Is it safe to use a benzodiazepine for withdrawal symptoms?

[bubbles]

Hi everyone

 

Over the years I've thought, many times, that my whole depression/anxiety/antidepressants/being-unable-to-get-off-them could have maybe been avoided by the careful use of a benzo for a few days very early on It would have lifted my mood and enabled me to get some sleep, thus heading off that spiral of exhaustion and rumination. I know someone who does this and has avoided ADs for years this way without becoming addicted to the benzo. Now, in those days, I wasn't receptive to the idea of drugs at all, so it wouldn't have been an option for me then. It is just now, with the benefit of hindsight (and side effects of the AD) that I am thinking about this.

 

There will be dark days ahead, as my history long before ADs involved quite a few periods of depression. I came out of all of them naturally, except for the last one where I was medicated. There was another one after that at about 6-8 months of my taper where I couldn't cope and on dr's advice I reinstated. My taper would have taken 10 or so months if I'd continued it.

 

So, I'm wondering about the careful use of a benzo next time this comes up. (It sounds as though I'm borrowing trouble, but I'm not, I promise! I am taking a pragmatic look at my history.) I do not, however, wish to replace one addiction (and I do believe that I am addicted to my AD - intolerable w/d, cravings...) with another.

 

How long is "safe" to use these drugs? My thinking is that if the safe term is, say (and I'm guessing here), 2 weeks, I will keep 1 week worth in the house, and have the other week at my mom's house, or a friend's house, so it isn't easy to just cave in and take extras. Or, is there an OTC option that could work too?

 

Bubbles

[Jemima]

Not a good idea. For one thing, benzo use increases one's chances of dying quite substantially:

 

http://www.medpagetoday.com/PrimaryCare/SleepDisorders/31391

 

And they are highly addictive, see Peter Breggin:

 

http://www.breggin.com/index.php?option=com_content&task=view&id=44&Itemid=66

 

One of the things that happens is called "spellbinding", a term coined by Dr. Breggin, and I can vouch that this is what occurs having been prescribed Ativan, as needed, along with Lexapro. The benzos have a rather drastic effect on a person's memory, to the point that I couldn't remember when I had taken my last dose or how much I'd taken. It seemed to take the edge off on my really bad days, but it certainly didn't get me through AD withdrawal any faster, and may in fact have drawn it out longer than necessary.

 

After reading an article by Breggin on how easily a person can become addicted to benzos, I quit cold and was very fortunate not to have any withdrawal symptoms from that. Please, don't try it.

[Skyler]

Hi everyone

How long is "safe" to use these drugs? My thinking is that if the safe term is, say (and I'm guessing here), 2 weeks, I will keep 1 week worth in the house, and have the other week at my mom's house, or a friend's house, so it isn't easy to just cave in and take extras. Or, is there an OTC option that could work too?

 

Bubbles

 

Hi Bubbles... I have spent 21 months tapering off benzos.. I'm at 1.25 mgs diazepam and have 2 months to go. There is no safe with benzodiazepines. You can think you are only taking them for a couple of weeks (which is long enough for many to become addicted, I've spoken to people who have become so in one week), but if you should happen to luck out, and find you can still get off, the next time round you may not be so fortunate. They are seductive, and will steal your life. Using them is like playing Russian Roulette.. at some point you will find yourself hooked. It's not if, but when.

 

Everything I've encountered makes me think they should only be given to inpatients in a hospital setting, and then for life threatening situations only.

 

Love yourself, stay away from them, they are poison

 

Schuyler

[bubbles]

Thank you both for your thoughtful responses.

[alexjuice]

Hey Bubbles,

 

In my experience benzos have more usefulness as drugs (recreational sense) than Drugs (pharmaceutical sense), though they are sometimes passed off as Drugs and given to people like me who then become dependent.

 

The two times I made major changes to my benzos I ended up in institutions. The second time I tried to commit suicide. I would do anything to be free from benzo Drugs yet I still take 'em every day. (Not to get a buzz or anything, but because I don't know how to stop and survive at this point.)

