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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 76 to 100 of 107. Go back in thread:
Posted by laima on August 29, 2006, at 17:57:12
In reply to Re: Psychopharmacology of addicting drugs » laima, posted by Squiggles on August 29, 2006, at 17:52:21
It's a shame they are not "nonprofit" organizations.
We'd likely all be much be better off if they were.> Drug companies are too big, too rich,
> too corporate-minded, too removed from
> the welfare of the patient, to patronizing
> of doctors and health care workers.
>
> I'm afraid of them, but I am also afraid
> of not having them as I need the drugs
> that they have rightly or wrongly provided.
>
> It's part of the evolution of our present
> culture I think -- it reminds me so much
> of the movie "Brazil" (apologies to Dr.
> Bob for forgetting the double quotes previously).
>
> Squiggles
Posted by bassman on August 29, 2006, at 18:51:00
In reply to Re: Psychopharmacology of addicting drugs » bassman, posted by laima on August 29, 2006, at 17:35:19
Sorry, maybe that wasn't worded right-I meant the scientists aren't going to distort the data; they genuinely WOULD like to help...just about all of them, in my experience. The Big Pharma nonesense just occurs long after the developing chemist is out of the picture-remember, the chemist doesn't know he's synthesizing a psychoactive drug-he finds that out after it has been screened. These days, 100,000 potential drugs might be synthesized a day!
Posted by bassman on August 29, 2006, at 18:54:33
In reply to Re: Psychopharmacology of addicting drugs » Squiggles, posted by laima on August 29, 2006, at 17:57:12
That's the realm of the true scientist-the guy that wants to develop a drug for one reason: he wants it to work really well, period. But the corporate structure beats the creativity and energy out of the excellent scientist...
Posted by laima on August 29, 2006, at 19:16:12
In reply to Re: Psychopharmacology of addicting drugs, posted by bassman on August 29, 2006, at 18:54:33
> That's the realm of the true scientist-the guy that wants to develop a drug for one reason: he wants it to work really well, period. But the corporate structure beats the creativity and energy out of the excellent scientist...
...and that's tragic. But I don't doubt it to be true. That's why I wish pharmaceutical development was exclusively the non-profit territory of only universities and med schools, paid for by govt grants and taxes, perhaps even private donations from philanthropists, for example.
I read a very sad article fairly recently which asserted drugs get developed mostly per problems of "rich" people in "developed countries"-while meanwhile poor and desitute people in places such as parts of Africa and elsewhere die from diseases that no one has any interest in looking for drugs to help cure- thanks to "no profits"-even though they are conditions such as having parasites that seem like they could easily be curable via drug therapy. (Sorry- I can't recall where I read this. NYTimes maybe?.)
And why find a true "cure" anyway, if that would only end your supply of steady customers? Ie, why not keep people "on therapy" indefinately?
It's hard not to feel jaded or cynical, but I'll try.
The pharmacutical industry strikes me as having a very dark side, though I myself and many others depend on it.
Posted by laima on August 29, 2006, at 20:39:32
In reply to Re: Psychopharmacology of addicting drugs, posted by bassman on August 29, 2006, at 18:51:00
Oh- I might not have been clear- I didn't mean to imply scientists would distort data- though I do think marketers and sales reps often rosey-up, "dumb-down", or oversimplify the facts for the public.Ie, "depression is a simple chemical imbalance". That is only a "theory" per most doctors I've talked to-maybe true- maybe more likely it's actually a tad more complicated.
> Sorry, maybe that wasn't worded right-I meant the scientists aren't going to distort the data; they genuinely WOULD like to help...just about all of them, in my experience. The Big Pharma nonesense just occurs long after the developing chemist is out of the picture-remember, the chemist doesn't know he's synthesizing a psychoactive drug-he finds that out after it has been screened. These days, 100,000 potential drugs might be synthesized a day!
