 Patients" First published: British Journal of Addiction (1987) https://www.benzo.org.uk/ashbzoc.htm

 

Of the 50 patients Ashton studied, she classified 24 patients as "Excellent & Fully Recovered" but if you read her definition of "Excellent &

Fully Recovered", she states: "- Minimal symptoms, leading normal life, full-time job, no regular medication, may still be 'highly strung')." Of the remaining 26 patients: 1 died from suicide, 4 relapsed or failed to withdraw from use within approximately 3 years of follow up, and for the other 21 patients, they still had post withdrawal symptoms (PWS) which hindered their quality of life to various and serious degrees, i.e. " - Some symptoms but able to lead normal life, full-time job - Coping but symptoms which interfere with life or require other drugs (e.g. betablockers, antidepressants) still present and - Off benzodiazepines but still polysymptomatic and/or needing other psychotropic medication (e.g. antidepressants, sedative/hypnotics). I repeat, of the 50 patients Ashton included in her study none truly fully recovered and about half of those 50 patients may still be 'highly strung' (not a very technical term but it denotes not being fully recovered).

 

As I previously stated, based upon my experience, my doctors' advice and the article I previously noted above (https://pubmed.ncbi.nlm.nih.gov/15762817/) "long-term low-dose benzodiazepine treatment may be NECESSARY for some patients". That observation is often overlooked by patients, doctors and too many others who write about this subject.

 

I agree with Libertas, this is just one study and a small one at that. Also, the overwhelming consensus is that most people who taper will recover.

 

People are free to believe what they want. I noted 3 studies above, including Ashton's. Also it would be helpful if you would include references making bold statements like the bolded text I quoted from your above post about the "overwhelming consensus is that most people who taper will recover."

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I agree with Libertas, this is just one study and a small one at that. Also, the overwhelming consensus is that most people who taper will recover.

 

Those were exactly the two points I wanted to make.  Thank you, Maugham1.

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Libertas,

 

 

Heather Ashton's manual which is still promoted widely on this forum indicates that none, I repeat NONE of her 50 patients which used benzodiazepines long-term truly and fully recovered from post withdrawal symptoms. See Tables 1 & 2 from "Benzodiazepine Withdrawal: Outcome in 50 Patients" First published: British Journal of Addiction (1987) https://www.benzo.org.uk/ashbzoc.htm

 

Of the 50 patients Ashton studied, she classified 24 patients as "Excellent & Fully Recovered" but if you read her definition of "Excellent &

Fully Recovered", she states: "- Minimal symptoms, leading normal life, full-time job, no regular medication, may still be 'highly strung')." Of the remaining 26 patients: 1 died from suicide, 4 relapsed or failed to withdraw from use within approximately 3 years of follow up, and for the other 21 patients, they still had post withdrawal symptoms (PWS) which hindered their quality of life to various and serious degrees, i.e. " - Some symptoms but able to lead normal life, full-time job - Coping but symptoms which interfere with life or require other drugs (e.g. betablockers, antidepressants) still present and - Off benzodiazepines but still polysymptomatic and/or needing other psychotropic medication (e.g. antidepressants, sedative/hypnotics). I repeat, of the 50 patients Ashton included in her study none truly fully recovered and about half of those 50 patients may still be 'highly strung' (not a very technical term but it denotes not being fully recovered).

 

 

I will take minimum symptoms, leading a normal life, full-time-job, no regular medication and "may still be highly strung" anytime over the other option, which I believe is horrible: "the study shows that long-term benzodiazepine use is associated with a considerable morbidity".

 

 

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Libertas,

 

 

Heather Ashton's manual which is still promoted widely on this forum indicates that none, I repeat NONE of her 50 patients which used benzodiazepines long-term truly and fully recovered from post withdrawal symptoms. See Tables 1 & 2 from "Benzodiazepine Withdrawal: Outcome in 50 Patients" First published: British Journal of Addiction (1987) https://www.benzo.org.uk/ashbzoc.htm

 

Of the 50 patients Ashton studied, she classified 24 patients as "Excellent & Fully Recovered" but if you read her definition of "Excellent &

Fully Recovered", she states: "- Minimal symptoms, leading normal life, full-time job, no regular medication, may still be 'highly strung')." Of the remaining 26 patients: 1 died from suicide, 4 relapsed or failed to withdraw from use within approximately 3 years of follow up, and for the other 21 patients, they still had post withdrawal symptoms (PWS) which hindered their quality of life to various and serious degrees, i.e. " - Some symptoms but able to lead normal life, full-time job - Coping but symptoms which interfere with life or require other drugs (e.g. betablockers, antidepressants) still present and - Off benzodiazepines but still polysymptomatic and/or needing other psychotropic medication (e.g. antidepressants, sedative/hypnotics). I repeat, of the 50 patients Ashton included in her study none truly fully recovered and about half of those 50 patients may still be 'highly strung' (not a very technical term but it denotes not being fully recovered).