 

Now, if you choose to think of your benzo as a drug, like beer, and have a few beers a few times a month, I think you'll survive though that's a lousy idea if you're nervous system is spun about already.

 

So my primary advice would be don't take em at all. Secondly, don't take em everyday no matter how small the dose or how short duration. Thirdly, if you want to get "drunk-ish" then you can probably accomplish this with benzos. Fourthly, I don't recommend getting "drunk-ish" with benzos.

 

All the legitimate reasons(social anxiety, PTSD, agoraphobia, non-psych diagnoses) for which benzos have been/stillare prescribed have treatments methods with better risk/reward. I can't think of a legit reason to put someone on a daily dose of any of em for more than 2-4 weeks. Benzos are free lunch, quick fix. Horrible in the long term.

 

Good luck,

Alex

 

PS - The only free lunch is in heaven.

[Barbarannamated]

Bubbles,

I understand your reasoning. I agree that benzos are extremely problematic if used regularly, I also know people who use them VERY judiciously in times of extreme stress only and have avoided use of daily medications and the problems that we are experiencing now. I personally feel *safer* with drugs that have an immediate effect (or lack of) and and don't have to be taken for several weeks which seems to allow for greater placebo effect. I realize this is one of the criteria that theoretically contributes to 'addiction or abuse potential'.

I believe there are different categories of 'safety' and the quest to find safer antidepressants/anxiolytics has evolved over the years from amphetamines, opiates, barbiturates, TCAs, benzos, MAOIs to serotonergics. The significant overlap between anxiety and depression complicates the picture. I don't like the dulling effect that benzos have on me. My 'depression' was originally an anergic, general malaise. I ended up on Klonopin to treat bruxism from Zoloft.

It's a pick-your-poison toss-up, but I agree that a drug that can be utilized on a very controlled as-needed basis feels less wrong to me.

I never experienced the benefit from SS/NRIs that I've heard described by many hut continued to updose, try another, augment... it was the 'decade of the brain' when these drugs were all coming to market. After several years I was VERY depressed.

I had multiple underlying endocrine disorders that were diagnosed recently.

[bubbles]

Alex, I was thinking occasional use of no more than 2-3 days.

 

I have a long history of depression. Mostly, after a few months (9-10, sometimes, sometimes less) I came out of it naturally. I spent hours and hours and thousands of dollars in therapy with no benefit. I did all the "lifestyle" things to help, and *nothing* helped. The AD was at a time when it just wasn't lifting and I was utterly non-functional.

 

Bub

[bubbles]

Thank you Barbara.

Bub

[Barbarannamated]

Alex, I was thinking occasional use of no more than 2-3 days.

 

I have a long history of depression. Mostly, after a few months (9-10, sometimes, sometimes less) I came out of it naturally. I spent hours and hours and thousands of dollars in therapy with no benefit. I did all the "lifestyle" things to help, and *nothing* helped. The AD was at a time when it just wasn't lifting and I was utterly non-functional.

 

Did you notice significant improvement with SS/NRIs? (sorry, i can't see your history from this screen)

[bubbles]

Barbara, yes I did have an improvement, after a bit. My doctor wasn't overwhelmed with my response and wanted me to switch early on, but I decided to persevere. However, it sounds like I'd have got a response from a sugar pill too, and with fewer problems (bruxism etc...).

 

This last depression was, in my opinion, the final stage of a severe anxiety and agitation. The anxiety and agitation would rise and rise and eventually there was just nowhere left to go - that degree of agitation just isn't sustainable. Then there was a plummet into a severe depression.

 

I have wondered, many times, how it would have turned out if I'd been able to cut off the agitation and anxiety earlier on, rather than riding the rollercoaster... But, maybe I'd just now be trying to get off benzos now, who knows.

 

It is a pick your poison thing, but also very much a going in with eyes open, which I cannot say was the case with the ADs.

