Just curious if anyone else here is taking a benzodiazepine along with ADD/ADHD medication.

I am prescribed to and take (daily) Valium, which is the only benzo that I've found to be both subtle and non-sedating (contrary to my slightly high-end dosage, 20 mg/day, and the indications). I've been prescribed to Xanax, Ativan and Klonipin in the past, all of which I ended up abusing (or, in the case of Klonipin, simply losing my memory while taking). Valium may have a long-standing stigma against it, but I find it to be the least problematic of its class in terms of side-effects, cost, and potential for abuse. Also, its very long half-life and bioaccumulation makes it possible to miss a dose (at least for me) for up to 24 hours before I start feeling withdrawal begin.

On one side of the coin, I'm very happy to have diazepam, since it works amazingly well as an anti-anxiety and (strangely) an anti-depressant drug. On the other side, of course, I know I'm an addict and can't bear the thought of withdrawal. I withdrew from a heavy Xanax dose (4-6 mg per day) cold turkey, and it was the most horrific thing on personal record. I withdrew from methadone cold turkey, which was bad, but benzo withdrawal in many ways is much worse than opiate withdrawal. To be honest, withdrawal aside, I can't really bear the thought of life without diazepam.

Again, I was just curious to know if anyone found benzodiazepines beneficial. I'll close with the most pressing questions I have on my mind:

Do the benefits outweigh the risks?

Is there a point when a medicine become an addiction, in addition to a being a treatment?

and, if so,

Does anyone think that some addictions are justifiable by the benefits brought by the drug?

My personal answers are, yes, yes, and yes, respectively:)

My explanation: Yes, I believe it's better to NOT be on an addictive medication to begin with, but if it helps keep your mind/mood in control (and by this I mean not fuzzy or doped-out, simply under control) I think it's well worth the risk. For one, along with the current ADD meds I take (Vyvanse, Adderall), I have completely given up drinking, and have no desire at all for even a sip. Also, I don't crave illicit drugs like I used to, before my current medication combo, and avoid them successfully. I'm pretty sure that if I went off Valium, I'd substitute with alcohol or something else. I have no problem sticking to the doctor's prescribed dosage of two 10mg tablets per day either. For me, there's no problem.

That's my two cents. :)

(also, please: constructive/thoughtful responses only, I've admitted the evils of the meds, admitted my addiction, so I hope not to be personally lectured/chastened here, although negative responses regarding benzos are welcome and encouraged! ;) )

I have been amazingly lucky. I was given Ritalin as a child and told that I simply could not tolerate most drugs. So I stayed away from most of them.

I have been given Valium on one occasion. It was not pretty. I will refuse it if a doc orders it.

I think that whatever allows you to successfully live and function is probably the right thing. I have a bipolar sister who takes a number of things to help manage her needs. As long as she is assisted by this, I don't see a problem. I use Adderall to manage my ADHD. It is only an issue if I step outside of the prescription. The pdoc decides how much I use to manage.

I know that you see yourself as an addict. I don't know that I agree. I think that your self awareness is such that you are very guarded. I think that even if a med is addictive, if it does what it needs to to help you to function, addiction is not an appropriate tag. I probably said that badly but hope I managed to make the point. The Adderall I take is no less addictive and I know that I function better with it than without it.

Without the med, I had frequent meltdowns, couldn't concentrate on anything, couldn't manage a real job but instead lived in the world of quick hit projects, had no social life whatsoever, self medicated on coffee and nicotine. With the med, I am functional. I can choose tasks. I can complete tasks. I feel human. To me, the benefits outweigh the risks.

I know that you see yourself as an addict. I don't know that I agree. I think that your self awareness is such that you are very guarded. I think that even if a med is addictive, if it does what it needs to to help you to function, addiction is not an appropriate tag. I probably said that badly but hope I managed to make the point.

No, that was very well said! :)

I guess labeling myself as an "addict" isn't particularly useful, however, I acknowledge the fact that there is a definite physical/emotional/psychological dependence to Valium and other benzos. And obviously this occurs with amphetamine/methylphenidate type drugs as well.

But I agree, as long as it's not taken to "get high" or "space out" or whatever, maybe it isn't an addiction. As much as calling eating a "food addiction" or a daily multivitamin a "vitamin addiction" would be useful, since food and vitamins are just like medications in one fundamental way-- they're chemical compounds that operate on the brain and which we depend on.

So I appreciate your view.

Benzos can cause a physical dependence and a benzo addiction to develop and upon cessation of long-term use a benzo withdrawl syndrome can occur. Benzos with shorter half-lives tend to be able to produce tolerance and addiction quicker, as the drug does not last in the system for as long, with resultant interdose withdrawal phenomenon and next-dose craving.

Personally, I take BuSpar. My pdoc refused to give me a drug that might produce a risk of addiction she recommended BuSpar. It's structure is unrelated to those of the benzos, but it has an efficacy comparable to diazepam in treated GAD. It shows no potential for drug addiction or drug tolerance compared to other drugs commonly prescribed for anxiety, especially benzos. It is non-sedating.

The action of a single dose is much longer than the short half-life of 2-3 hours indicate. The bioavailablity of BuSpar is very low and variable to extensive first pass metabolism. The drug is quickly absorbed. BuSpar is also useful as an augmenting agent for the treatment of anxiety when added to SSRIs (Prozac) and to potentially lessen their sexual side effects.

The main disadvantage of BuSpar is that it takes 1-2 weeks before its anxiolytic effects become noticeable. Many may require a higher dosage (max: 60mg/day) to adequately respond to treatment. The downfall is that it makes it particularly difficult to treat patients pretreated with benzos, for they know the immediate effects of these anxiolytics. Often some have to be initially co-treated with a benzo for an immediate anxiolytic effect.

It's indications are GAD, OCD, agoraphobia, augmentation of SSRI-treatment against depression and ADHD. Most frequent adverse effects include vertigo, headaches, nervousness, agitation, light-headedness, and nausea. Like most drugs used to treat many mental disorders the adverse effects disappear with continued therapy, or are less frequent if the intial dose is low and increased gradually.

Good Luck.

I know benzodiazepines are effective for anxiety, but the withdrawal is a very high risk to add to the mix. I recommend to please reconsider taking these medications for prolonged periods of time and learn/find coping mechanisms instead because that will benefit you much more in the long term and without the risks of the future with benzos.

I am just going to put my .02 cents in and recommend trying L-Theanine amino acid supplements in doses of 100-200mg daily instead. In studies it has shown to be as effective as benzodiazepines and it also has been shown to increase Alpha Waves in the brain (which cause a relaxed state with increased concentration/focus). The effects of Theanine are definitely noticable to me and I guarantee they are not placebo. I take it before public speaking events for the accounting organization I run and I notice a difference without it. It takes about 40min-1 hour to kick in and it lasts about 3 hours. Even though it is anxiloytic its benefits may be somewhat limited under certain circumstances (such as extremely stressful situations).

Here are some links:
http://www.web-us.com/l-theanine_anxiety_reducer.htm

http://www.ncbi.nlm.nih.gov/pubmed/15378679?dopt=Abstract

Here are some customer reviews of it:
http://www.revolutionhealth.com/drugs-treatments/rating/l-theanine-theanine

Here's a study I can't post the link to because of the format:

"L-Theanine reduces psychological and physiological stress responses.

