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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by femlite on November 24, 2003, at 0:00:52
Ive heard some say this.
Im BP II and take benzos for occasional anxiety.I take 1 mg Ambien evry pm and ativan 1mg as needed which is 4 or 5 times a week.
Posted by Elle2021 on November 24, 2003, at 0:59:45
In reply to Do Benzos increase Depression in long run ?, posted by femlite on November 24, 2003, at 0:00:52
I'm not sure about increasing depression in the long run, I know they do seem to increase my depression while I'm taking them. Maybe you should ask your doctor if the level of depression your experiencing is normal or caused by the benzos. I would be interested to hear what he says. :)
Elle
Posted by psychlover on November 24, 2003, at 23:31:23
In reply to Re: Do Benzos increase Depression in long run ? » femlite, posted by Elle2021 on November 24, 2003, at 0:59:45
I know Dr. Ivan Goldberg of Depression Central has said that Klonopin makes depression worse while Ativan does not. My psychiatrist disagreed however, so I am still on Klonopin. I believe it could be making my depression worse, but while I am taking antidepressants it is almost impossible to say for sure.
Hope this helps!
-psychlover
Posted by Viridis on November 26, 2003, at 1:39:31
In reply to Do Benzos increase Depression in long run ?, posted by femlite on November 24, 2003, at 0:00:52
This is just my experience ( and my psychiatrist agrees): if your depression is the result of anxiety, then benzos can be a great help. Klonopin is the best antidepressant I've tried, but the really severe depression I've experienced is the result of anxiety. If your depression has other causes, then benzos may not be the answer. But Klonopin (and Xanax) work for me.
Posted by zeugma on November 26, 2003, at 19:11:50
In reply to Re: Do Benzos increase Depression in long run ?, posted by Viridis on November 26, 2003, at 1:39:31
So far I haven't had a return of depression. And my anxiety is perfectly capable of existing without depression (though it may have helped cause it in the past). Been on Klonopin for over three weeks now. It is the best thing I have ever taken for anxiety.
Posted by ace on November 26, 2003, at 21:28:42
In reply to Re: Do Benzos increase Depression in long run ?, posted by zeugma on November 26, 2003, at 19:11:50
> So far I haven't had a return of depression. And my anxiety is perfectly capable of existing without depression (though it may have helped cause it in the past). Been on Klonopin for over three weeks now. It is the best thing I have ever taken for anxiety.
Great to here! I am actually pro-benzo use...so many doctors are overly cautious I think. Dependence and tolerance are very bad with benzos they say.1. Dependence- people do become somewhat dependent on Benzos- just like they do on ADs. However, if the benzo is withdrawn at a slow pace, there is no evidence that benzos create horror withdrawals or irreversible dependence. people drop from 5 mg Xanax to 1mg Xanax and wonder why they have a prob! Inreality, they should go slowly from 5.5mg, then 5mg, then 4.5 etc etc.
In plus, for people who can't live a normal life, I think some would prefer benzo "dependence" over constant suffering and running.
2. Tolerance- Benzos produce an initial torelance that peters out around 4 weeks or a bit more. Then the same dose can be maintained with continued efficacy. Apart from alcoholics and drug abusers, I have rarely heard from people that they need to continually raise their benzo dose...infact a lot can LOWER it with continued efficacy.
Good luck with the Klonopin! Wish I had it available here in Australia!
Ace.
Posted by Caleb96 on November 27, 2003, at 16:26:48
In reply to Re: Benzo Blabber! » zeugma, posted by ace on November 26, 2003, at 21:28:42
This debate has been going on for years. I remember when Xanax came out in the early 1980s, the literature (and sales reps!) told MDs that Xanax didn't aggravate depression like Valium. The bottom line is benzodiazepines (BZs) are DOWNERS, and as a general rule, downers aggravate depression when taken for long periods. This is one reson why doctors tell their patients not to drink if they have depression. Alcohol is a downer (see below). My educated (but not expert advice) is that BZs, to varying degrees, aggravate depression. ADs may couteract this enough that overall, you feel much better. If you're still anxious, BZs can be useful in alleviating symptoms and is worth the price of a possible redution in effect of the AD.