Posted by Phillipa on August 29, 2006, at 21:11:56
In reply to Re: Psychopharmacology of addicting drugs, posted by fca on August 28, 2006, at 20:34:39
Yes it does but my thing is that my pdoc had me on valium and I switched on my own. So it made a big difference. Now I have to wean down to the proper dose of valium. No she didn't prescribe K for me an old script I had I was taking. Oh today she said I was a nervous wreck and added xanax. She 's into addictions and has no problem with benzos. She's very old and agrees they have a good track record for no permanent damage to any organs. Just take as prescirbed.. Bad me. Love Phillipa
Posted by Meri-Tuuli on August 30, 2006, at 4:41:43
In reply to Re: Psychopharmacology of addicting drugs » bassman, posted by laima on August 29, 2006, at 19:16:12
> I read a very sad article fairly recently which asserted drugs get developed mostly per problems (Sorry- I cof "rich" people in "developed countries"-while meanwhile poor and desitute people in places such as parts of Africa and elsewhere die from diseases that no one has any interest in looking for drugs to help cure- thanks to "no profits"-even though they are conditions such as having parasites that seem like they could easily be curable via drug therapy.Oh yes I've read alot of similar stuff. Its like 95% of drug company research money etc goes into drugs for 'rich' countries and then its usually stuff that we don't *really* need like cold remedies and things like that.
Kind regards
Meri
Posted by notfred on August 30, 2006, at 21:24:11
In reply to Re: Psychopharmacology of addicting drugs, posted by bassman on August 28, 2006, at 13:19:48
I've never become tolerant of any benzo I've taken except Ativan
Same here, mostly Ativan for over 20 years. I have never had to increase the dose. I became tolerant to the euphoria quite quickly but otherwise 1 mg Ativan is effective today as it
was decades ago. Some days I take none, some days 1 and some days 2.
Posted by Squiggles on August 31, 2006, at 7:15:52
In reply to Re: Psychopharmacology of addicting drugs, posted by notfred on August 30, 2006, at 21:24:11
> I've never become tolerant of any benzo I've taken except Ativan
>
>
> Same here, mostly Ativan for over 20 years. I have never had to increase the dose. I became tolerant to the euphoria quite quickly but otherwise 1 mg Ativan is effective today as it
> was decades ago. Some days I take none, some days 1 and some days 2.
Well, i'll be darned; i am mystified;i thought at least only clonazepam belonged in an interface
between benzodiazepines and anti-convulsants.Does anybody know what is going on? Is it
possible that taking the benzo EVERY single
day makes the difference in addiction?Squiggles
Posted by Phillipa on August 31, 2006, at 18:23:31
In reply to Clonazepam dosing » notfred, posted by Squiggles on August 31, 2006, at 7:15:52
This thread is so long I've forgotten a lot of it but Squiggles did you say you had to up your dose? I thought you were just asking if that's what happens over time. If a person is an abuser he /she will probably want some type of high. I'd think then they'd choose alchohol, cocaine, or another illegal substance? Love Phillipa
Posted by Squiggles on August 31, 2006, at 19:51:37
In reply to Re: Clonazepam dosing » Squiggles, posted by Phillipa on August 31, 2006, at 18:23:31
> This thread is so long I've forgotten a lot of it but Squiggles did you say you had to up your dose? I thought you were just asking if that's what happens over time. If a person is an abuser he /she will probably want some type of high. I'd think then they'd choose alchohol, cocaine, or another illegal substance? Love Phillipa
No! I don't want to raise my dose; the first
time my dr. raised the dose, i put up a fuss;
but he saw something i did not i guess.No-- my question is why do other benzos
require an increase at shorter intervals,
because of tolerance, and clonazepam does
not? Was there a change in the chemical
structure of clonazepam -- it's just strange
that it is so unique in this sense.Squiggles
Posted by Phillipa on August 31, 2006, at 20:12:15
In reply to Re: Clonazepam dosing » Phillipa, posted by Squiggles on August 31, 2006, at 19:51:37
Thanks, I think valium is the same? Love Phillipa again.