 

 

I will take minimum symptoms, leading a normal life, full-time-job, no regular medication and "may still be highly strung" anytime over the other option, which I believe is horrible: "the study shows that long-term benzodiazepine use is associated with a considerable morbidity".

 

Again, this is just one study, one of the first studies on benzodiazepine withdrawal. Since then, an overweening

 

I agree, Maugham. "Highly strung" describes a number of people I know who are doing just fine!

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Libertas,

 

 

Heather Ashton's manual which is still promoted widely on this forum indicates that none, I repeat NONE of her 50 patients which used benzodiazepines long-term truly and fully recovered from post withdrawal symptoms. See Tables 1 & 2 from "Benzodiazepine Withdrawal: Outcome in 50 Patients" First published: British Journal of Addiction (1987) https://www.benzo.org.uk/ashbzoc.htm

 

Of the 50 patients Ashton studied, she classified 24 patients as "Excellent & Fully Recovered" but if you read her definition of "Excellent &

Fully Recovered", she states: "- Minimal symptoms, leading normal life, full-time job, no regular medication, may still be 'highly strung')." Of the remaining 26 patients: 1 died from suicide, 4 relapsed or failed to withdraw from use within approximately 3 years of follow up, and for the other 21 patients, they still had post withdrawal symptoms (PWS) which hindered their quality of life to various and serious degrees, i.e. " - Some symptoms but able to lead normal life, full-time job - Coping but symptoms which interfere with life or require other drugs (e.g. betablockers, antidepressants) still present and - Off benzodiazepines but still polysymptomatic and/or needing other psychotropic medication (e.g. antidepressants, sedative/hypnotics). I repeat, of the 50 patients Ashton included in her study none truly fully recovered and about half of those 50 patients may still be 'highly strung' (not a very technical term but it denotes not being fully recovered).

 

 

I will take minimum symptoms, leading a normal life, full-time-job, no regular medication and "may still be highly strung" anytime over the other option, which I believe is horrible: "the study shows that long-term benzodiazepine use is associated with a considerable morbidity".

 

Again, this is just one study, one of the first studies on benzodiazepine withdrawal. Since then, an overweening

 

I agree, Maugham. "Highly strung" describes a number of people I know who are doing just fine!

 

Is there a medical definition of "highly strung"? I will post this article which describes and provides references for prolonged benzodiazepine withdrawal sequelae and offer my sincere best wishes to all:

 

https://en.wikipedia.org/wiki/Post-acute-withdrawal_syndrome

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Libertas,

 

 

Heather Ashton's manual which is still promoted widely on this forum indicates that none, I repeat NONE of her 50 patients which used benzodiazepines long-term truly and fully recovered from post withdrawal symptoms. See Tables 1 & 2 from "Benzodiazepine Withdrawal: Outcome in 50 Patients" First published: British Journal of Addiction (1987) https://www.benzo.org.uk/ashbzoc.htm

 

Of the 50 patients Ashton studied, she classified 24 patients as "Excellent & Fully Recovered" but if you read her definition of "Excellent &

Fully Recovered", she states: "- Minimal symptoms, leading normal life, full-time job, no regular medication, may still be 'highly strung')." Of the remaining 26 patients: 1 died from suicide, 4 relapsed or failed to withdraw from use within approximately 3 years of follow up, and for the other 21 patients, they still had post withdrawal symptoms (PWS) which hindered their quality of life to various and serious degrees, i.e. " - Some symptoms but able to lead normal life, full-time job - Coping but symptoms which interfere with life or require other drugs (e.g. betablockers, antidepressants) still present and - Off benzodiazepines but still polysymptomatic and/or needing other psychotropic medication (e.g. antidepressants, sedative/hypnotics). I repeat, of the 50 patients Ashton included in her study none truly fully recovered and about half of those 50 patients may still be 'highly strung' (not a very technical term but it denotes not being fully recovered).