L-Theanine is an amino acid contained in green tea leaves which is known to block the binding of L-glutamic acid to glutamate receptors in the brain. Because the characteristics of L-Theanine suggest that it may influence psychological and physiological states under stress, the present study examined these possible effects in a laboratory setting using a mental arithmetic task as an acute stressor. Twelve participants underwent four separate trials: one in which they took L-Theanine at the start of an experimental procedure, one in which they took L-Theanine midway, and two control trials in which they either took a placebo or nothing. The experimental sessions were performed by double-blind, and the order of them was counterbalanced. The results showed that L-Theanine intake resulted in a reduction in the heart rate (HR) and salivary immunoglobulin A (s-IgA) responses to an acute stress task relative to the placebo control condition. Moreover, analyses of heart rate variability indicated that the reductions in HR and s-IgA were likely attributable to an attenuation of sympathetic nervous activation. Thus, it was suggested that the oral intake of L-Theanine could cause anti-stress effects via the inhibition of cortical neuron excitation.
Biol Psychol. 2007 Jan;74(1):39-45"

"Effects of theanine, r-glutamylethylamide, on neurotransmitter release and its relationship with glutamic acid neurotransmission.

Theanine, r-glutamylethylamide, is one of the major amino acid components in green tea and many researchers have compared theanine’s effects with glutamic acid because the chemical structure is similar. In the previous study, we demonstrated that theanine can pass brain-blood barrier and may play as an agonist or an antagonist of some receptors. In this study, we investigated the effects of theanine on neurotransmitter release in the rat brain striatum by in vivo brain microdialysis and examined whether theanine affected glutamate transporters by comparing it with a glutamate transporter blocker, L-trans-Pyrrolidine-2,4-dicarboxylic acid (L-trans-2,4-PDC). Because we investigated whether the effects of theanine is similar to L-trans-2,4-PDC on the brain neurotransmission, we measured dopamine release and some amino acids release which are known as excitatory or inhibitory neurotransmitters from neurons by theanine or L-trans-2,4-PDC perfusion into the rat brain striatum. L-trans-2,4-PDC or theanine perfusion into the brain striatum caused dopamine release from dopaminergic neurons. In addition, L-trans-2,4-PDC perfusion increased glutamic acid, aspartic acid and, whereas theanine perfusion prevented aspartic acid release and increased glycine release. These results suggested that the mechanism of dopamine release caused by theanine is different from glutamate transporter blockers or glutamic acid. Further, L-trans-2,4-PDC cause excitatory neurotransmission, whereas theanine may inhibit excitatory neurotransmission and cause inhibitory neurotransmission via glycine receptors. Nutr Neurosci. 2005 Aug;8(4):219-26"

They give me temazepam at my heart doctor, for the insomnia. It knocks me out, I take it every other night, with ambien on the nights between, so I dont get too used to either drug.

Thanks for the input so far.

hannielaggie: I've heard about BuSpar. I'm curious, assuming one has been taking BuSpar for enough time for accumulation in the brain to occur, how do the effects "come on"? Is it a noticeable shift from anxiety to calm, or is it subtle? Can you tell a big difference when you don't take it/forget to take it? Have you ever had a benzo; if so, how does it compare?

The part of your post about it being difficult to switch to for benzodiazepine users is valid. It's hard to let go of that "instant gratification" factor, which of course, is also a symptom of ADD. I was put on Gabapentin once to "replace" Xanax-- basically, the medication did nothing, considering it was being prescribed off-label for anxiety and is indicated usually for nerve pain.

demo3210: That's a very interesting bit of information. I'll have to pick up that supplement and give it a try, perhaps putting off a diazepam dose to see if I can notice a change. I am currently on a MEGADOSE of n-acetyl-cysteine (not sure if I spelled that right, but it's some sort of amino acid precursor), vitamin D3, folic acid, and omega-3 fatty acids, all ordered by the doc. They seem to help... hard to explain, but when I remember to take all of them my mind seems more "lubricated"? Probably makes sense with all that oil in the pills, since most are gelcaps of some sort. :)

It could be just rebound from the many years of benzo use I've been through, but every natural or vitamin-type supplement I've tried has not been close to as effectve as the benzos for severe anxiety or panic attacks. I've tried tons of things like valerian tea, chamomile tea, green tea, you name the tea-- I've tried it :) I've also tried many herbal supplements like St. John's Wort and concentrated valerian pills, and marijuana (legality aside, it is an herb-- incidentally it made my anxiety much worse). None has seemed to work, even all of them combined, as well as one of the benzo-class drugs.

But then again, that could just be rebound from the psychological/physical dependence. I'll certainly not tap-dance around the fact that benzos are extremely habit-forming, and should be avoided at all costs unless nothing else works. I have to say, finding the benzo with the fewest side-effects for me has been a great help. Xanax and others like it are just too much, too fast, and don't last. My diazepam dose helps keep me stable... perhaps one day I can do without it.

Thanks again for the info, I'll look into it! :)

reesah: Temazepam is a knockout pill to be sure. Unfortunately for me, it has the opposite effect, as it keeps me awake! I used to take 30 mg at a time and even double up doses (this is bad, everyone, don't do it!) and it never helped for sleep. Interestingly, temazepam is an inactive metabolyte of diazepam, one of the chemicals produced after diazepam metabolyzes. I'm not real sure what that means, all I know is that it is in your body after you take diazepam, but somehow not bioavalable. Also, the next step down the sleep aid ladder is the still more potent flurazepam (Dalmane), and that one did make me a little drowsy. Both flurazepam and temazepam are EXTREMELY potent benzodiazepines and should be taken with great care.

You mentioned Ambien-- I've been prescribed that as well. It is a very interesting drug. It often helped me sleep, but only for about three hours until the main effects wore off. Even tried the extended-release, still more expensive brand name version, Ambien CR, and that was indistinguishable from the 10 mg instant-release. Also, I experienced vivid hallucinations on Ambien almost every time I took it.

I think it's only fair to mention, though, that the half-life of temazepam is quite long, just like that of diazepam, and if you're taking it every other night, it's still (theoretically, depending on many factors including your individual metabolism) in your system when you're taking the Ambien. Do you take the temazepam every other night regularly, or just on an as-needed basis? If regularly, do you notice any adverse reaction (irritablitly, headaches, neck/back pain, irritated eyes or "rebound insomnia")if you miss a dose of either of these for two days in a row or more? Both are listed as habit-forming, and I have had experience with a habit with both as well.

If they help, though-- and it should be obvious by now that this is my stance on the issue-- that's wonderful. Sleep is one thing we just can't do without. Lack of sleep makes me absolutely demonic in my moods, especially coupled with ADD medication.

For sleep, nothing works as effectively (or at all) as my Seroquel... I asked to be taken off it, but the doc thinks it should stay for a while, so at least it helps me sleep, although it makes me very groggy if I don't sleep over 8 hours or under 10.