 

Bub

[Shanti]

I, too, would be very reluctant to resort to this. The risk of Benzo addiction is just not worth is. There are good things to help with nerves. Such as valerian, vervain, warm baths, meditation and deep breathing. I also find homeopathy extremely helpful for me in anxiety. Gelsemium and Stramonium are good alternatives to benzos without the risk of addiction and withdrawal. Good luck! Remember, this is all temporary and we'll get through to the other side.

[bubbles]

Ok, I have decided that it doesn't sound very safe, so I will avoid it.

Thanks

Bub

[Barbarannamated]

Kava kava is something that has helped in times of stress - there seems to be a great difference in quality -

[alexjuice]

Hey bubbles,

 

If I were in your shoes, I'd try magnesium citrate, glycinate, etc first. Then valerian, by the dropper ideally. I don't know much about kava kava. The few times I tried it, I didn't notice much effect. Also it may be bad on your liver, so i would do my research. L'theanine is, for me, both calming and helps with concentration.

 

I think benzos are fine for acute panic situations. Is that what you envision?

 

To me a panic suitable for benzo intervention wouldn't last 2-3 days. But I know people who have "break the glass" prescriptions of Ativan or Xanax on hand for emergencies. The risk is in succumbing to the notion of taking them everytime distressful events occur.

 

One thing I've learned in my case. Many of the things I did with good hope and intentions due to extreme distress have ended up hurting me, in retrospect, rather than helping. So that's something I would try to keep in mind, though it is very difficult to execute when crap hits fan and nobody has the answer and I feel I am clinging to life.

 

I wish I had a "take back" for most of my desperate choices.

 

This is a tough deal bubbles. Sending you hugs and good tidings.

 

Alex

 

Ps - tidings are good things, right? They're in that Christmas song.

[Skyler]

Ok, I have decided that it doesn't sound very safe, so I will avoid it.

Thanks

Bub

 

Bravo.. very good decision. I would not wish what I've gone through, or others I've encountered who have had far worse.. on anyone. And for the few days respite you would get here and there.. why put yourself in jeopardy.

 

Schuyler

 

PS.. as with half life of antidepressants, the shorter acting the benzo, the more quickly people get addicted. One of the admins on TRAP ( a big benzo forum) got addicted to Clonazepam in 7 days. She was obviously very credible, and made a compelling case.

[Jemima]

Ok, I have decided that it doesn't sound very safe, so I will avoid it.

Thanks

Bub

 

GOOD!!!

 

I also had a very severe depressive crash where I became nonfunctional. Looking back, I believe it was due to extremely low cholesterol (134 due to Lipitor) combined with one of my ordinary depressions that historically lifted by themselves within two or three months. (Lipitor is now known to cause depression.) So please consider any non-psychiatric drugs you may be on. Fish oil has also helped me a great deal and it's one of the few supplements I could tolerate early on in withdrawal from Lexapro.

 

I can't tell you how relieved I am that you've decided against benzos.

[Altostrata]

This is such an excellent conversation! Thanks for starting it, bubbles, and everyone chiming in with their 2 pennies.

[Whatever]

I never heard of people becoming addicted to ADs. (I am referring to Shuyler's post).

[bubbles]

Whatever, I think this is a terminology thing - dependence vs addiction, and the common dictionary definition of addiction vs the medical definition. I have, however, read in a few places that SSRIs do not cause either.

 

I consider myself addicted to my SSRI, especially now that I'm finding I experience cravings for the drug as well as w/d symptoms when I drop my dose.

 

Anyway, I like Irving Kirsch's statement that it may not technically be addiction, but it looks very similar. (I'm paraphrasing from memory here, I can look up the quote if anyone is interested.)

 

Bubbles

[alexjuice]

 

Anyway, I like Irving Kirsch's statement that it may not technically be addiction, but it looks very similar. (I'm paraphrasing from memory here, I can look up the quote if anyone is interested.)

 

Bubbles

 

Yea. If it walks like a duck, talks like a duck, swims like a duck, eats like a duck but doesn't updose or get hungover, then it's not exactly a duck but from a distance it looks a lot like a duck.

