![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 141 to 165 of 175. Go back in thread:
Posted by Amberlin on November 1, 2002, at 10:55:05
In reply to Re: Klonopin as a dumb drug - Hiba, Viridis, Franz » Amberlin, posted by Franz on November 1, 2002, at 10:05:36
I spoke to my therapist today but she will be out of town next week.
I'm holding out until I get health insurance the middle of this month, and then I can switch back to a private practice for a psychiatrist..but I'll stick with my current therapist.
Thanks for the concern, everyone. I'm stopping the abuse of my Klonopin right now..and will discuss a higher dose with my doctor on Monday. I'll just have to put a call in to get a response. I hate communicating that way instead of face to face, but I guess that is how it has to be sometimes.
Posted by Franz on November 2, 2002, at 17:55:56
In reply to Re: thanks Re: Klonopin as a dumb drug » Franz, posted by viridis on October 30, 2002, at 5:09:17
Thanks to all.
I have almost decided to give Klonopin a try (does it help with indecision and motivation hehe).
I have an appointment with a general doctor which I will consult. If I have not a response I will go to a psychiatrist.
Can Klonopin be used on demand or is it better to use a small dose every day?.
One thing that makes me consider alprazolam is its supposed antidepressive properties, although I understand you need a high dose for that and I do not want to take a dose that can make me sleepy or cause dependence problems more easy.
I did a search and found clonazepam:Clonazepam was introduced in the US in 1976 and in
Japan in 1981. The mechanism of clonazepam's ac-
tion has not yet been established. With a high affinity
for central benzodiazepine receptors, clonazepam is
a facilitator of gamma-aminobutyric acid system, and
also increases central synthesis of serotonin,
dopamine and noradrenaline, and mimics the effect of
the neurotransmitter glycine. This is a combination
of effects that may offer antidepressive action.Clonazepam has been recognised as a useful augmen-
tation (i.e. adding a medication onto the existing, on-
going drug treatment) for the treatment of
prolonged depression.
http://www.depression.org.uk/main/pdf/treatmedication8.pdfDoes not look like the antibenzo groups from UK right?.
But the question is, how is that it was introduced in 1976 and we know about it so late?. Marketing strategies?. They have a target now for panic?.
...increases central synthesis of serotonin,
dopamine and noradrenaline,?Never heard of that!. Is that documented anywhere?. Maybe at high doses?.
...mimics the effect of
the neurotransmitter glycine?Why not to take glycine then?.
About the thread on generics and brand name, I have tried brand name and generic alprazolam and I think there is a difference, but maybe it is subjective and also dependent on time because how you feel the effect depends on the amount of times you have used it (mean you will feel the same drug acting different at different times).
Posted by viridis on November 3, 2002, at 0:39:09
In reply to Re: thanks Re: Klonopin as a dumb drug »All » viridis, posted by Franz on November 2, 2002, at 17:55:56
Hi Franz,
It sounds like you have a good plan. I would definitely try Klonopin, and it probably can be used on an as-needed basis. My main concern would be that it can cause side effects (I experienced sleepiness, clumsiness, and short-term memory loss for the first couple of weeks that I took it, but then these completely went away -- all were mild anyway). So, if you only take it sporadically, you might get the side effects. The tradeoff is that regular use has a high likelihood of causing dependency (like many other medications, including antidepressants). You'll just have to try it and see how it affects you.
I do take Xanax (alprazolam) as-needed, maybe once every week or two. It's great for "breakthrough" anxiety, and as long as I keep the dose at 0.5 mg or lower, it works very well. Above this dose, I feel very sleepy. I'm definitely not dependent on Xanax, although I probably am dependent on Klonopin. But whenever I take Xanax, I can feel it, whereas daily Klonopin is undetectable, except that the anxiety is under control and I can think clearly.
I believe that Klonopin was originally marketed as an anti-epileptic drug (and the doses that epileptics took were huge compared to those for the anxiety/panic population). My understanding is that its anti-epileptic properties fade over time, whereas its anti-anxiety properties persist, so it shifted over to being an anxiolytic as doctors recognized its usefulness for anxiety patients and moved on to other drugs for epileptics.