...
Darn, all the hassles that come with the benefits of medication. I was talking with a person last night about this issue... he had a truly admirable attitude, saying he felt it was a personal issue of pride that he wanted to be completely off meds, and strove for that. He said that when he had been prescribed Ativan, the doctor asked him how much he thought he would need for a month, and he only asked for three pills, and said he's only taken half of one in three months. I told him that I wish I could feel that way. It should be noted though, that he was drinking heavily, and I don't drink. Sometimes I wonder if it's just a trade-off for some people (like me), a sort of "pick-your-poison" type exchange. When my friends applaud me for not drinking at all, even in moderation, I always tell them that I'm pretty sure if I wasn't on the meds, I would be drinking heavily on a regular basis.
I'm interested in this topic because of the reactions I've gotten when I mention I take Valium, which range from extremely negative half the time, to very positive about 30% of the time (usually from other benzo users), to complete indifference 10% of the time, with the remaining 10% being something like "Hook me up!" or "Can I have some?" (which of course I say "no" to, because sharing meds is illegal, unethical and irresponsible and absolutely does not lead to good things).

I appreciate the feedback! Maybe hearing views from the wonderful folks on this forum will help me adjust my attitude towards benzos, and perhaps contribute to either A) me weaning off the drug for good, or B) me coming to terms with it and no longer worrying so much about using diazepam. Either way, I think it's positive.

It took me two years to taper off of 25mg. of diazepam after 5 years of daily use. It was the hardest thing I've ever done. I believe that benzos absolutely are not worth the dependancy/withdrawal that comes if used regularly for a chronic condition.
Not judging the OP or anyone else who is already stuck on benzos. I do urge anyone who is not yet on them, to stay that way.

I noticed the effects within a few days actually. It was a very calming feeling. Try it out.

Thanks hannilaggie, I'll think about talking to my doc about that next appointment and see if the MD thinks it's right for me.

It took me two years to taper off of 25mg. of diazepam after 5 years of daily use. It was the hardest thing I've ever done.

I can imagine. It will be hard when the time comes... I've been on it and other benzos for 3-4 years, with a couple withdrawals in between.


I forgot to mention that when I started on Vyvanse, I noticed a marked decrease in anxiety. I have another thread about treating symptoms instead of the disease... perhaps I should reread my own words here. I'm thinking more and more that Valium's benefits may not actually be much more than sustaining a dependence. If the Seroquel is a holdover from what I believe to be a misdiagnosis of bipolar, and Vyvanse has helped immensely with what I believe to be the true diagnosis, adult ADD, then perhaps Valium is a holdover from a previous misdiagnosed anxiety disorder.

It's just so damn hard to think of being without it. I know that's a weakness of will. I know where my strengths and my weaknesses are, and this is a weakness.

I appreciate you all prompting me to think harder about this difficult situation.

reesah: Temazepam is a knockout pill to be sure. Unfortunately for me, it has the opposite effect, as it keeps me awake! I used to take 30 mg at a time and even double up doses (this is bad, everyone, don't do it!) and it never helped for sleep. Interestingly, temazepam is an inactive metabolyte of diazepam, one of the chemicals produced after diazepam metabolyzes. I'm not real sure what that means, all I know is that it is in your body after you take diazepam, but somehow not bioavalable. Also, the next step down the sleep aid ladder is the still more potent flurazepam (Dalmane), and that one did make me a little drowsy. Both flurazepam and temazepam are EXTREMELY potent benzodiazepines and should be taken with great care.

You mentioned Ambien-- I've been prescribed that as well. It is a very interesting drug. It often helped me sleep, but only for about three hours until the main effects wore off. Even tried the extended-release, still more expensive brand name version, Ambien CR, and that was indistinguishable from the 10 mg instant-release. Also, I experienced vivid hallucinations on Ambien almost every time I took it.

I think it's only fair to mention, though, that the half-life of temazepam is quite long, just like that of diazepam, and if you're taking it every other night, it's still (theoretically, depending on many factors including your individual metabolism) in your system when you're taking the Ambien. Do you take the temazepam every other night regularly, or just on an as-needed basis? If regularly, do you notice any adverse reaction (irritablitly, headaches, neck/back pain, irritated eyes or "rebound insomnia")if you miss a dose of either of these for two days in a row or more? Both are listed as habit-forming, and I have had experience with a habit with both as well.

If they help, though-- and it should be obvious by now that this is my stance on the issue-- that's wonderful. Sleep is one thing we just can't do without. Lack of sleep makes me absolutely demonic in my moods, especially coupled with ADD medication.

For sleep, nothing works as effectively (or at all) as my Seroquel... I asked to be taken off it, but the doc thinks it should stay for a while, so at least it helps me sleep, although it makes me very groggy if I don't sleep over 8 hours or under 10.
.

I take the temazepam "as needed" and the ambien every other night.

Usually I end up taking the tem. once or twice a week. If I have a lot of projects to do for work I will not take either, and then I end up awake all night, but haven't had any other ill effects.

It used to be that I had no sleep schedule at all and could never predict when I'd get tired, and couldn't fall asleep at all if I wanted to. I've had insomnia my entire life. These drugs...I don't care if I am taking them for the rest of my life, as long as my sleep schedule is more somewhat-normal, so I haven't been too worried about :"how to stop taking them":

I just want to make sure they continue to work, not try to stop with them. after thirty years of insomnia and trying every natural remedy known to man I have absolute faith in anything that works and have no intention of trying to quit a medication that actually helps me.

edited to add: the ambien knocks me out. I tend to wake up after about six hours those nights. But I don't mind early rising, it is FAR better for me than no sleep at all.

Just a quick note, from my perspective;

I need these drugs to sleep. If I needed a drug to walk, a drug to metabolize sugar, a drug to breathe,,,,I'd take those too.

IS taking insulin a "habit"?

If you need a drug to treat a condition that will not go away, then you need the drug.

I think the idea that drugs are bad in general is dangerous. I see a lot of bipolar and scizophrenic friends of mine screw themselves up because of that. If the drug you are taking is treating a condition that cannot be cured, you may as well take it, and take it your whole life long, in prescribed and correct doses.

No need to think of treatment of a disease as a "habit". Insomnia, serious anxiety disorders, OCD, ADD, bipolar...these are illnesses and they may require lifelong treatment. There is no shame in taking care of yourself. I don't like the idea that someone needing medication means they are "weak", because a lot of these illnesses have a chemical imbalance which needs addressing, same as diabetes, same as many other illnesses.

DO what you must to be healthy, and let the criticism slide off your back.

They give me temazepam at my heart doctor, for the insomnia. It knocks me out, I take it every other night, with ambien on the nights between, so I dont get too used to either drug.

AFAIK the mechanism by which the two promote sleep is the same. Non-benzos like zolpidem are more targeted, so alternating with zolpidem might reduce the chance of getting dependent on temazepam (it does what zolpidem does, and more, the "more" causing dependence), but not the other way around.

I am not sure about this, so take with a proverbial grain of salt.

Hey Dj,

I'm glad you found my post insightful. I didn't mean for you to go off your benzos entirely to try the L-Theanine. I mean that would be great if you did, but as you know, stopping benzos abruptly may result in nasty side-effects and under high doses of benzos, possibly death. So please be careful in doing whatever you decide to do.

Best of luck.

I need these drugs to sleep. If I needed a drug to walk, a drug to metabolize sugar, a drug to breathe,,,,I'd take those too.

IS taking insulin a "habit"?

If you need a drug to treat a condition that will not go away, then you need the drug. ...

There is no shame in taking care of yourself. I don't like the idea that someone needing medication means they are "weak", because a lot of these illnesses have a chemical imbalance which needs addressing, same as diabetes, same as many other illnesses.

