Benzodiazepines

Two days ago, on July 9, Richard Lewis published on Mad in America a post in which he draws attention to the prolific worldwide prescribing of benzodiazepines, and the problems that this creates. The article includes a music video of a song which Richard has written and performs. The song is called Benzo Blue, and it “highlights the struggles of the millions of worldwide victims/survivors of prescribed benzodiazepine drugs such as Xanax, Ativan, Klonopin, and Valium.” ...

It’s been almost 3 months since I have ingested any antidepressants or benzos. Almost died after drinking a large amount of vodka with the daily does of pills. Went to a rehab for a month and have been clean since. This is after over 27 years of benzos and prozac. I am 60 years old and am finally coming a awake. The Withdrawals, notably the restless leg and horrible cramping have been horrid at night, but I am totally committed to staying off the evil pills! Thanks for listening! ...

The first benzodiazepine – chlordiazepoxide – became available, from Hoffman-La Roche, in 1960, under the brand name Librium. It was soon followed by: diazepam (Valium) 1963; nitrazepam (Mogadon) and oxazepam (Serax) in 1965; temazepam (Restoril) 1969; clorazepate (Tranxene) 1972; flurazepam (Dalmane) 1973; clonazepam (Klonopin) 1975; lorazepam (Ativan) in 1977; and alprazolam (Xanax) in 1981; etc. Benzodiazepines are categorized as sedative/hypnotics, which means that they have a relaxing, generally pleasant, sleep-inducing effect, and were embraced promptly by psychiatry for the "treatment" of anxiety, tension, worry, sleeplessness, etc. In this respect, the benzodiazepines largely replaced the earlier barbiturates, which had received a great deal of negative publicity because of their much publicized role in lethal overdoses, both accidental and intentional. ...

On March 17, 2013, I wrote a post titled Withdrawal from Benzodiazepines. In that post I wrote: "Withdrawal from these drugs is potentially dangerous, incidentally, and medical supervision is a good idea, especially if the dependence is marked. Try to find a physician other than the one who got you hooked on them in the first place. In severe cases, hospitalization is required." On December 27, 2014, a reader (Nancy Rubenstein) left a comment which stated that this is dangerous advice in that "…there are literally less than a handful of doctors nationwide who have proven they can handle this. There is no safe hospitalisation for people in psych drug withdrawal…" Nancy also pointed out that when people do go to hospital for emergency withdrawal problems, they are often met with disbelief, and that this disbelief can result in further problems, e.g. diagnosis of a "mental illness", further drugging, etc… All of these points are well taken, and I appreciate Nancy’s feedback. I received similar feedback from Monica Cassani (Beyond Meds) in March of 2013. ...

On November 19, 2014, the Australian and New Zealand Journal of Psychiatry published Benzodiazepine use and aggressive behaviour: A systematic review, by Bonnie Albrecht et al, from Deakin University, Melbourne, Australia. Here are the authors’ conclusions: "There appears to be a moderate association between some benzodiazepines and subsequent aggressive behaviour in humans. The circumstances under which aggressive responding may be more likely to follow benzodiazepine use remain unclear, although some evidence suggests dose and/or personality factors may influence this effect." ...

On September 9, 2014, the BMJ published an article by Sophie Billioti de Gage et al. The article was titled Benzodiazepine use and risk of Alzheimer’s disease: case-control study, and concluded: “Benzodiazepine use is associated with an increased risk of Alzheimer’s disease. The stronger association observed for long term exposures reinforces the suspicion of a possible direct association, even if benzodiazepine use might also be an early marker of a condition associated with an increased risk of dementia. Unwarranted long term use of these drugs should be considered as a public health concern.” [Emphasis added] ...

On September 9, 2014, the BMJ published an article by Sophie Billioti de Gage et al. The article is titled Benzodiazepine use and risk of Alzheimer’s disease: case-control study. The research was a study based on data from the Quebec health insurance program database. Here are the authors’ conclusion: "Benzodiazepine use is associated with an increased risk of Alzheimer’s disease. The stronger association observed for long term exposures reinforces the suspicion of a possible direct association, even if benzodiazepine use might also be an early marker of a condition associated with an increased risk of dementia. Unwarranted long term use of these drugs should be considered as a public health concern." ...

I recently read an article by Fredric Neuman, MD, Director of the Anxiety and Phobia Center at White Plains Hospital, NY. The article is titled The Use of the Minor Tranquilizers: Xanax, Ativan, Klonopin, and Valium, and was published in June 2012 by Psychology Today. Thanks to Medicalskeptic for the link. Dr. Neuman opens by telling us that benzodiazepines are “…very commonly prescribed for any sort of discomfort.” ...

On February 25, Kristina Fiore published an article on MedPage today. It’s titled Killing Pain: Xanax Tops Charts. The article is based on a study conducted by Jann M et al, and published in the February 2014 issue of the Journal of Pharmacy Practice. The study is titled Benzodiazepines: a major component in unintentional prescription drug overdoses with opioid analgesics. Here’s a quote: "During 2003 to 2009, the 2 prescriptions drugs with the highest increase in death rates were oxycodone 264.6% and alprazolam 233.8%. Therefore, benzodiazepines have a significant impact on prescription drug unintentional overdoses second only to the opioid analgesics. The combination prescribing of benzodiazepines and opioid analgesics commonly takes place. The pharmacokinetic drug interactions between benzodiazepines and opioid analgesics are complex. The pharmacodynamic actions of these agents differ as their combined effects produce significant respiratory depression." ...

On November 28, I put up a post on the adverse effects of benzodiazepines, including the potential for protracted and serious withdrawal problems. Since then I’ve become aware of a helpful and interesting resource in this area. It’s called Benzo Info, and is on Monica Cassani’s blog, BeyondMeds. Monica has first-hand experience of benzodiazepine withdrawal, and her comments and suggestions are always helpful, supportive, and insightful. She also provides a comprehensive list of links to other materials dealing with specific aspects of this problem, including forums and support groups. ...