I can't comment much about glycine, except to say that many substances can't cross the blood-brain barrier (i.e., just swallowing them doesn't automatically allow them into to your brain, which has a very controlled-access policy for many chemicals). Maybe glycine falls into this category, or maybe it's modified to some other chemical before it gets there.
Re: generics: among generic versions of Klonopin I've noticed a difference (Teva seems most effective). I've never noticed this with any other generic drugs, and Squiggles found the same thing. With alprazolam, I've only taken the Teva generic, and it works fine. A while back (months ago) there was a thread in which many people complained about the lower potency of certain generic brands of alprazolam, so there may be something in the manufacturing process that makes a difference.
Good luck with Klonopin -- just give it a while before you make a final judgement. It's very subtle, but effective for many.
All the best,
Viridis
Posted by Squiggles on November 3, 2002, at 7:37:14
In reply to Re: thanks Re: Klonopin as a dumb drug, posted by viridis on November 3, 2002, at 0:39:09
I was wondering about your name: Viridis:
Is that a Greek name?
Squiggles
Posted by viridis on November 3, 2002, at 14:54:15
In reply to Re: thanks Re: Klonopin as a dumb drug »All » viridis, posted by Franz on November 2, 2002, at 17:55:56
Hi Franz,
I was curious about your question regarding glycine, so I did a little more investigating, since my previous answer was just speculative. I'm not an expert on neurophysiology, but I am a biologist (different area of research), so these things get me interested. I've only done a quick scan of the available information, but here's what I've found so far.
First a bit of background -- glycine is an amino acid. Amino acids are the "building blocks" of proteins, and there are 20 different ones that are linked together in different combinations to make different proteins. Then there are others that aren't used to make proteins, but play other roles in the body. Glycine is one of the "non-essential" amino acids, meaning that although it's very important, it can be synthesized in the body from other amino acids (particularly serine). So, it's unlikely that a person would be deficient in glycine unless they have an extremely protein-deficient diet. Contrary to my earlier speculation, glycine crosses the blood-brain barrier easily.
Some amino acids also act as neurotransmitters, chemicals that carry messages from one nerve cell to another. They're released from one cell and bind to a specific receptor on the membrane of another cell, which in turn causes various changes in that cell (these can include how the receiving cell sends chemical messages to yet other cells). Glycine is one of the neurotransmitter amino acids. Another is GABA (gamma-aminobutyric acid). GABA is synthesized in the brain from another amino acid, glutamate, and there seems to be some argument about whether GABA can cross the blood-brain barrier and if so, how easily.
The effects of neurotransmitters vary depending on which cell receives them, and there can be various ways in which the process can work abnormally -- not enough or too much of a given neurotransmitter may be released, the receptors for the neurotransmitter on receiving cells can be faulty or too few in number, or the cell may respond abnormally to the neurotransmitter.
With respect to clonazepam, it and other benzodiazepines appear to work primarily by enhancing the binding of GABA to specific receptors on certain brain cells. GABA has a "damping" effect on the excitability of these cells by controlling the flow of ions across the membrane (especially chloride ion in the case of GABA receptors affected by benzos) . Various conditions (including epilepsy and excessive anxiety/panic) appear to result from overexcitability of these cells, perhaps due to flaws in the GABA receptors. By enhancing the affinity of the GABA receptors for GABA, benzos correct this problem.
I'm not sure where glycine fits into this; there is some mention of clonazepam also acting like glycine as a neurotransmitter, but most of the literature I've looked at so far focuses on clonazepam's interaction with a particular subtype of GABA receptor.
There are lots of commercial sites that promote oral glycine and GABA as treatments for anxiety, and who knows -- maybe that could work for some people. But given the ready availability of glycine in the diet, the body's ability to make more, and the questions about whether oral GABA can even get into the brain, I'm skeptical. On top of that, if the problem lies with the receptors for these substances, I'm not sure that flooding the brain with more of them would help much anyway. This is speculation on my part, but I have tried taking oral GABA in the past and never noticed any effect.
Anyway, that's what I've pieced together so far. Good luck with your treatment!