DO what you must to be healthy, and let the criticism slide off your back.

You know, I really appreciate this. I admire it when someone takes as firm a stand as you have, something I wish I could do, and aspire to do, on issues like this one. Obviously you can see I'm torn on this, I'm a flip-floppy sort of person in that I tend to look at an issue of this nature from all sides, trying to see all possible perspectives... one more problem of ADD for me. This thread is an example of that manifestation: I take a stand, then I question it. Believe me, it wreaks havoc in my social/personal/professional life in that I tend to be unable to take a stand sometimes, being aware of the validity of multiple points of view and multiple opposing bits of information.

I have no problems taking a stand on what I consider "hard issues," things like defending myself or a loved one or a stranger from physical or verbal violence, standing up for people being picked on, helping someone in an emergency rather than panicking or gawking, or getting in the face of anyone who gets off on bullying people. Those are things I'm good at making firm stands on. When it comes to my own damn self, though...well, I guess that's where I have trouble. The other side of the issue haunts me-- the concerns about withdrawal, the stigma that some people brandish (no one in this thread, of course!!) by calling me a "junkie" or looking down on me as "weak" for taking what I need, as they more often than not sip their sixth gin and tonic of the night or smoke another bongful of weed (what they consider "harmless, non-addictive" little pastimes...huh!), or perhaps just find sanctuary in some form of religious zealotry, a drug in and of itself (zealotry here... I'm not denouncing religion, merely the "high" some people seem to get from feeling holier-than-thou in their damn ivory towers. I'm convinced there's a dopamine/serotonin/something cascade involved).

But, I guess, as a good friend of mine likes to say, "You'll have that."

Anyway, your view makes perfect sense. And it seems like some doctors have this point of view, while others will not take a chance with these types of drugs under any circumstances. I've dealt with both kinds. The one I have now is in the middle-- willing to keep me WELL without needlessly weaning me off the diazepam because it's "by the book," or because diazepam is "habit-forming," because doing so might trigger a relapse of my terrible previous life. This doctor is the first one ever whom I feel is honestly concerned about my well-being, rather than his/her reputation as a "pill-dispenser" or an "enabler". I literally owe this doctor my life.

I used to mope around depressed and flit in and out of mental hospitals like a moth to a flame, now I can't seem to do enough productive things. I work, I write, I make music, I do woodworking, I train in martial arts, I have great relationships with my parents and friends, and I just get **** done. :) I used to enter into relationships that were doomed from the start, now I challenge the societal-TV-film-media-institution-enforced notion that I "need" anyone but myself to be truly "complete". It's so freeing.

I used to "hate myself," now I absolutely love being me, for the first time ever. I've finally developed and refined a complete-- if still a little fragile, like a plaster cast of a statue waiting to be filled with bronze-- sense of self-respect and self-esteem. Part of joining this forum for me was to see how other people who share a common disorder deal/cope with things. It's been so useful so far.

These are great developments!

Anyway, sorry for the speech :o I get this way sometimes. This thread was supposed to be about benzos, not about silly old me. That said, I'm happy with the diazepam, but keeping all options on the table.

Just a quick note, from my perspective;

I need these drugs to sleep. If I needed a drug to walk, a drug to metabolize sugar, a drug to breathe,,,,I'd take those too.

IS taking insulin a "habit"?

If you need a drug to treat a condition that will not go away, then you need the drug.

I think the idea that drugs are bad in general is dangerous. I see a lot of bipolar and scizophrenic friends of mine screw themselves up because of that. If the drug you are taking is treating a condition that cannot be cured, you may as well take it, and take it your whole life long, in prescribed and correct doses.

No need to think of treatment of a disease as a "habit". Insomnia, serious anxiety disorders, OCD, ADD, bipolar...these are illnesses and they may require lifelong treatment. There is no shame in taking care of yourself. I don't like the idea that someone needing medication means they are "weak", because a lot of these illnesses have a chemical imbalance which needs addressing, same as diabetes, same as many other illnesses.

DO what you must to be healthy, and let the criticism slide off your back.


Respectfully, the problem with this analysis in the context of benzodiazepines is this: tolerance builds to the therapeutic effects, requiring one to increase the dose over time or one winds up in "tolerance withdrawal." Eventually, one hits the "tolerance ceiling" and no further increase in benzo dosage will get them out of withdrawal. For these unfortunates, there is then no way out other than to taper off feeling utterly horrible the whole way.

The above is a generalization. There can be large individual differences: some people can continue to get a therapeutic response from 0.5 mg. of Xanax for years. Others would become tolerant to that dose in a matter of weeks.

This is not a thread about "drugs"--it is a thread about benzodiazepines specifically. All too often people go on benzos for anxiety (as I did), only to find that eventually the anxiety gets worse and they have to increase the dose. I had enough of that after 5 years, and decided I wanted off. That's when the real horror began. I thought I knew what anxiety was before--I had no idea. Benzo withdrawal amplifies anxiety to an extreme level, and it can last for an incredibly long time. The same holds true for people who take benzos for sleep: tolerance to the hypnotic effects also builds over time--typically faster than the anti-anxiety effects. Rebound insomnia can last a very, very long time.

I encourage anyone who is curious about benzos to simply google "benzodiazepine withdrawal" and do a bit of reading.

I am not anti-drug. I am not even anti-benzo---they are very effective drugs for short term use for certain applications. But regular, long-term use carries a very hefty price for many.

How's the BuSpar inquiry going?

Im given pretty much an unlimited script of 10mg valiums because of a panic disorder thats quite crippling if triggered. While benzos and stims dont compliment each other at all benzos are a nessecary evil to some of us.

Eventually, one hits the "tolerance ceiling" and no further increase in benzo dosage will get them out of withdrawal. For these unfortunates, there is then no way out other than to taper off feeling utterly horrible the whole way.

Hmmm, I've not noticed this effect. I've been on benzodiazepines for years and not had to increase my dose due to increased tolerance. Perhaps it's because of Valium's long half-life and considerable bioaccumulation, but I never have the urge to go over my 20mg a day. If I do that, it makes me quite drowsy!

I'm a longtime benzo user... I know a few others... and while I agree that tolerance does build, I have to strongly disagree (based on multiple experiences) with the proposal that no amount of benzo would pull one out of withdrawal. In withdrawal, even a small dose of a comparable benzo to the one you're withdrawing from will provide almost instantaneous relief. I'm stable with Valium now, with the ADD treatment keeping me level too, but I once was at a point where I would take 4-5 Xanax bars in one day, sometimes more-- that's 8-10 mg. I had no problem dropping back down to my "minimum," which was about 3 mg at that point-- still a heavy dose, yes. But when I was in withdrawal from this tremendous amount, 3 mg of lorazepam daily kept withdrawal at bay... but then they took me down to 2 one day and 0 the next day... withdrawal central. No relief. Also, phenobarbital is very effective in treating benzo withdrawal, particularly that of Xanax, which has arguably the most severe symptoms of withdrawal.