 

 

I will take minimum symptoms, leading a normal life, full-time-job, no regular medication and "may still be highly strung" anytime over the other option, which I believe is horrible: "the study shows that long-term benzodiazepine use is associated with a considerable morbidity".

 

Again, this is just one study, one of the first studies on benzodiazepine withdrawal. Since then, an overweening

 

I agree, Maugham. "Highly strung" describes a number of people I know who are doing just fine!

 

Is there a medical definition of "highly strung"? I will post this article which describes and provides references for prolonged benzodiazepine withdrawal sequelae and offer my sincere best wishes to all:

 

https://en.wikipedia.org/wiki/Post-acute-withdrawal_syndrome

 

The wikipedia link you posted refers to two anecdotal cases and does not reference studies. One of them mentions 18 months as an endpoint. Nobody questions that post-withrawal issue can last for 18 months. But forever? No

 

 

I don't know what Dr. Ashton meant by saying some of these people are high-strung.

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Well, if we're discussing language, I'd be interested in knowing what the term "hysteria" refers to in 2020 language. What specific behavioural or physiological symptoms were they talking about, and how would those things be described now? I doubt they'd use that term today. 
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Well, if we're discussing language, I'd be interested in knowing what the term "hysteria" refers to in 2020 language. What specific behavioural or physiological symptoms were they talking about, and how would those things be described now? I doubt they'd use that term today.

 

I don't think it really matters.

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If anyone IS interested, there's quite a bit of controversial history with regards to the use of this word in describing psychological issues.

 

 

From McGill University's Office of Science and Society, this article gives some background:

 

https://www.mcgill.ca/oss/article/history-quackery/history-hysteria

 

Here's an excerpt:

 

Hysteria was basically the medical explanation for ‘everything that men found mysterious or unmanageable in women’, a conclusion only supported by men’s (historic and continuing) dominance over medicine, and hysteria’s continued use as a synonym for “over-emotional” or “deranged.” It’s also worth noting how many of the problems physicians were attempting to fix in female patients, were not problems when they presented in male patients. Gendered stereotypes, like the ideas that women should be submissive, even-tempered, and sexually inhibited, have caused tremendous damage throughout history (and continue to do so today). It doesn’t seem so coincidental then that most modern treatments for hysteria involved regular (marital) sex, marriage or pregnancy and childbirth, all ‘proper’ activities for a ‘proper’ woman.

 

All things considered, most doctors and women alike were glad to see hysteria deleted from official Diagnostic and Statistical Manual of Mental Disorders in 1980.

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If anyone IS interested, there's quite a bit of controversial history with regards to the use of this word in describing psychological issues.

 

 

From McGill University's Office of Science and Society, this article gives some background:

 

https://www.mcgill.ca/oss/article/history-quackery/history-hysteria

 

Here's an excerpt:

 

Hysteria was basically the medical explanation for ‘everything that men found mysterious or unmanageable in women’, a conclusion only supported by men’s (historic and continuing) dominance over medicine, and hysteria’s continued use as a synonym for “over-emotional” or “deranged.” It’s also worth noting how many of the problems physicians were attempting to fix in female patients, were not problems when they presented in male patients. Gendered stereotypes, like the ideas that women should be submissive, even-tempered, and sexually inhibited, have caused tremendous damage throughout history (and continue to do so today). It doesn’t seem so coincidental then that most modern treatments for hysteria involved regular (marital) sex, marriage or pregnancy and childbirth, all ‘proper’ activities for a ‘proper’ woman.

 

All things considered, most doctors and women alike were glad to see hysteria deleted from official Diagnostic and Statistical Manual of Mental Disorders in 1980.

 

This word was used for centuries but it is not used anymore.

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If anyone IS interested, there's quite a bit of controversial history with regards to the use of this word in describing psychological issues.