Viridis
Posted by Alan on November 3, 2002, at 16:28:40
In reply to Re: Convinced At last ! Thank you Squiggles..., posted by hiba on October 29, 2002, at 9:58:34
> This is a sudden shock for me. I found the instance of "Protracted withdrawal syndrome" associated with benzodiazepines in the latest version of MARTINDALE THE COMPLETE DRUG REFERENCE. Although the reference they given is Dr. Ashton,( the figure most benzo lovers don't approve,) I think there should be some fact in it. I know the importance of "MARTINDALE" in the world of medicine.
> So, you are right in this regard dear Squiggles, the existence of long and unusual withdrawal symptoms should not be necessarily a benzophobic hypothesis. I appreciate your determination to stand for what you found right. It is only because of that I went through MARTINDALE once again.
> HIBA
>
===============================================Dear Hiba,
The recitiation of Ashton's conclusions about PWS carries with it two problems (besides the fact that it is the only source cited by MARTINDALE as I understand it). It is the same problem that manifests itself when being used as a reason by some that bzds are dangerous in that the risks outweigh the benefits re: treatment of chronic anxiety with bzds.
1)Ashton's writings are based on her own personal observations of other's *selected* research, not *her own* scientific research. That is why her rhetoric is consistent with and always qualified with "perhaps", "suggests", "MAY conclude", etc. It is not science or research per se.
2)Ashton is also basing her conclusions on her own personal practice...and purely through the prism of an "addictionologist". One knows what problems what one gets into generalising for the general population based on a small sample or an individual's experience.
Alan
Posted by Squiggles on November 3, 2002, at 16:59:30
In reply to Re: Convinced At last ! » hiba, posted by Alan on November 3, 2002, at 16:28:40
A man who carries a cat by the tail
learns something he can learn in no
other way.
Mark Twain
Hee hee.Squiggles
Posted by Rick on November 3, 2002, at 17:49:04
In reply to Re: thanks Re: Klonopin as a dumb drug »All » viridis, posted by Franz on November 2, 2002, at 17:55:56
> Can Klonopin be used on demand or is it better to use a small dose every day?In general it's more effecive to use a small dose daily. If you still have occasional breakthrough anxiety, a small-dose of quick-acting Xanax would be useful. As you can see, I'm recommending exactly the protocol Viridis is using. Even if you develop dependency, coming off low-dose clonazepam with a slow taper is usually not much of a problem. (Note that I said "usually," not "never.")
I think it's preferable to NOT physically "feel" the drug, as you likely would with as-needed use, but instead to have the clonazepam in the "background," unobtrusively guarding against anxiety. And -- while there is no guarantee -- sleepiness and other side effects are likely to go away as your body adjusts to them. But the chemically-mediated anti-anxiety effects will remain. If you're like most maintenance dose clonazepam users, you will reach an ideal dose from a few months of experimentation (maybe even sooner), and will thereafter maintain about the same dose, or even find that you can decrease it somewhat. In summary, using clonazepam as-needed you will probably develop tolerance to the side effects but not to the theraputic effects.
> But the question is, how is that it was introduced in 1976 and we know about it so late?.
Clonazepam's original indication (and still its only official indication in many countries) was as an anti-epileptic, as Viridis pointed out. But it has been widely studied for anxiety disorders since the early eighties.
>Marketing strategies?
That's certainly not the case now, since clonazepam is off-patent. In fact, that's why there's so much more focus on SSRI's. With generic versions dominating the benzo marketplace, the original benzo developers (e.g., Roche for clonazepam), have no financial incentive to find new indications; promote the safety of the drugs and defend against benzophobia; or research new uses.
(There is indeed benzo research going on, but for a new variety that will hopefully be more precise in which GABA receptors are targeted -- the goal being to maintain the anti-anxiety effects while eliminating the side effects.)
Clonazepam, in particular, is effective in an extremely wide array of "unofficial" indications, including several anxiety disorders (e.g., GAD, OCD adjunct, gold-standard benzo for social anxiety); bipolar adjunct; tremor of various etilogies; pain, including TMJ; Restless Legs Syndrome; and more.
> Why not to take glycine then?