I will agree that users become tolerant to small doses and often develop a need/desire for more, but it seems that there's actually a ceiling after which you don't feel the need to raise the dosage. Again, this is from personal research and personal experience, so I'll have to look into that, and if there are people this happens too, they are unfortunate indeed!


hannielaggie: haven't had the chance to check on the BuSpar thing yet. My doc is out of town plus I don't have an appointment till April. I've heard mixed things from a friend/fellow benzo taker, who says it doesn't do anything... but then, you mentioned in your post the problem of benzo users trying it out and expecting instant results.

Hmmm, I've not noticed this effect. I've been on benzodiazepines for years and not had to increase my dose due to increased tolerance. Perhaps it's because of Valium's long half-life and considerable bioaccumulation, but I never have the urge to go over my 20mg a day. If I do that, it makes me quite drowsy!

I'm a longtime benzo user... I know a few others... and while I agree that tolerance does build, I have to strongly disagree (based on multiple experiences) with the proposal that no amount of benzo would pull one out of withdrawal. In withdrawal, even a small dose of a comparable benzo to the one you're withdrawing from will provide almost instantaneous relief. I'm stable with Valium now, with the ADD treatment keeping me level too, but I once was at a point where I would take 4-5 Xanax bars in one day, sometimes more-- that's 8-10 mg. I had no problem dropping back down to my "minimum," which was about 3 mg at that point-- still a heavy dose, yes. But when I was in withdrawal from this tremendous amount, 3 mg of lorazepam daily kept withdrawal at bay... but then they took me down to 2 one day and 0 the next day... withdrawal central. No relief. Also, phenobarbital is very effective in treating benzo withdrawal, particularly that of Xanax, which has arguably the most severe symptoms of withdrawal.

I will agree that users become tolerant to small doses and often develop a need/desire for more, but it seems that there's actually a ceiling after which you don't feel the need to raise the dosage. Again, this is from personal research and personal experience, so I'll have to look into that, and if there are people this happens too, they are unfortunate indeed!


You quoted/commented on paragraph 1 of my post without reference to paragraph 2, which was intended as a qualifier: there are large individual differences in how tolerance develops in different people. I never hit the tolerance ceiling either, but it's definitely a real phenomenon and does happen to some people. That doesn't mean it will happen to you. It does seem to happen more often with the more potent/shorter-acting benzos (e.g. Xanax; Ativan; Klonopin), but it can certainly happen with valium too.

I respectfully disagree that pheno is effective for "treating" benzo withdrawal. It will prevent seizures and it will supress many symptoms while you are taking it, because it works on GABA in much the same fashion as benzos do--but it's not really "treating" it IMO. The GABA complex is altered by long term use of benzos, and this system repairs itself very gradually. There are a bunch of drugs that work on GABA that are often prescribed to try and help with withdrawal (e.g. Neurontin; Trileptal; Lyrica; Phenobarbital) but IMO none of them really help reduce withdrawal in the long run. Rather, they tend to supress (delay) symptoms. They can prevent seizures when people are taken off of benzos rapidly, but they cannot speed up the rate at which the GABA complex repairs itself.

I'm not a doctor or anything--this is just a subject I've spent a great deal of time dealing with. If anyone wants more information on benzo withdrawal and recovery, feel free to PM me and I can give you links to different references available on the internet.

Best,
-tom

You quoted/commented on paragraph 1 of my post without reference to paragraph 2, which was intended as a qualifier...

You're right, guilty as charged. ;) guess that's the ADD... lol Things shouldn't be taken out of context!

There are a bunch of drugs that work on GABA that are often prescribed to try and help with withdrawal (e.g. Neurontin; Trileptal; Lyrica; Phenobarbital) but IMO none of them really help reduce withdrawal in the long run.

I can personally attest to the fact that Neurontin doesn't help. I was once put on high-dose gabapentin and it did very little other than eliminate nerve pain which didn't exist in the first place. :) The sad truth is that only a benzo will most effectively alleviate benzo withdrawal... but that's really just postponing the withdrawal anyway!

I suppose just because I haven't experienced the "tolerance ceiling" yet is no good reason to think it can't happen. Sort of like saying the world is flat because I've never walked around it and come back to the same spot. But, as I'm sure you know, benzo users are quite reticent to think about that dark, dark place called withdrawal... it's downright terrifying. A lot of us spend an excessive amount of time rationalizing and justifying what is basically a mixed blessing-- yeah, I get relief from the diazepam... yeah, I'll probably have to pay the piper one day. Already paid him a few times before but he keeps coming back to town blowing that damn pipe and I can't help but groove with him.

Sometimes I ask myself, what would happen if I was stranded on a deserted tropical island without my valium?....

...And the answer: a sticky, sweaty time of withdrawal--with campfire parrot hallucinations and periods of rolling around in the surf clutching my head-- made still worse by coconut-milk-induced diarrhea. And after the with-d's... hyper-focusing on building my palm-tree shanty and befriending the local rhesus monkey population. And trying to figure out how to shave with a clam shell.

Phenobarbital is the only one on that list that would help benzo withdrawal. The only thing that truly helps is proper tittration over a few weeks.. I would suspect an old fashioned mind destroying withdrawal may cure someone of the desire to eat xanaxs daily and may be the best thing for them long term.

If you have to take benzos the biggest rule is to never ever take them daily.

I'm taking upto 10mg of nitrazepam at night just now.Its working wonders cause i havent slept in dayz...anyone had any experience with this drug? it similar to valium?

Also, phenobarbital is very effective in treating benzo withdrawal, particularly that of Xanax, which has arguably the most severe symptoms of withdrawal.

Isn't that like saying crack is very effective at treating cocaine withdrawal (if you'll pardon the reference to illegal drugs)? Why in the world, other than having nothing besides phenobarbital on hand, would you want to do that?

I'm taking upto 10mg of nitrazepam at night just now.Its working wonders cause i havent slept in dayz...anyone had any experience with this drug? it similar to valium?

Very potent stuff. 10 mg is on the high side of the dose spectrum. According to my handy-dandy benzo equivalency chart, 2.5 mg of nitrazepam is roughly equivalent to 5 mg diazepam (Valium), so 10 mg is equivalent to 20 mg Valium, which is my entire combined daily dose.

This is one of the nitrobenzos, which includes the infamous flunitrazepam, or Rohypnol-- commonly known as "roofies." They don't even prescribe flunitrazipam in the USA anymore since the medical community agrees that its misuse outweighs the benefits.

Flurazepam and Temazepam (Dalmane and Restoril) are comparable in potency.

These varieties are long-acting and tend to cause more impairment and amnesia than Valium or Xanax, since they're geared towards severe or debilitating insomnia. Valium is sort of the mother of the benzos (with Librium-- clordiazepoxide-- being the grandmother), and all the rest are synthesized from the earlier ones.

Nitrazepam is a rare prescription in the USA. Use with caution, it can be habit forming in as little as a few days, and above all, DO NOT drink AT ANY TIME while taking it. It lingers in your system for the whole next day. Alcohol has a synergistic reaction with benzos like these (or any benzo), meaning one drink and one pill won't equal the combined effect of both, it could equal ten times the combined dose, or a hundred. Alcohol and a benzo is an amnesiatic, often deadly combination.

That said, I'm happy that it's helping you sleep. We all need sleep, and sometimes we need a little help. I see nothing wrong with accepting that help. :)

Isn't that like saying crack is very effective at treating cocaine withdrawal (if you'll pardon the reference to illegal drugs)? Why in the world, other than having nothing besides phenobarbital on hand, would you want to do that?