[Barbarannamated]

Alex ~

I knew you would explain it as only you can ~

{{{HUGS}}}

[bubbles]

Alex, the updosing thing makes me wonder too. SSRIs poop out and people do updose, or their doc changes them to another drug...

[alexjuice]

Huh. Sounds like a duck to me.

 

:-)

[elizabeth11]

Bubbles-

 

Have you considered Valerian? As a more natural alternative?

 

Others will chime in who know more about it.

[bubbles]

Elizabeth, I did try it, and didn't find it did anything, so I discontinued.

 

Is it something you have to take for a while to "build up" before benefit? Or, maybe I was just too far gone at that stage - I was very unwell then. I was already taking St John's Wort, so open to complementary therapies.

 

Bubbles

[Whatever]

So the consensus on this forum is that ADs cause addiction?

 

I am not trying to disagree, it's just in my experience when I went cold turkey I had no cravings for any of the six meds I stopped taking. They got flushed down the toilet and that was it.

[Barbarannamated]

So the consensus on this forum is that ADs cause addiction?

 

I am not trying to disagree, it's just in my experience when I went cold turkey I had no cravings for any of the six meds I stopped taking. They got flushed down the toilet and that was it.

 

Whatever ~

Not in the traditional definition of cravings or addiction but more a sense of 'tempted to reinstate to feel better than currently' which probably fits the definition of psychological dependence more closely -

Personally I think the whole classification system used to determine addiction needs to be overhauled - just my 2cents

[Whatever]

Ahhhhh...that makes total sense. Much more than ducks. BTW I agree IN WHOLE with your two cents. IMO "addiction" is used when the actual condition is "dependence".

 

As in benzos some people develop addiction, they abuse benzos by taking more than their prescribed amount; while some people can take their prescribed amount for years, never abuse them but would most likely develop dependence, where life becomes an anxiety horror show once the benzo is no longer in the body.

[alexjuice]

Hey whatever,

My sense is that there is no consensus here but that most posters feel that addiction, like in the case of alcoholism, is a different animal than dependency on a psychiatric medication. But that there are some similarities with regards to withdrawal. Barbs response is a succinct explanation of one feature we often see upon discontinuation.

 

Personally, against the broader view, I see more similarities between addiction and psych drug dependency than I see differences, though they are clearly not the same thing. Particularly for people like me, and most posters here, who have experienced terrible extended problems on d/c of psych meds.

 

2 reasons.

 

I'm offended that the medicalpharmaceutal establishment gets to define terms which are unclear to general audiences who understand colloquial meaning rather medical/industry lingo. Telling a guy a drug is "potentially addictive" will, IMO, cause more deliberation than telling him that he could see "potential discontinuation effects". And, since I've been a big huge drug addict and alcoholic and have lived with over 200 drug addicts and drunks and done more than 18 months in inpatient, outpatient and residential treatment, it's my opinion that many of the worst aspects of addiction, like the destructive effect on the health of the body, are prominent effects of psychiatric Drugs as well in many cases.

 

There are a lot of things I can say about the subject. But i guess i said the main two things, though. Firstly, that psych meds consumers and alcoholics are different. And, secondly, I think it'd be in the health interest of all psych med naive individuals if they were told their psych meds were potentially addictive since I think this would result in fewer people initiating which would effectively make outcomes like mine more rare.

 

If that doesn't isn't clear, my apologies, I'm all foggy, I'm exhausted and also trying to type on a mobile touch screen thing.

 

Hope you are doing well.

 

Alex

 

PS - also having lived with the label "addict" and also as "psychiatric patient" I find I was neither and that while I can say I used to use cocaine (which is no disqualifier from election to the nations presidency) I can not talk openly about psych med history unless I want to endure alienation and disqualification from persons and groups I'd like to have relationships with. My personal history influences my opinion on this stuff. I wrote about some stuff related to this in this post http://survivingantidepressants.org/index.php?/topic/1838-david-healys-in-north-america-march-2012-speaking-engagements/page__view__findpost__p__18722 here.