Believe me, that will not provide benefits even remotely similar to clonazepam. In fact, some preparations of glycine include Pangamic Acid, which carries risks including carcinogenity. (Not trying to scare anyone here...MOST glycine preparations are probably safe, except for TMG - Tri-Methyl-Glycine).
You should strongly consider a trial of daily small-dose clonazepam. As long as you haven't taken it more than a month, any possibility of withdrawal symptoms should be especially remote.
If, for some reason, you try it as-needed and either aren't finding sufficient relief, or don't like the side effects, keep in mind that your experience could be quite different with daily use.
Good Luck,
Rick
Posted by Alan on November 3, 2002, at 17:50:53
In reply to Re: Convinced At last ! » Alan, posted by Squiggles on November 3, 2002, at 16:59:30
http://www.guardian.co.uk/Archive/Article/0,4273,4201752,00.html
Of particular interest are the two paragraphs about the WHO's recitation of the statistical prioritisation of those drugs with the most complaints about withdrawal.
Alan
Posted by viridis on November 3, 2002, at 22:40:00
In reply to Re: Klonopin as a dumb drug (Completely OFF TOPIC » viridis, posted by Squiggles on November 3, 2002, at 7:37:14
Hi Squiggles,
It's not clear whether "Viridis' has a Greek or Latin origin. It isn't my real name, of course; I chose it as a pseudonym for this board for several reasons.
First, when I started lurking here, I considered myself pretty naive compared to some of the people on the board who have been through trials of many more psychotropic drugs than I have. I'm a biologist, so I tried to think of a name that subtly conveyed this limited experience and incorporated elements of my field. Scientific names of organisms have two parts: the genus, and the specific epithet, which is often descriptive (e.g., humans are Homo sapiens: Homo is the genus, and sapiens is the specific epithet, and together they form the scientific name). There are many organisms whose specific epithet is "viridis", which means "green". This is also everyday slang for "naive".
I also happen to like the color green, and on top of that, my wife and I are avid gardeners. Plus, green ("virid") connotes growth, something I'm trying to achieve, in part by learning from the experiences of others here.
So, that's an explanation (however convoluted) of how I came up with the name. Again, the exact source of the term is uncertain, but it probably has a Greek or Latin origin.
So -- how come you're Squiggles?
Best,
Viridis
P.S. I suspect we're entering the territory of Psychosocial Babble, somewhere I haven't been yet.
Posted by hiba on November 4, 2002, at 0:51:11
In reply to Re: Convinced At last ! » hiba, posted by Alan on November 3, 2002, at 16:28:40
Hello Alan,
Glad you are back in the forum once again.
Perhaps you might be wondering what my conviction is! It was just to state, the so called "protracted withdrawal" is mentioned in a renowned clinical manual. Still I didn't hesitate to reveal the doubtful nature of the given reference. Dr. Ashton's studies are being consistently challenged as they are mostly based on anecdotal evidences. "Martindale" professionals are very particular in collecting data from almost all available sources. That could be the reason.
"Protracted withdrawal syndrome" is still much controversial. Using a benzo in high doses for a considerably long period of time and stopping it abruptly may cause a longer than unusual withdrawal syndrome. This is arguably right. But such an usage and cessation is alien to clinical practice. Unsupervised usage of a drug and consequent complications are not an indicative of drug toxicity. Since we are discussing the medically supervised benzo usage, we have a better reason to neglect protracted withdrawal syndrome. It is not only how the drug treats you, it is how you treat the drug. If you want to abuse a drug, it shouldn't be a benzo or a narcotic. I have seen guys mixing phenergan(promethazine)with wine to augment the sedative high of the antihistamine.Benzophobia has done more than enough so far. Some practitioners were (or still?) prescribing hard antipsychotics to treat anxiety disorders because of the fear of benzo dependence. Once I got a prescription of Trazodone from an internist for sleeping problems. In PDR there is warning in block letter as "Trazodone is associated with priapism." Internist had justification. In low doses trazodone is safe. But many urologists believe drug induced priapism is not dose dependent. The reason for prescribing trazodone for sleep problems is its dissociation with dependence. But when the choice is an irreversible physical damage or a slight medical dependence, what makes sense is most important. That is all the fact about benzodiazepines.