Kind of... more like saying amphetamine or methylphenidate is effective at treating cocaine withdrawal, since phenobarbital is a barbiturate and Xanax a benzodiazepine. Just as amps or methylphenidate and cocaine are both stimulants of different "families", such is the relationship between phenobarbital and Xanax-- depressant "cousins," if you will. :)

As to the second Q, well, for one, Xanax withdrawal is very painful, emotionally and physically, and can cause convulsions and death in severe cases. In addition, phenobarbital is a medically accepted treatment for benzo withdrawal. I think it's completely reasonable and rational, although some docs won't do it. Most doctors are in the business of easing the suffering of their patients (although many are of the "tough love" variety and prefer to lecture and recommend vitamins or exercise to actually prescribing anything-- and don't get me wrong, these things are important and I take plenty of both, they just aren't cure-all's), so some will treat the withdrawal symptoms with phenobarbital. This is usually done in a single prescription with a small amount of pills (5-10 perhaps).

Phenobarbital is one of the less potent barbiturates, and if used simply through the duration of Xanax withdrawal (all told, 4 days to a week and a half, depending on metabolism, diet, length of addiction, etc.), will most likely not become habit forming. The doctor will certainly NOT give out more phenobarbital after the withdrawal since it's only prescribed to treat said withdrawal. That would be unprecedented and therefore medically unjustifiable.

So the theoretical goal of the prescribing doctor would be to alleviate the symptoms of the patient's system detoxing from the Xanax, and when the withdrawal is done, so is the phenobarbital, and the person is free of addiction/withdrawal once again. I did say theoretically here... everything depends on the individual and his/her dosage of Xanax and pheno.

fxfake, I totally understand the point of what you're saying and where it's coming from. I just think it's right and proper to help someone's suffering even if they have been a victim of addiction to a prescription, or even made a bad choice and became addicted on the street, and are forced to face withdrawal. We're all human beings, we all need help sometimes.

And I'll sound the disclaimer once more that I am not a medical doctor, just a human lab rat who's had a lot of pills pushed through his system by doctors, and has done lots of casual research on this particular subject at the rat-library (internet) ;).

As to the second Q, well, for one, Xanax withdrawal is very painful, emotionally and physically, and can cause convulsions and death in severe cases. In addition, phenobarbital is a medically accepted treatment for benzo withdrawal.

That doesn't mean it's a good idea. Why is phenobarbital any better than Xanax, Klonopin, or Valium?

I think it's completely reasonable and rational, although some docs won't do it. Most doctors are in the business of easing the suffering of their patients (although many are of the "tough love" variety and prefer to lecture and recommend vitamins or exercise to actually prescribing anything-- and don't get me wrong, these things are important and I take plenty of both, they just aren't cure-all's), so some will treat the withdrawal symptoms with phenobarbital. This is usually done in a single prescription with a small amount of pills (5-10 perhaps).

Phenobarbital is one of the less potent barbiturates, and if used simply through the duration of Xanax withdrawal (all told, 4 days to a week and a half, depending on metabolism, diet, length of addiction, etc.), will most likely not become habit forming.

How does phenobarbital shorten the withdrawal period for Xanax (I thought it was weeks or more)? Doesn't phenobarbital work because it has similar effects to benzos?

Ill be more blunt and open in this response and hope some mod doesnt spank me for it.

Its a older and more intense sedative. Unlike with benzos which only have a theoretical LD50 its not hard to accidently kill yourself with Phenobarbital. This is why there was a big switch to benzos in the 70s, you can eat handfulls of xanax and not die or even be in physical danger. Im not saying anyone should do that because it'd cause you to blackout and probably do something stupid. Also, alcohol is used quite often by people withdrawing from benzos as they share a common mode of action on GABAa receptors.

The first three or four days of cold turkey benzo withdrawal is really the uncomfortable part. There may be residual effects for a while but they're pretty minor.

Its a older and more intense sedative. Unlike with benzos which only have a theoretical LD50 its not hard to accidently kill yourself with Phenobarbital. This is why there was a big switch to benzos in the 70s, you can eat handfulls of xanax and not die or even be in physical danger. Im not saying anyone should do that because it'd cause you to blackout and probably do something stupid. Also, alcohol is used quite often by people withdrawing from benzos as they share a common mode of action on GABAa receptors.

This is why I don't get the point of switching to barbiturates. They are more dangerous and stop the withdrawal because they have [almost] the same effects as benzos. I could understand using benzos to get off of barbiturates, but not the other way around.

The first three or four days of cold turkey benzo withdrawal is really the uncomfortable part. There may be residual effects for a while but they're pretty minor.

How is one going through withdrawal when taking phenobarbital? Doesn't it stop the withdrawal symptoms because you're not going through withdrawal?

Despite my seeming skepticism, I get the feeling there is something that I am missing... otherwise why would doctors use phenobarbital? OTOH doctors used to think that short acting drugs were less habit forming than long-acting drugs (e.g. Xanax vs. Valium).

The first three or four days of cold turkey benzo withdrawal is really the uncomfortable part. There may be residual effects for a while but they're pretty minor.

The length of time needed to recover following a rapid withdrawal from benzos varies considerably between different individuals. For many people, it can take a heck of a lot longer than a few days to get over those residual symptoms. For more information, visit any of the the benzo withdrawal forums on the web.

I encourage anyone who is curious about benzos to simply google "benzodiazepine withdrawal" and do a bit of reading.

I am not anti-drug. I am not even anti-benzo---they are very effective drugs for short term use for certain applications. But regular, long-term use carries a very hefty price for many.


I am going to try and shoot right between you and reesah simply because I agree with both perspectives. The difference between taking a medication for some thing like diabetes is that the effectiveness of medication at a certain dose can be measured in glucose levels where as medicating for some thing like anxiety is not.

I read about tolerance levels and ADD medications all the time - I thought at one time I after ten years on adderall maybe experiencing this. I talked to my doctor who told me this was unlikely and the medication decrease in effect must be due to some thing else.

I found out some time later I was hypothyroid - I wasn't absorbing the medication like I should. I no longer feel the medication working because my body has adjusted to the chemical changes long ago. However I did notice I was having a hard time focusing especially here and at work Other people were saying I was acting like I had not taken my medications when the fact was I had - that is how I knew about the decrease in effectiveness to begin with.

The adderall still changed my brain chemistry even though I wasn't feeling my medications and when I quit absorbing it as I had been the chemical changes were not taking place I did not with draw but the medication was not effective as it had been because it was no longer allowing me to control my direction of focus and length of attention span

It may be that someone can take a specific dose of benzodiazepams without having to have constant increase for the same reasons.

I do not see taking medications as the problem - Like ressah said there should be no shame in this - the huge problem with tolerance withdraws and all that crap seem to come mostly from people who take medications to generate a feeling as opposed to eliminating one such as insomnia or anxiety. The medications for most should continue to cause the same chemical changes in the brain that they did in the very beginning the difference being once the body adjust to the changes caused by the drug the person may no longer feel the effects of those changes.

Some drugs to produce a physical dependence however by gradual with draw - stepping off of them slowly should render these tolerable as long as the person has not created a psychological addiction to go with the physical dependence.