[Whatever]

 

Ok, I have decided that it doesn't sound very safe, so I will avoid it.

Thanks

Bub

 

Schuyler

 

PS.. as with half life of antidepressants, the shorter acting the benzo, the more quickly people get addicted. One of the admins on TRAP ( a big benzo forum) got addicted to Clonazepam in 7 days. She was obviously very credible, and made a compelling case.

 

Thank you Barb and Alex. I think that we are all on the same page. It was just this quote above that I have problems with, because I think it is misleading what is being said about ADs. In fact I disagree with what is said about Clonazempan because it is actually a very long acting benzo, with a half life of 30-50 hours.

[Barbarannamated]

Ahhhhh...that makes total sense. Much more than ducks. BTW I agree IN WHOLE with your two cents. IMO "addiction" is used when the actual condition is "dependence".

 

As in benzos some people develop addiction, they abuse benzos by taking more than their prescribed amount; while some people can take their prescribed amount for years, never abuse them but would most likely develop dependence, where life becomes an anxiety horror show once the benzo is no longer in the body.

 

Agree. Drugs effect everyone differently. I never met a benzo that I liked; I was put on Klonopin for Zoloft-induced bruxism/TMJ. Of course, I'm dependent now and NOT looking forward to the challenge of tapering that. Can't even consider it at this point.

 

In college, people were using various 'wakefulness agents' and diet drugs to study. They put me to sleep. Needless to say, they didn't help with studying.

Without going into specifics, I've had several idiosyncratic or paradoxical responses to drugs. When I hear someone say that Xanax or other benzo alleviates short term stress with 1 dose, I'm envious. I never had that response.

The worst drug I ever took was hydromorphone for pain. I don't know where it ranks in abuse potential, but, based on how completely nonfunctional and STUPID I felt on it, it's difficult to imagine anyone desiring that effect.

I don't like anything that causes me to feel dull or less alert. Unfortunately, that's exactly what SS/NRIs did for me, however insidiously.

 

I had a cat who had a paradoxical reaction to Valium and was bouncing off the walls for several hours. Thankfully, I tried it before the flight it was suggested for.

 

Just my thoughts on why I think the whole 'one size fits all addiction paradigm' should be scrapped. There is so much hype about addiction potential of opiates for pain. Docs are afraid and restricted in their use. They resort to drugs they PERCEIVE to be safer because that's what the guidelines and addictionologists say. Cymbalta, for example. 'nuff said.

 

One last point...I believe this also contributes to people going outside the medical system and finding pain relief on the street or internet.

[Whatever]

Good points.

 

I had a paradoxical reaction to Percocet which I was placed on after radical ankle surgery awhile back. It made me manic and crazy. I begged my surgeon for something else and at least he looked at me and said "let me guess the stuff is making you crazy".

 

Addiction is a huge industry now. It is also tied up in politics. In NY state politicians control opiates and benzos by prohibiting refills on them. But this just gives rise to a huge black market where you can buy Xanax and Vicodin on the street or drugs on the Internet. There are even "online pharmacy forums" where one can find the most reputable sources for drugs, which includes people ordering benzos from foreign countries.

 

I have a huge problem with "addiction" , how it is defined and how it is applied to everything, like chocolate and emotions. The addiction as a disease is questionable to me in many cases. I tend to think of addiction as a combination of a behavioral component, skewed reward systems and self medication tied up in physical changes made to the body or mind due to certain substances (chocolate plays with insulin, so does alchohol). On the other hand some people just want to go through life drugged...like I suspect your sister does.

 

Addictionologists label people and I see no good that can come from that. Being labeled when you are already in shame for abusing something is not going to create an impetus to want to change, it is going to promote denial. And there stands the addictionologist shaking their head saying that denial is part if the disease. Just like pdocs shaking their heads saying that WD is verification of a mental disorder. And in all of this people and patients are isolated, labeled and made to feel they are the only person who is like this.