Good luck Alan, Take care
HIBA
Posted by Squiggles on November 4, 2002, at 7:11:15
In reply to Re: Re: Klonopin as a dumb drug (Completely OFF T » Squiggles, posted by viridis on November 3, 2002, at 22:40:00
Kewoool!!!
Squiggles is the name of my cat;
:-)
Posted by Squiggles on November 4, 2002, at 7:15:26
In reply to Re: Convinced At last ! Welcome back Alan!, posted by hiba on November 4, 2002, at 0:51:11
In my case, my doctors were ready to give me
an additional, no a third antidepressant and
take away the benzo, WAYYY before the Benzo
group made any noise; i refused both, knowing
the benzo had caused inter-dose withdrawal,
asked for lowering of the Synthroid, and i have
never had a panic attack since.I'm just darn lucky, these doctors were so
nice and cooperated with me. Osler said
"listen to your patient, he is giving you the
diagnosis" and perhaps he rubbed off on them,
coming from the same neck of the woods;The point is, that the the practice you speak
of was there before the benzo noise.Squiggles
Posted by hiba on November 6, 2002, at 1:24:41
In reply to Re: Convinced At last ! Welcome back Alan! » hiba, posted by Squiggles on November 4, 2002, at 7:15:26
> In my case, my doctors were ready to give me
> an additional, no a third antidepressant and
> take away the benzo, WAYYY before the Benzo
> group made any noise; i refused both, knowing
> the benzo had caused inter-dose withdrawal,
> asked for lowering of the Synthroid, and i have
> never had a panic attack since.
>
> I'm just darn lucky, these doctors were so
> nice and cooperated with me. Osler said
> "listen to your patient, he is giving you the
> diagnosis" and perhaps he rubbed off on them,
> coming from the same neck of the woods;
>
> The point is, that the the practice you speak
> of was there before the benzo noise.
>
> Squiggles
So Dear Squiggles,Do you think that practice is anyway right ? What is more affordable to a patient? A slight medical dependence or call it addiction or an irreversible physical damage ?
Still you can argue a physical damage could be the root of physiological dependence. But anyway it is reversible. Consider it short term or protracted, the symptoms will resolve over time and only a person with an underlying disorder will find it hard to come off benzos completely. "The fault here is not in our stars, but in ourselves"
But the case of APs or ADs are not the same. APs can cause "tardive dyskinesia" which is irreversible. ADs cause significant pschological dependence, that a patient seldom reaches pre-drug level once he is familiarized with Antidepressants. In my experience SSRIs are the worst in this regard. I don't feel depressed anymore, but when I try to come off prozac, it is not depression that comes back, but a hollow-feeling which I hate most.
HIBA
Posted by Squiggles on November 6, 2002, at 7:22:43
In reply to Re: Convinced At last ! Welcome back Alan! » Squiggles, posted by hiba on November 6, 2002, at 1:24:41
Hiba,
You are absolutely correct in my view-- between
medical addiction and irreversible damage, the former
is to be preferred; but you do not take into account
the starting point of addiction, the dose, and the
length of time ( could be a lifetime ) and also the
type of drug.As you say some drugs are different than others;
whether benzos or ADs, what is to be done--leave
the person on the drug despite the possible adverse
effects or take him off?I think the problem is not that he SHOULD not come
off but that the drs. do not know HOW to get him off--
they need a psychopharmacologist or addictionologist to
do it.This is not something new - many people died of
barbiturates in the 40s and 50s and many
alcoholics needs special care to be detoxed.As for the irreversibility problem, I am not so sure
that the same severity of damage cannot be done with
benzos as well as ADs - though i sympathize with
your nasty "hollow" feeling - sounds like depression
without a cause;Psychopharmacology is an art.
Squiggles
Posted by Alan on November 6, 2002, at 7:55:43
In reply to Re: Convinced At last ! Welcome back Alan! » hiba, posted by Squiggles on November 6, 2002, at 7:22:43
I am not so sure
> that the same severity of damage cannot be done with
> benzos as well as ADs
> Squiggles
=============================================http://www.guardian.co.uk/Archive/Article/0,4273,4201752,00.html
Please note the two paragraphs about the comparative stastical rate of complaint between the two types of drugs re: withdrawal.
