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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 jay on February 21, 2002, at 15:28:24
OK..time for my rant. :-) I asked my doc yesterday about what are the best treatments for anxiety...and he stumbled, and the first thing he said was "antidepressants"..and that was all about he could answer.That, to me, is sad. We have an excellent, amazing and effective medication in benzos, a med that can almost be an instant 'lifesaver', and is safer then most medications. I would almost say benzos are 'anti-suicide', as I think they can relieve the piercing tension and anxiety that leads up to suicide. NO anitdepressant, or any other medication can do such a thing.
Is there any way to change this? Are there any massive lobby groups that are around that are fighting for benzos, to break the stigma? There has got to be a way, something, as these are amazing medications that *save lives*, and actually improve the quality of life. I would bet money they are worth much more than any antidepressant.
Comments?
Jay
Posted by mdertinger on February 21, 2002, at 15:35:27
In reply to Psychiatry doesn't know how treat anxiety!, posted by jay on February 21, 2002, at 15:28:24
So Xanex is a benzo? My husband says it's a narcotic. Is that the same?
Get a new doctor. Mine prescribed Xanex from the beginning.
Posted by Squiggles on February 21, 2002, at 15:36:31
In reply to Psychiatry doesn't know how treat anxiety!, posted by jay on February 21, 2002, at 15:28:24
I found from experience the
alt.support.anxiety-panic
group to be the most hostile group on the
net towards the anti-benzo camp and
its members.You might find the kind of support for benzos
you are looking for there.Squiggles
Posted by JohnX2 on February 21, 2002, at 17:39:12
In reply to Psychiatry doesn't know how treat anxiety!, posted by jay on February 21, 2002, at 15:28:24
Klonopin saved my life. It cured a severe myofacial pain and
stabilized my mood. It was a bandaid solution until I found the right
medicines to treat my bipolar and myofacial pain, but it was there.Pdocs are an interesting bunch. I have had 4. 2 were duds. My current
pdoc is excellent. He treats over 500 patients but he can remember every
detail about my case and always calls me back the same day even late at
night to personally discuss any concern I have. It just takes some looking
around to find the right physician.As far as anxiety goes, if someone is in the middle of panic attacks I would
prescribe a holdover benzo like Klonopin and ween the patient onto a SSRI.
Its always better long term to be on an SSRI. If the SSRIs don't hold, then
I wouldn't demonize maintaining the person on the benzo if that is what is
required to maintain a dignified quality of life.Best regards,
John
>1
> OK..time for my rant. :-) I asked my doc yesterday about what are the best treatments for anxiety...and he stumbled, and the first thing he said was "antidepressants"..and that was all about he could answer.
>
> That, to me, is sad. We have an excellent, amazing and effective medication in benzos, a med that can almost be an instant 'lifesaver', and is safer then most medications. I would almost say benzos are 'anti-suicide', as I think they can relieve the piercing tension and anxiety that leads up to suicide. NO anitdepressant, or any other medication can do such a thing.
>
> Is there any way to change this? Are there any massive lobby groups that are around that are fighting for benzos, to break the stigma? There has got to be a way, something, as these are amazing medications that *save lives*, and actually improve the quality of life. I would bet money they are worth much more than any antidepressant.
>
> Comments?
>
> Jay
Posted by Alan on February 21, 2002, at 17:49:51
In reply to Psychiatry doesn't know how treat anxiety!, posted by jay on February 21, 2002, at 15:28:24
>
> OK..time for my rant. :-) I asked my doc yesterday about what are the best treatments for anxiety...and he stumbled, and the first thing he said was "antidepressants"..and that was all about he could answer.
>
> That, to me, is sad. We have an excellent, amazing and effective medication in benzos, a med that can almost be an instant 'lifesaver', and is safer then most medications. I would almost say benzos are 'anti-suicide', as I think they can relieve the piercing tension and anxiety that leads up to suicide. NO anitdepressant, or any other medication can do such a thing.
>
> Is there any way to change this? Are there any massive lobby groups that are around that are fighting for benzos, to break the stigma? There has got to be a way, something, as these are amazing medications that *save lives*, and actually improve the quality of life. I would bet money they are worth much more than any antidepressant.
>
> Comments?
>
> Jay
***********************************
Of course they are. The drug co's have new theories and pills to hand out now though and use the catch word "non habit forming" which is terribly misleading and meant to slam and take over the BZD market.The World Health Organisation has endorsed the use of BZD's for anxiety long OR short term therapy - hardly a drug pushing organisation.
Specialists are finally waking up to the facts that you cite Jay and the only thing to do is to educate with ALL of the research out there cotradicting the "high risk factor of addiction" put out there in ignorance or by design by the makers of Paxil and the like....
Have you read:
http://bearpaw8.tripod.com/pd.html
Now there is some serious, clearly written info that destigmatises the drug....especially if you scroll down and read about the medications, including the ssri's and then the BZD's.
Alan
Posted by OldSchool on February 21, 2002, at 18:12:38
In reply to Re: Psychiatry doesn't know how treat anxiety!, posted by mdertinger on February 21, 2002, at 15:35:27
> So Xanex is a benzo? My husband says it's a narcotic. Is that the same?
LOL Xanax is NOT a narcotic. Its a controlled substance but definitely not a narcotic. A narcotic is more like an opiate drug...heroin or vicodine or morphine...stuff like that.