 

Mental Health Care is an oxymoron.

[Rhiannon]

Hey bubbles,

 

If I were in your shoes, I'd try magnesium citrate, glycinate, etc first. Then valerian, by the dropper ideally. I don't know much about kava kava. The few times I tried it, I didn't notice much effect. Also it may be bad on your liver, so i would do my research. L'theanine is, for me, both calming and helps with concentration.

 

I think benzos are fine for acute panic situations. Is that what you envision?

 

To me a panic suitable for benzo intervention wouldn't last 2-3 days. But I know people who have "break the glass" prescriptions of Ativan or Xanax on hand for emergencies. The risk is in succumbing to the notion of taking them everytime distressful events occur.

 

One thing I've learned in my case. Many of the things I did with good hope and intentions due to extreme distress have ended up hurting me, in retrospect, rather than helping. So that's something I would try to keep in mind, though it is very difficult to execute when crap hits fan and nobody has the answer and I feel I am clinging to life.

 

I wish I had a "take back" for most of my desperate choices.

 

This is a tough deal bubbles. Sending you hugs and good tidings.

 

Alex

 

Ps - tidings are good things, right? They're in that Christmas song.

 

aw Alex, you are so adorable!

[Rhiannon]

Alex, I was thinking occasional use of no more than 2-3 days.

 

I have a long history of depression. Mostly, after a few months (9-10, sometimes, sometimes less) I came out of it naturally. I spent hours and hours and thousands of dollars in therapy with no benefit. I did all the "lifestyle" things to help, and *nothing* helped. The AD was at a time when it just wasn't lifting and I was utterly non-functional.

 

Bub

 

I spend a lot of time helping people who are trying to get off benzos so I lean toward "omg run as fast as you can in the other direction!"

 

But speaking more practically, I think 2-3 days in a row is probably too much (too much chance of developing withdrawal symptoms), but one or two nonconsecutive days a week of a low dose for a few weeks might be okay if one is desperate for help and it actually works. (Benzos aren't really known for their antidepressant properties, they tend to lean more towards causing depression.)

 

People do become addicted with only occasional and intermittent use, I've seen several people have a hard time tapering off after only intermittent use. More often what happens with intermittent use is that overall anxiety levels increase and people start taking higher doses more often.

[Skyler]

Rhi

I think 2-3 days in a row is probably too much (too much chance of developing withdrawal symptoms), but one or two nonconsecutive days a week of a low dose for a few weeks might be okay if one is desperate for help and it actually works. (Benzos aren't really known for their antidepressant properties, they tend to lean more towards causing depression.)

 

People do become addicted with only occasional and intermittent use, I've seen several people have a hard time tapering off after only intermittent use. More often what happens with intermittent use is that overall anxiety levels increase and people start taking higher doses more often.

Benzos cause problems for nonconsecutive days if they are long acting. People will take 2 or 3 diazepam a week, thinking they are not addicted, but diazepam's action covers up to 4 days, so it is possible to be addicted. I just spoke with someone who assured me that there was no addiction... she only takes them to sleep, two or three times a week. And went on to give a good description of rebound insomnia, with no clue that there is an addictive component at work. And then, as you say, they are veryy seductive, that dose tends to creep up.

 

Schuyler

[Barbarannamated]

Rhi and all~

I never responded to serotonergics in a good way only side effects (bruxism in particular) and trazodone does help sleep -

Benzos have done nothing aside from helping bruxism although my understanding is that long ago they were considered 'antidepressant' because of anxiolytic effect alleviating depression - Healy describes SSRIs as having effect like alcohol and I have read others who say SSRIs may help anxious depression -

*Only for the sake of discussion - I am curious about others' takes on the interplay between anxiety/stress/depression - they all seem to be running together in diagnosis and treatment -

Also given the depressive effects of SS/NRIs (G Fava) are they less depressogenic long term than benzos - the evolution of these classes seems to be very familiar -

 

Just to confirm - I agree that they're all to be avoided at all costs -