Alan
Posted by Squiggles on November 6, 2002, at 8:44:57
In reply to Withdrawal...AD's vs. bzds » Squiggles, posted by Alan on November 6, 2002, at 7:55:43
Alan,
I think "convinced at last" is meant to
refer to "the protracted syndrome" debate by
Hiba.Anyway, yes I have seen this article before
actually. The problem is (not so much for me
as i am sucker for sufferring people) that many
ADs have their very own private law firm for
particular drugs now; i kid you not. This
may be viewed with a very cynical eye.
For as true and convincing as these SSRI reports
may be, the "other" side, for whatever reasons
may use statistical artillary--e.g. "but 66% of
my patients who have taken this drug have not
killed their child, cat, dog, parrot, etc."As for the initial disease cropping up, how
ironic that the very same argument has been
used in the benzo debate. And really quite
poor at that, as it seem ubiquitous with any
product that is viewed as causally responsible
for an adverse effect. I think that a
comparison between before and after mental states
IS the correct reply to that, as Dr. Healy points
out here.I know someone personally, who took an SSRI for
a very short period of time. I think time taken
is very important (is it possible that brain changes
take place with repeated dosage?); and finding it
very agitating and disagreeable, was weaned off over
a month i believe. I don't think there have been
any problems.However, one should consider the initial
state of the person taking say PROZAC - which is what
this person took: if the person is in a depressed AND
agitated condition with severe anxiety the effect of
PROZAC may be very different from someone say in
something more catatonic.It seems that all these drugs have quick and profound
brain changes. I know that the discoverer of PROZAC
actually won the Nobel prize, and much was made
of his homely background (just a country boy making
good, etc. etc.) and I wonder if his mentors and
colleagues just didn't get a little too romantic.Of course, there is another problem with new drugs..
all new drugs... to see the effect on humans rather
that experimental animals, required a few years if not
decades. Perhaps the very obvious and fast observations
of SSRIs are a blessing in disguise, as new drugs
are now replacing them.Regarding the comparison to benzos... I can't say really;
certainly you do not hear of such rage, leading to
murders, suicides, but there is rage enough to account
for airplaine rage, and car rage, and possibly domestic
rage; the thing with benzos, is that in cases of
panic and agitation resulting from inter-dose withdrawal,
there is the dubious advantage of being able to pop
another pill. You can't do that with SSRIs.Squiggles
Posted by Alan on November 6, 2002, at 18:46:16
In reply to Re: Withdrawal...AD's vs. bzds » Alan, posted by Squiggles on November 6, 2002, at 8:44:57
> Alan,
>
> I think "convinced at last" is meant to
> refer to "the protracted syndrome" debate by
> Hiba.Yes, and I throughly addressed that in an earlier post.
> Regarding the comparison to benzos... I can't say really;
> certainly you do not hear of such rage, leading to
> murders, suicides, but there is rage enough to account
> for airplaine rage, and car rage, and possibly domestic
> rage; the thing with benzos, is that in cases of
> panic and agitation resulting from inter-dose withdrawal,
> there is the dubious advantage of being able to pop
> another pill. You can't do that with SSRIs.
>
> Squiggles
==========================================
Interdose withdrawals are demonstrative of having not kept steady state levels to begin with. Otherwise it's a case of simple mismangement or lack of understanding about the usage of the medication by the patient...not to mention longer half-life versions available to both physician and consumer alike. It is really no more complicated than that.The key disadavantage about the AD's is that they work in a completely different way and work over the longer term. That is why many augment with bzds since the activating or agitating effect of being so stimulatd by AD's is in need of an antidote.
What's dubious is the acceptance by government agencies (the FDA comes to mind) of AD's for anxiety disorder in the first place with the co's admitted test results in the 30 - 50% efficacy range and bzds far, far above that.
There is a life cycle for newly introduced drugs (or many new products) that the ssri's are beginning to see whiplash from overprescription now just like valium suffered from in the late 60's and early 70's.