DETAILS (Not essential reading):
My guess is, by their nature, bezodiazepines are sedatives, so they tend to keep your CNS neurons in a less polarized state. In other words, it takes more effort (by adjacent neurons) to evoke a response in the neuron. That's kind of a crude explanation of why BZs are calming.
Second, BZs act on the same chloride ion channel as acohol. Normally, an endogenous ligand (that's a fancy way of saying a special chemical found naturally in the CNS) binds to a receptor site on the chloride ion channel and allows chloride ions enter the neuron. That special chemical is named GABA or gamma-aminobutyric acid. When chloride ions enter the neuron, they depolarized it to some degree (in other words, depolarization makes the neuron less likely to fire--it takes more input from neighboring nerve cells to get a response.
You're probably thinking, where the heck is this guy going with this. Well, BZs bind to a subunit of the chloride ion channel and enhance GABAs effect--in other word, GABA kind of becomes a super-GABA, and makes the nerve even more resistant to firing. This is also why alcohol works, but its mechanism is a little different. The key result is you have a calming, sedating effect we associate with benzodiazepines. If you take enough, you'll get "drunk."
Posted by zeugma on November 29, 2003, at 10:25:32
In reply to Re: Benzo Blabber!, posted by Caleb96 on November 27, 2003, at 16:26:48
> This debate has been going on for years. I remember when Xanax came out in the early 1980s, the literature (and sales reps!) told MDs that Xanax didn't aggravate depression like Valium. The bottom line is benzodiazepines (BZs) are DOWNERS, and as a general rule, downers aggravate depression when taken for long periods. This is one reson why doctors tell their patients not to drink if they have depression. Alcohol is a downer (see below). My educated (but not expert advice) is that BZs, to varying degrees, aggravate depression. ADs may couteract this enough that overall, you feel much better. If you're still anxious, BZs can be useful in alleviating symptoms and is worth the price of a possible redution in effect of the AD.
>
> DETAILS (Not essential reading):
>
> My guess is, by their nature, bezodiazepines are sedatives, so they tend to keep your CNS neurons in a less polarized state. In other words, it takes more effort (by adjacent neurons) to evoke a response in the neuron. That's kind of a crude explanation of why BZs are calming.
>
> Second, BZs act on the same chloride ion channel as acohol. Normally, an endogenous ligand (that's a fancy way of saying a special chemical found naturally in the CNS) binds to a receptor site on the chloride ion channel and allows chloride ions enter the neuron. That special chemical is named GABA or gamma-aminobutyric acid. When chloride ions enter the neuron, they depolarized it to some degree (in other words, depolarization makes the neuron less likely to fire--it takes more input from neighboring nerve cells to get a response.
>
> You're probably thinking, where the heck is this guy going with this. Well, BZs bind to a subunit of the chloride ion channel and enhance GABAs effect--in other word, GABA kind of becomes a super-GABA, and makes the nerve even more resistant to firing. This is also why alcohol works, but its mechanism is a little different. The key result is you have a calming, sedating effect we associate with benzodiazepines. If you take enough, you'll get "drunk."I suppose this is another reason SSRI's are seen as such a boon by pdocs: they treat anxiety without inducing depression. The problem is I have severe, treatment-resistant anxiety, and it interferes with my ability to participate in normal activities even when I'm not depressed. Which is depressing in itself, even if it doesn't immediately trigger depression. It's interesting that prior to Klonopin, the only thing that worked for my debilitating social anxiety was alcohol. Alcohol, of course, has so many side effects and is so short-acting that it is not a viable treatment :)
I suppose this is why NARDIL is such a wonder drug. It treats the terrible, treatment-resistant anxiety AND it knocks out the depression too. How do you think Nardil does this exactly? Specifically, how does Nardil's effect on anxiety NOT stem from some kind of CNS depressant effect that leads to depression? Any other drugs that might mimic this effect?
Thanks,
z
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