 

 

From McGill University's Office of Science and Society, this article gives some background:

 

https://www.mcgill.ca/oss/article/history-quackery/history-hysteria

 

Here's an excerpt:

 

Hysteria was basically the medical explanation for ‘everything that men found mysterious or unmanageable in women’, a conclusion only supported by men’s (historic and continuing) dominance over medicine, and hysteria’s continued use as a synonym for “over-emotional” or “deranged.” It’s also worth noting how many of the problems physicians were attempting to fix in female patients, were not problems when they presented in male patients. Gendered stereotypes, like the ideas that women should be submissive, even-tempered, and sexually inhibited, have caused tremendous damage throughout history (and continue to do so today). It doesn’t seem so coincidental then that most modern treatments for hysteria involved regular (marital) sex, marriage or pregnancy and childbirth, all ‘proper’ activities for a ‘proper’ woman.

 

All things considered, most doctors and women alike were glad to see hysteria deleted from official Diagnostic and Statistical Manual of Mental Disorders in 1980.

 

This word was used for centuries but it is not used anymore.

 

Yes, thank goodness.

 

And this paper answers the other questions I had re: how "hysteria" symptoms would be classified today:

 

"What Is Hysteria? The Past and Present"

 

https://www.verywellmind.com/what-is-hysteria-2795232 

 

 

Here's an excerpt:

 

Hysteria In Modern Psychology

 

In 1980, the American Psychological Association changed their diagnosis of "hysterical neurosis, conversion type" to that of "conversion disorder."3 Today, psychology recognizes different types of disorders that were historically known as hysteria, including dissociative disorders and somatic symptom and related disorders.

 

Dissociative Disorders

 

Dissociative disorders are psychological disorders that involve an interruption (a dissociation) in aspects of consciousness, including identity and memory. These types of disorders include dissociative fugue, dissociative identity disorder, and dissociative amnesia.

 

Somatic Symptom Disorder

 

In the most recent update of the DSM, the DSM-5, symptoms that were once labeled under the broad umbrella of hysteria fit under what is now referred to as somatic symptom disorder.4 There are several related conditions:

 

    Illness anxiety disorder (formerly hypochondriasis)

    Conversion disorder (functional neurological symptom disorder)

    Other specified somatic symptom and related disorder

    Psychological factors affecting other medical conditions

    Factitious disorder

    Unspecified somatic symptom and related disorder

 

Somatic symptom disorder involves having a significant focus on physical symptoms such as weakness, pain, or shortness of breath. This preoccupation with symptoms results in significant distress and difficulties with normal functioning. The individual may or may not have a medical condition. It is important to note that this does not involve faking an illness; whether the person is sick or not, they believe that they are ill.

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I have presented this meta analysis before but, it is worth reviewing again. Note, Definition of meta analysis:  "examination of data from a number of independent studies of the same subject, in order to determine overall trends."

 

https://academic.oup.com/acn/article/33/7/901/4734935

 

"The Residual Medium and Long-term Cognitive Effects of Benzodiazepine Use: An Updated Meta-analysis"

 

Conclusion (in part):

.

.

.

"In conclusion, the results of this meta-analytic study are important in that they corroborate the mounting evidence that a range of neuropsychological functions are impaired as a result of long-term benzodiazepine use, and that these are likely to persist even following withdrawal. Furthermore, the findings highlight the problems associated with long-term benzodiazepine therapy as well as the important clinical implications of these results. More specifically, it is clear that the residual neuropsychological sequelae must be considered when making treatment decisions for these patients."

 

Conflict of interest

 

None declared.

 

 

My suggestion: search out, analyze and follow the best science available. I will leave this discussion for now and share this link to a song called "Ship Of Fools". The lyrics of the song are not directed to any specific group that I am aware of but, they may be meaningful to many aspects on this journey we call life. Best Wishes

 

 

Lyrics:

 

Went to see the captain, strangest I could find,

Laid my proposition down, laid it on the line.

I won't slave for beggar's pay, likewise gold and jewels,

But I would slave to learn the way to sink your ship of fools.

 

Ship of fools on a cruel sea, ship of fools sail away from me.

It was later than I thought when I first believed you,

Now I cannot share your laughter, ship of fools.

 

Saw your first ship sink and drown, from rockin' of the boat,

And all that could not sink or swim was just left there to float.

I won't leave you drifting down, but woh it makes me wild,

With thirty years upon my head to have you call me child.

 

Ship of fools on a cruel sea, ship of fools sail away from me.

It was later than I thought when I first believed you,

Now I cannot share your laughter, ship of fools.

 

The bottles stand as empty, as they were filled before.

Time there was and plenty, but from that cup no more.

Though I could not caution all, I still might warn a few:

Don't lend your hand to raise no flag atop no ship of fools.

 

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