There is a huge difference between psychological addiction and chemical dependence - hence my reason for writing them as I do. I smoked and the cigarettes contained both addiction and dependence - dependence is when I physically go through withdraw when I quit using a substance which I did when I first quit smoking cigarettes. They also have a psychological addictive propriety also where as I wanted to smoke because in my mind I felt I needed to. I mentally associated certain activities with smoking cigarettes.

It isn't the physical dependence that causes ex-smokers to crave a cigarette ten years after they quit - the physical dependence on nicotine for me is long gone however it is the psychological addiction that rears it ugly head from time to time in the form of cravings.


So when some one says to you this drug is only psychologically addicting remember it is that aspect of addiction that is the hardest to over come The physical dependence doesn't normally last long where as the psychological one can last for years.Xanax has the potential for both as do many narcotics however it is the psychological addiction that one need to be concern with. I use xanax to control anxiety to stop painful spasms I do not take it for the way it makes me feel I am not looking for a buzz.

That doesn't mean it's a good idea. Why is phenobarbital any better than Xanax, Klonopin, or Valium?

I never said it was a good idea. I said it helped relieve symptoms of withdrawal and was medically accepted.

How does phenobarbital shorten the withdrawal period for Xanax (I thought it was weeks or more)? Doesn't phenobarbital work because it has similar effects to benzos?

I never said it shortened the withdrawal period. I said it was used for the duration of withdrawal, which wildly varies from person to person, and used to help the pain.

Benzo withdrawal is physical, mental, emotional agony, hallucinations, tremors, seizures, delusions, and really can only be understood through experience. Not recommended. I've been unfortunate enough-- and, possibly just plain stupid enough-- to have gone through it firsthand. It sucked.

There's no real answer to this issue. If nothing else, I've learned from this thread that there's only one person anyone needs to be accountable to for taking medication like this. Just one. And that person isn't in the sky somewhere, he/she's looking at the screen right now.

crap, didn't mean to double post, how do you delete a post, moderators?

I never said it shortened the withdrawal period. I said it was used for the duration of withdrawal, which wildly varies from person to person, and used to help the pain.

Benzo withdrawal is physical, mental, emotional agony, hallucinations, tremors, seizures, delusions, and really can only be understood through experience. Not recommended. I've been unfortunate enough-- and, possibly just plain stupid enough-- to have gone through it firsthand. It sucked.

I once took Klonopin (1mg/day for ~2 months); withdrawal from that was unpleasant, so I can imagine how bad it must be to stop after taking Xanax for few years at higher doses.

What I'm trying to understand is why one would want to withdraw using phenobarbital instead of just tapering off the benzo (either itself, or after switching to a long-acting benzo like Valium). What are the supposed benefits?

I see what you're saying, fxfake. I hope I didn't sound terse/defensive in my previous response, I had tried to edit the post to more clearly explain what I was trying to say, but passed the time limit on editing. :) Moderators! Where were ya? ;)

I once took Klonopin (1mg/day for ~2 months); withdrawal from that was unpleasant, so I can imagine how bad it must be to stop after taking Xanax for few years at higher doses.

1 mg of Klonopin for two months most certainly would have been very unpleasant to withdraw from. I'm guessing you took it in two .5 mg doses each day? It's a fairly light dose, but taken regluarly for that amount of time would have inevitably produced some sort of withdrawal. Light benzo withdrawal seems to involve a period of physical/emotional unease of varying intensity, irritability, and difficulty sleeping for a time.

At that dosage/time bracket of use, I am guessing that a doctor would most certainly have NOT considered giving out phenobarbital for this, even if there was no taper-down. Just like if you jam your wrist (as recently happened to me in martial arts-- ouch!), they're not going to prescribe morphine, percocet or even vicodin. If the wrist was broken, perhaps they might weigh the risks of prescribing an opiate of some sort.

Really awful benzo withdrawals, notoriously those of Xanax in particular-- the kind with the seizures, hallucinations, persistent insomnia and wrenching physical and emotional pain, and even potential coma or death-- tend to happen after large doses for medium to long periods of time. Sort of like the burn you get from the stove depends on how hot the stove was, how long you held your hand there, the moisture of your skin, etc, etc. Xanax is a red hot stove, and doesn't take as long as Klonipin to get hot enough to "burn" you badly with withdrawals.

This is because Xanax is the benzo that seems to produce a "high" rather than a treatment (Ativan is similar, though not as bad). I know several people in longtime methadone treatment (a terrible treatment, if you ask me), and they literally stockpile Xanax because it "boosts their high" from the methadone. They buy it from overseas pharmacies in bulk. Not a very good way to use a drug like this. That's plain abuse, and is inappropriate and dangerous.

Why the Xanax "high"? Pharmacologically speaking, compared to Klonipin, Xanax has a much shorter half-life, and a much more powerful onset and a sharper dropoff. This is because Xanax is intended for very short periods of usage as needed for panic attacks or extreme anxiety, and it's very good at what it does. Hence the "high" or "rush" at the onset.

The problem is-- or was, in my case-- that sometimes you will be kept on Xanax for a long period of time, especially if you relocate, don't have insurance or a regular doctor, and thus have to keep switching docs as the county/VA hospital goes through them. The reason for this is often because a "fill-in" doctor comes in for a month or two to keep things going, and he or she usually won't adjust your treatment radically-- and usually not even touch it-- because they want you to work with a doc long-term. But equally often, there never will be a long-term doctor at a county health center or a veteran's hospital clinic for long periods of time. Your Xanax dose will inexorably creep higher and higher, since alprazolam (why does that word still make me shudder??) is not meant for long-term treatment, and the effects only last for 4-6 hours before mild withdrawal starts.

Hence, one more reason a family doctor or regular psychiatrist is very important to have. Fortunately for me, I finally have a regular psychiatrist these days-- and it's made a world of difference.

What I'm trying to understand is why one would want to withdraw using phenobarbital instead of just tapering off the benzo (either itself, or after switching to a long-acting benzo like Valium). What are the supposed benefits?

Tapering is, hands-down, the best option. For the sake of this discussion, let's assume that tapering was impossible for one of many potential reasons, and the person went off "cold turkey." Enter, phenobarbital.

The way I first learned about phenobarbital as a withdrawal treatment was from a psychiatrist I saw after I'd already been withdrawing from a lengthy, heavy Xanax dose through the worst time, and he said, "I'd have prescribed you a small amount of phenobarbital to help with the worst symptoms, but you're already mostly out of the woods, so I'm going to put you on Seroquel to help with the sleeping." It's important to point out that with Xanax, "death" is in the list of potential withdrawal symptoms. So the gravity of the withdrawal often determines the radical nature of the treatment.

Personally, I'd experienced all the earlier listed symptoms of severe Xanax withdrawal, including losing my ability to speak clearly without slurring words for a few days. Absolutely terrible! By the time I got to my new psych., I was simply in the severe insomnia/hallucination stage, and so he struck down phenobarbital. I'm glad he did-- I don't want to take a damn barbiturate!

*****>>> To address your MAIN question:

The idea of the phenobarbital as a withdrawal aid, as I understand it, is this: The doctor wants you off the Xanax. So, like I said before, a small, very limited amount of phenobarbital with zero refills is prescribed to help alleviate the worst Xanax withdrawal symptoms. It's not close enough in chemical structure to a benzodiazepine to prolong the withdrawal. It's a low dose, not like the reds of the 60's and 70's, and has little potential for addiction at that small dose and limited quantity. Still, the Xanax withdrawal keeps on keepin' on during the pheno use, and the doctor hopes that it'll help enough to get you "through the woods."

