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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by cybercafe on June 22, 2003, at 4:49:52
if i took 6 mg of lorezepam 2 or 3 times a week, would it become less effective over time?
Posted by djmmm on June 22, 2003, at 9:01:04
In reply to how do you gain tolerance to a benzo?, posted by cybercafe on June 22, 2003, at 4:49:52
most likely...tolerance is complex, and involves adaptation of neurotransmitter systems, liver enzymes, etc. I would post a link on benzodiazepine tolerance but most are very "anti-benzo" and the information is ALWAYS bias.
Try this site on the pharmacology of tolerance
http://abdellab.sunderland.ac.uk/Lectures/Parmacology/Introdoc/Toxicity.html
Posted by cybercafe on June 22, 2003, at 19:15:31
In reply to Re: how do you gain tolerance to a benzo?, posted by djmmm on June 22, 2003, at 9:01:04
> most likely...tolerance is complex, and involves adaptation of neurotransmitter systems, liver enzymes, etc. I would post a link on benzodiazepine tolerance but most are very "anti-benzo" and the information is ALWAYS bias.
>
> Try this site on the pharmacology of tolerance
>
> http://abdellab.sunderland.ac.uk/Lectures/Parmacology/Introdoc/Toxicity.htmlhmmm... people seem to believe there is a point at which you can take a steady state amount of benzo and not get any more tolerance...
so i'm thinking that if i take a lot at once, have it in my system for 6? hours, then go at least another 18 hours with none in my system at all, i should be even less likely to gain a tolerance no?
Posted by Viridis on June 22, 2003, at 21:32:31
In reply to how do you gain tolerance to a benzo?, posted by cybercafe on June 22, 2003, at 4:49:52
I don't know the answer to your question; I'd think that using Ativan only occasionally would prevent tolerance from occurring, but maybe not. I take Xanax occasionally (sometimes a few days in a row, then not for a week or two) and always at low doses. I have noticed that the tiny 0.25 mg doses that once were effective do essentially nothing now; 0.5 mg helps and sometimes I take a little more (although much more makes me sleepy).
I take Klonopin daily, and am at the same 1 mg dose I started with two years ago. My pdoc says that he has many patients on K who have stayed at the same dose for years with no need to increase; tolerance quickly develops to the side effects, but not the anxiolytic effects. He considers it an extremely safe benzo with little tolerance or abuse risk.
I asked him about my need for more Xanax (not more often, just more when I do need it). He said fine, take as much as you need. I also asked him if it was cross-tolerance from the daily use of Klonopin, and he thought this was unlikely since these benzos are structurally quite different. He didn't seem surprised, and said this just happens sometimes, and not to worry unless I find myself needing larger amounts at increasing frequent intervals.
Posted by Caleb462 on June 22, 2003, at 21:43:35
In reply to Re: how do you gain tolerance to a benzo? » cybercafe, posted by Viridis on June 22, 2003, at 21:32:31
> I don't know the answer to your question; I'd think that using Ativan only occasionally would prevent tolerance from occurring, but maybe not. I take Xanax occasionally (sometimes a few days in a row, then not for a week or two) and always at low doses. I have noticed that the tiny 0.25 mg doses that once were effective do essentially nothing now; 0.5 mg helps and sometimes I take a little more (although much more makes me sleepy).
>
> I take Klonopin daily, and am at the same 1 mg dose I started with two years ago. My pdoc says that he has many patients on K who have stayed at the same dose for years with no need to increase; tolerance quickly develops to the side effects, but not the anxiolytic effects. He considers it an extremely safe benzo with little tolerance or abuse risk.
>
> I asked him about my need for more Xanax (not more often, just more when I do need it). He said fine, take as much as you need. I also asked him if it was cross-tolerance from the daily use of Klonopin, and he thought this was unlikely since these benzos are structurally quite different. He didn't seem surprised, and said this just happens sometimes, and not to worry unless I find myself needing larger amounts at increasing frequent intervals.While they do have different structures... clonazepam and alprazalom still both activate the same receptors... so I wouldn't be suprised if it WAS some sort of cross-tolerance effect.
Posted by Viridis on June 22, 2003, at 22:45:14
In reply to Re: how do you gain tolerance to a benzo?, posted by Caleb462 on June 22, 2003, at 21:43:35
That was my thinking too, but my pdoc seems to believe that K and X act quite differently, so doubts cross-tolerance (although wouldn't rule it out altogether). In any case, Xanax is a fairly minor player in my treatment, and I'm sure he'll give me what I need, since it's quite clear that I don't get off on benzos so have very low abuse risk.
He did give me some Gabitril, and suggested I try it and see what I think -- apparently some of his colleagues have had good success with it in anxiety patients, and he said he's thinking of trying it himself. I'm curious to test it, but am waiting to settle in on my trial of Strattera (so far, a very good med -- minimal side effects and a great sense of calm/focus).
Posted by Caleb462 on June 22, 2003, at 23:11:03
In reply to Re: how do you gain tolerance to a benzo? » Caleb462, posted by Viridis on June 22, 2003, at 22:45:14
> That was my thinking too, but my pdoc seems to believe that K and X act quite differently, so doubts cross-tolerance (although wouldn't rule it out altogether). In any case, Xanax is a fairly minor player in my treatment, and I'm sure he'll give me what I need, since it's quite clear that I don't get off on benzos so have very low abuse risk.
>
> He did give me some Gabitril, and suggested I try it and see what I think -- apparently some of his colleagues have had good success with it in anxiety patients, and he said he's thinking of trying it himself. I'm curious to test it, but am waiting to settle in on my trial of Strattera (so far, a very good med -- minimal side effects and a great sense of calm/focus).I'd also be interesting in trying Gabitril... I've only heard negative things from this board, but this board is only a very small sample of patients... so, yeah.
My doc won't prescribe a benzo. I did get some Xanax from my temporary p-doc during my recent hospital stay... it had little effect on me. I noticed nothing at 0.5 mg, and only slight effects at 1 mg... 1.5 mg worked ok but it put me to sleep. So altogether, I was pretty unimpressed with Xanax's anxiotylic effects - yet it is considered so effective by so many. Perhaps I have a naturally high tolerance for benzos?
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