Unfortunately, it's not the patients that never recovered from the overuse and overprescriptions of these drugs...quite the contrary. Far more damaging are the lingering misperceptions and pure stigmatising baloney still seized on by the anti-bzd movment...that which unnecessarily scares off potential candidates for bzd therapy due to these misperceptions.
Alan
Posted by Squiggles on November 6, 2002, at 20:16:48
In reply to Benzodiazapines and drug life cycles » Squiggles, posted by Alan on November 6, 2002, at 18:46:16
That's very astute Alan; i think i agree with
most of what you say. I have said it before
that benzos if prescribed correctly and
appropriately, are efficacious and safe--but
i think that has not been done in so many
cases.Also, the augmentation of a benzo with an AD
which creates anxiety is a good idea, but then
you must choose the right one, and you must
monitor the co-existence of the two drugs.Infact, you could argue that many PROZAC and other
SSRI cases were tragic because of the lack
of an addiction of a tranquillizing drug, like
a benzo.Squiggles
Posted by Franz on November 6, 2002, at 21:00:08
In reply to More on glycine/GABA » Franz, posted by viridis on November 3, 2002, at 14:54:15
Thanks for the followup viridis
I already swalloed my first klono 0.25mg more than an hour ago. I am not sure what I feel, like a mild sedation maybe, I am not fully alert, but I was also tired, so I can´t tell. The effect seems different than from Xanax.
The doctor told me to take 2 doses of 0.25mg/day, morning, evening. I wonder if I can take less, like 0.12 twice or 0.25/day. I will keep taking a dose at day.
I see I am very resistant to take anythig, but I expect some benefit.
I think you are right rgarding precursors, they can work sometimes (I like B vitamins, aminoacids, etc) but when there is a regulation problem precursors can not work well enough.
I read you can use GABA under the tong, also there are nasal sprays (not sure if with GABA exactly).
In phobias an anxiety I read there is a problem with the noradrenergic system.
I think I will quit here and go to sleep, I can´t elaborate much now and feel sleepy.
Do yuo think 0.12mg is too slow a dose?. I will ask the doctor next week.
I have to ask how much alcohol (wine, beer) I can take.
> Hi Franz,
>
> I was curious about your question regarding glycine, so I did a little more investigating, since my previous answer was just speculative. I'm not an expert on neurophysiology, but I am a biologist (different area of research), so these things get me interested. I've only done a quick scan of the available information, but here's what I've found so far.
>
> First a bit of background -- glycine is an amino acid. Amino acids are the "building blocks" of proteins, and there are 20 different ones that are linked together in different combinations to make different proteins. Then there are others that aren't used to make proteins, but play other roles in the body. Glycine is one of the "non-essential" amino acids, meaning that although it's very important, it can be synthesized in the body from other amino acids (particularly serine). So, it's unlikely that a person would be deficient in glycine unless they have an extremely protein-deficient diet. Contrary to my earlier speculation, glycine crosses the blood-brain barrier easily.
>
> Some amino acids also act as neurotransmitters, chemicals that carry messages from one nerve cell to another. They're released from one cell and bind to a specific receptor on the membrane of another cell, which in turn causes various changes in that cell (these can include how the receiving cell sends chemical messages to yet other cells). Glycine is one of the neurotransmitter amino acids. Another is GABA (gamma-aminobutyric acid). GABA is synthesized in the brain from another amino acid, glutamate, and there seems to be some argument about whether GABA can cross the blood-brain barrier and if so, how easily.
>
> The effects of neurotransmitters vary depending on which cell receives them, and there can be various ways in which the process can work abnormally -- not enough or too much of a given neurotransmitter may be released, the receptors for the neurotransmitter on receiving cells can be faulty or too few in number, or the cell may respond abnormally to the neurotransmitter.
>
> With respect to clonazepam, it and other benzodiazepines appear to work primarily by enhancing the binding of GABA to specific receptors on certain brain cells. GABA has a "damping" effect on the excitability of these cells by controlling the flow of ions across the membrane (especially chloride ion in the case of GABA receptors affected by benzos) . Various conditions (including epilepsy and excessive anxiety/panic) appear to result from overexcitability of these cells, perhaps due to flaws in the GABA receptors. By enhancing the affinity of the GABA receptors for GABA, benzos correct this problem.