So do you see the difference?

It's safe to say that benzos don't do anything to help benzo withdrawal run its course. If you take one at the worst point of withdrawal, it'll relieve the symptoms temporarily, but then they will continue afterwards just as if you'd put a disturbing scene on a DVD on pause for a moment, and when you come back to it, it starts right back up in the middle of that scene. Phenobarbital would be more like a blindfold during that most disturbing scene that will fall off when the scene's over or almost over.

I hope this makes sense. :)

I am going to try and shoot right between you and reesah simply because I agree with both perspectives. The difference between taking a medication for some thing like diabetes is that the effectiveness of medication at a certain dose can be measured in glucose levels where as medicating for some thing like anxiety is not.

I read about tolerance levels and ADD medications all the time - I thought at one time I after ten years on adderall maybe experiencing this. I talked to my doctor who told me this was unlikely and the medication decrease in effect must be due to some thing else.

I found out some time later I was hypothyroid - I wasn't absorbing the medication like I should. I no longer feel the medication working because my body has adjusted to the chemical changes long ago. However I did notice I was having a hard time focusing especially here and at work Other people were saying I was acting like I had not taken my medications when the fact was I had - that is how I knew about the decrease in effectiveness to begin with.

The adderall still changed my brain chemistry even though I wasn't feeling my medications and when I quit absorbing it as I had been the chemical changes were not taking place I did not with draw but the medication was not effective as it had been because it was no longer allowing me to control my direction of focus and length of attention span

It may be that someone can take a specific dose of benzodiazepams without having to have constant increase for the same reasons.

I do not see taking medications as the problem - Like ressah said there should be no shame in this - the huge problem with tolerance withdraws and all that crap seem to come mostly from people who take medications to generate a feeling as opposed to eliminating one such as insomnia or anxiety. The medications for most should continue to cause the same chemical changes in the brain that they did in the very beginning the difference being once the body adjust to the changes caused by the drug the person may no longer feel the effects of those changes.

Some drugs to produce a physical dependence however by gradual with draw - stepping off of them slowly should render these tolerable as long as the person has not created a psychological addiction to go with the physical dependence.

There is a huge difference between psychological addiction and chemical dependence - hence my reason for writing them as I do. I smoked and the cigarettes contained both addiction and dependence - dependence is when I physically go through withdraw when I quit using a substance which I did when I first quit smoking cigarettes. They also have a psychological addictive propriety also where as I wanted to smoke because in my mind I felt I needed to. I mentally associated certain activities with smoking cigarettes.

It isn't the physical dependence that causes ex-smokers to crave a cigarette ten years after they quit - the physical dependence on nicotine for me is long gone however it is the psychological addiction that rears it ugly head from time to time in the form of cravings.


So when some one says to you this drug is only psychologically addicting remember it is that aspect of addiction that is the hardest to over come The physical dependence doesn't normally last long where as the psychological one can last for years.Xanax has the potential for both as do many narcotics however it is the psychological addiction that one need to be concern with. I use xanax to control anxiety to stop painful spasms I do not take it for the way it makes me feel I am not looking for a buzz.

It is actually pretty rare for someone to have a true *addiction* to benzodiazepines (characterized by cravings, temptation to exceed prescribed dose, etc). There certainly are people with true addictions to benzos, but most simply take them as prescribed, as I did. This makes absolutely no difference when it comes to the intensity and difficulty of benzo withdrawal. It is an intensely physical experience.

Tolerance in the context of amphetamines vs. benzos is the same concept, but the consequences are really not comparable.

Again, people build tolerance to benzos at very different rates, and some people can come off of benzos much easier than others. But do not underestimate how difficult it can be--physically--to come off of these drugs once dependance has developed.

Honestly, this is something that probably has to be experienced to be truly believed & understood. I wouldn't wish it on my worst enemy.

Best,
-tom

Again, people build tolerance to benzos at very different rates, and some people can come off of benzos much easier than others. But do not underestimate how difficult it can be--physically--to come off of these drugs once dependance has developed.

Honestly, this is something that probably has to be experienced to be truly believed & understood. I wouldn't wish it on my worst enemy.



I understand physical with draw just fine. I am not doubting it -

I do not doubt people with draw off of stimulants. Just because I do not experience it doesn't mean it doesn't happen too other people. On the other hand just because I experience a physical with draw doesn't automatically mean every one reading will.

It just seem like those who are looking for a specific feeling instead of symptom relief have a tendency to take higher doses thus increasing their chances of having a difficult time stopping the medication. It seems reasonable that the dose, frequency and length of time would have a lot to do with the experience as well.

I think the point I failed to communicate effectively is physical dependence is a bio- chemical thing and not a moral short coming.

The idea of the phenobarbital as a withdrawal aid, as I understand it, is this: The doctor wants you off the Xanax. So, like I said before, a small, very limited amount of phenobarbital with zero refills is prescribed to help alleviate the worst Xanax withdrawal symptoms. It's not close enough in chemical structure to a benzodiazepine to prolong the withdrawal.

The thing is that benzos and barbiturates do almost the same thing. Benzos cause the GABAa Cl channel to open more often, whereas barbiturates cause them to stay open longer (apparently this is the reason that the former are much safer than the latter). I somehow doubt that a barbiturate does not prolong the withdrawal any less than, say, Valium.

However, phenobarbital's long duration of action and lack of fun effects would seem to be sensible reasons to use it. Of course it's also much more dangerous than a benzo.

I somehow doubt that a barbiturate does not prolong the withdrawal any less than, say, Valium.

Believe me, there is a distinct difference. I'll try one last comparison to clear up what the idea behind the pheno is.

Valium is indicated for severe alcohol withdrawal.

....I was going to expand, but I think that's all I'm going to say since I'm beginning to feel like I'm promoting barbiturate use, which is the last thing I want! I'm only saying it can be useful in alleviating suffering of a certain nature under a doctor's careful vigilance. That's all.

Honestly, this is something that probably has to be experienced to be truly believed & understood. I wouldn't wish it on my worst enemy.


Tominal's point is absolutely accurate... it's something that would be best understood through experience, and that's not recommended, so perhaps it's best something not worth trying to tackle. :)

This an old thread but I wanted to add something. Part of the reason for benzo addiction is the way they are prescribed. For example, on my bottle of Xanax it reads.."take one tablet by mouth twice daily", now if I took it like that I would surely become addicted in no time. It should read.."take only as needed, no more than two tablets daily". Doctors should make it very clear to only use these drugs when you absolutely need to. There are many people out there that will take them everyday just because the label on the bottle says so. I try not to take any more then three pills in a whole week.

This an old thread but I wanted to add something. Part of the reason for benzo addiction is the way they are prescribed. For example, on my bottle of Xanax it reads.."take one tablet by mouth twice daily", now if I took it like that I would surely become addicted in no time. It should read.."take only as needed, no more than two tablets daily". Doctors should make it very clear to only use these drugs when you absolutely need to.

That's something that should be made clear when you start the med.

Plenty of people take benzos on a daily basis. Of course this usually results in physical dependence.