>
> Get a new doctor. Mine prescribed Xanex from the beginning.I agree...I have no trouble whatsoever getting benzos if I want them.
Posted by BobS. on February 21, 2002, at 19:14:42
In reply to Re: Psychiatry doesn't know how treat anxiety!, posted by OldSchool on February 21, 2002, at 18:12:38
260 BMJ VOLUME 324 2 FEBRUARY 2002 bmj.com
GlaxoSmithKline, a leading
drugs manufacturer, was last
week forced to admit that paroxetine,
a widely prescribed antidepressant
and the company’s
best selling drug, can cause
severe withdrawal symptoms
when stopped.
The Food and Drug Administration
in the United States published
a new product warning
about the drug, and in the same
week the International Federation
of Pharmaceutical Manufacturers
Associations declared the
company guilty of misleading the
public about paroxetine on US
television a year ago.
“This drug has been promoted
for years as safe and easy to
discontinue,” said Charles
Medawar, head of Social Audit, a
consumer research group specialising
in medicines policy. “The
fact that it can cause intolerable
withdrawal symptoms of the kind
that could lead to dependence is
enormously important to
patients, doctors, investors, and
the company.
“GlaxoSmithKline has evaded
the issue since it was granted a
licence for paroxetine over 10
years ago, and the drug has
become a blockbuster for them,
generating about a tenth of their
entire revenue. The company has
been promoting paroxetine
directly to consumers as ‘nonhabit
forming’ for far too long.”
Mr Medawar lodged a complaint
a year ago after a
spokesman from GlaxoWellcome,
then a UK company,
described withdrawal symptoms
with paroxetine as “very rare”
during an appearance on an
American television network.
The spokesman added “[withdrawal]
occurs in only two out of
every 1000 patients . . . Even then
the symptoms are mild and short
lived.”
In fact, withdrawal symptoms
such as bad dreams, paraesthesia,
and dizziness occur in up to 7%
of patients, according to the new
product information. The warning
also mentions anecdotal
reports of agitation, sweating, and
nausea and tells doctors to consider
restarting treatment if
symptoms become intolerable.
The complaint was originally
dismissed but went to appeal.
On 18 January the International
Federation of Pharmaceutical
Manufacturers Associations announced
that GlaxoSmithKline
had breached two of the industry’s
codes of practice. The federation
ruled that the spokesman’s
comments were promotional and
were wrong.
Dr Peter Haddad, consultant
psychiatrist for Salford’s Mental
Health Service NHS Trust,
welcomed the FDA’s safety
warning. He said: “Withdrawal
side effects from antidepressants
are far commoner than
many people realise, and
there’s evidence that paroxetine
has one of the highest rates. In
most cases the symptoms are
mild, but in a minority they are
severe and prolonged—and
treatable only by restarting the
drug.”
“There is also the danger of
misdiagnosis and inappropriate
investigation. Severe dizziness
can easily look like labyrinthitis.
Patients should be warned not to
stop taking their antidepressants
suddenly, and doctors should
taper the dose at the end of treatment,
keeping a close watch for
withdrawal symptoms,” Dr Haddad
added.
He also called for discontinuation
problems to be thoroughly
assessed before new antidepressant
drugs are licensed. “This is
a seriously under-researched
area. There’s no good evidence
to help doctors get the dosing
right as patients come off treatment.
It’s still a matter of trial
and error.”
Withdrawal from paroxetine can
be severe, warns FDA
Alison Tonks Bristol
328, 25, 186
Posted by noa on February 24, 2002, at 15:58:02
In reply to Cut and Paste from the Feb 2. issue of the BMJ, posted by BobS. on February 21, 2002, at 19:14:42
Interesting.
IMHO, I think it is good that the press is bringing this out, and that the manufacturers need to acknowledge the withdrawal problems of medications.
However, I wouldn't want the pendulum to swing the other way--ie, not getting meds approved if there are withdrawal effects. Perhaps, instead, they can be approved as long as the withdrawal effects are noted for doctors and patients, just like other unwanted effects. Also, maybe they could do some research on antidotes to the withdrawal effects, and that could be part of the insert information on proper use of the medication, along with those instructions we get about taking with or without food, etc.
In other words, I hope the baby doesn't get thrown out with the bathwater. Would I have elected to take Effexor if I had known about the withdrawal effects? I don't know. I think it is impossible to say at this point, 6 years later. Now that I have been taking it for 6 years, despite its not being perfect---annoying side effects, etc.---it has saved my life, so knowing that now, I would choose it again despite withdrawal effects potentials.
But clearly, having the information to be able to anticipate and plan for the withdrawal effects of Effexor (and Paroxetin, et al) is clearly essential in the informed consent process.
One more thing--I think the assumption that the advocate from Social Audit makes---that difficulty in discontinuation leads to dependence--is possibly a faulty or hasty one. It depends on what you mean by dependence, of course (is that a Clintonism or what!?), but his assumption suggests that the withdrawal effects of these meds is akin to withdrawing from substances that users feel cravings for. IMHO, they are quite different. These ADs do not generate these kinds of cravings, and I have my doubts about there being a lot of people who have stayed on such meds because of the withdrawal symptoms---it may be hell getting through it, but, at least from the folks here whose posts I read, I certainly don't see evidence of a life-long addiction in cases where the person decides to go off of medication.
Thanks for sharing the journal article.
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