>
> I'm not sure where glycine fits into this; there is some mention of clonazepam also acting like glycine as a neurotransmitter, but most of the literature I've looked at so far focuses on clonazepam's interaction with a particular subtype of GABA receptor.
>
> There are lots of commercial sites that promote oral glycine and GABA as treatments for anxiety, and who knows -- maybe that could work for some people. But given the ready availability of glycine in the diet, the body's ability to make more, and the questions about whether oral GABA can even get into the brain, I'm skeptical. On top of that, if the problem lies with the receptors for these substances, I'm not sure that flooding the brain with more of them would help much anyway. This is speculation on my part, but I have tried taking oral GABA in the past and never noticed any effect.
>
> Anyway, that's what I've pieced together so far. Good luck with your treatment!
>
> Viridis
>
>
Posted by Alan on November 6, 2002, at 21:16:29
In reply to Re: Benzodiazapines and drug life cycles » Alan, posted by Squiggles on November 6, 2002, at 20:16:48
> Infact, you could argue that many PROZAC and other
> SSRI cases were tragic because of the lack
> of an addiction of a tranquillizing drug, like
> a benzo.
>
> Squiggles
============================================
Typo, right? You meant "addition" not "addiction".
Very Freudian.Alan
Posted by Squiggles on November 6, 2002, at 21:27:23
In reply to Re: Benzodiazapines and drug life cycles » Squiggles, posted by Alan on November 6, 2002, at 21:16:29
Touche; and I thought I was immune to that stuff;
Squiggles
Posted by Squiggles on November 7, 2002, at 8:00:33
In reply to Re: Benzodiazapines and drug life cycles » Alan, posted by Squiggles on November 6, 2002, at 21:27:23
Alan,
Something I forgot to tell you in the past,
which may round out the picture for your
regarding benzo prescription. When I successfully
got off Xanax, my doctor congratulated me
for accomplishing something very difficult, and
good for me. Though this was not the case
for Rivotril, i was given free reign to attempt
it. Unfortunately, it did not work. The point
of course is that doctors are aware of the
pernicious effects of benzos and unfortunate
job they have of prescribing on a continuous basis.Squiggles
Posted by Alan on November 7, 2002, at 14:13:05
In reply to Re: Benzodiazapines and drug life cycles » Squiggles, posted by Squiggles on November 7, 2002, at 8:00:33
> Alan,
>
> Something I forgot to tell you in the past,
> which may round out the picture for your
> regarding benzo prescription. When I successfully
> got off Xanax, my doctor congratulated me
> for accomplishing something very difficult, and
> good for me. Though this was not the case
> for Rivotril, i was given free reign to attempt
> it. Unfortunately, it did not work. The point
> of course is that doctors are aware of the
> pernicious effects of benzos and unfortunate
> job they have of prescribing on a continuous basis.
>
> Squiggles
==========================================
I'm sure that the real good ones are also aware of the long term effect of un or under treated anxiety on the psyche and the physical body...many all too obvious to list here.
The best of doctors always assess the benefit/risk ratio with all of their individual patients in the ideal world.The problem is that in a world representing reality (a world coming up quite short of that ideal), drugs are misprescribed, patients are mis dx'd, and patients are not followed up on throughly by physicians - those that in contrast know their patients AND their medications intimately (well the patients not too intimately, that's a whole different subject).
Alan
Posted by Squiggles on November 7, 2002, at 14:24:54
In reply to Re: Benzodiazapines and drug life cycles » Squiggles, posted by Alan on November 7, 2002, at 14:13:05
Yeah, well you have to look at things in
perspective; no doubt you are affluent and
living in some place like Rhode Island.
Here, in Canada we have public health care,
which means everyone gets treated (though
not so intimately as you might like), and
given the sparse population of the country
and the high taxation, you can't expect
the Hollywood treatment you can get in
the States.Look around you.. look at Israel and Palestine,
look at the third world countries, children are
dying hardly before they're born from diseases,
AIDS is an epidemic, get real.Squiggles
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