Posted by notfred on September 1, 2006, at 14:29:09
In reply to Clonazepam dosing » notfred, posted by Squiggles on August 31, 2006, at 7:15:52
>
> Does anybody know what is going on? Is it
> possible that taking the benzo EVERY single
> day makes the difference in addiction?
>
> Squiggles
>
Yes, addiction and dependance are worlds a part; they are no where near the same thing.Everyone will become dependent to some degree
if they take benzos every day for an extended period. If I take Atavin for maybe a month every day I become dependant, though mild. It is not an issue unless I am stupid and go cold turkey.Addiction is perhaps the difference between someone who has 2 beers every night and and an
alcoholic.Addiction always carries serious negative consequences. Despite these serious consequences
the drug/meds use continue and increases.You might want to do some google searches on this, ie "Addiction vs Dependance" as there is lots of info on what the difference between them.
Posted by bassman on September 1, 2006, at 14:50:12
In reply to Re: Clonazepam dosing, posted by notfred on September 1, 2006, at 14:29:09
Exactly. We all become dependent on benzos in the same sense that a diabetic is dependent on insulin...stop taking them abruptly and you'll be very uncomfortable. Addiction is active drug-seeking behavior. Good idea to search it if unclear about the difference. As I mentioned before, I'm surprised about trouble withdrawing from Klonopin...in fact it is the benzo docs in the US often have a person switch to from other benzos before withdrawing. I find particularly easy to withdraw from...
Posted by Squiggles on September 1, 2006, at 16:31:47
In reply to Re: Clonazepam dosing, posted by bassman on September 1, 2006, at 14:50:12
The discussion is starting to get circular;
i feel that i am taking up too much time
on this recurring subject. I have my ideas
about the linguistic distinction you make,
and I do not think that your perspective,
possibly shared by social workers, correlates with
biochemistry-- which is where it's at.So bring on the chemists, if you want
another round. :-)Squiggles
Posted by Squiggles on September 1, 2006, at 17:11:34
In reply to Re: Clonazepam dosing » bassman, posted by Squiggles on September 1, 2006, at 16:31:47
On second thought, let's put
the whole thing in vitro :-).Bye
Squiggles
Posted by notfred on September 1, 2006, at 17:15:13
In reply to Re: Clonazepam dosing » Phillipa, posted by Squiggles on August 31, 2006, at 19:51:37
> No-- my question is why do other benzos
> require an increase at shorter intervals,
> because of tolerance, and clonazepam does
> not? Was there a change in the chemical
> structure of clonazepam -- it's just strange
> that it is so unique in this sense.
>
> Squiggleslength of action I think. For someone who requires
every day doses of a benzo, it is going to take more for the benzos with shorter 1/2 lives. More frequent doses and higher doses to get to an average level in the body that will control anxiety.Peaks and valleys in levels are really hard on those who have constant anxiety. The longer acting
benzos (Val, Clonazepam) are better suited if one needs a benzo every day; after a few doses levels
are constant. Any change in levels happens slowly.
Posted by Squiggles on September 1, 2006, at 17:21:47
In reply to Re: Clonazepam dosing, posted by notfred on September 1, 2006, at 17:15:13
>
> length of action I think. For someone who requires
> every day doses of a benzo, it is going to take more for the benzos with shorter 1/2 lives. More frequent doses and higher doses to get to an average level in the body that will control anxiety.
>
> Peaks and valleys in levels are really hard on those who have constant anxiety. The longer acting
> benzos (Val, Clonazepam) are better suited if one needs a benzo every day; after a few doses levels
> are constant. Any change in levels happens slowly.
>
>
>
>No, that's not it -
Squiggles
Posted by bassman on September 1, 2006, at 17:46:31
In reply to Re: Clonazepam dosing » bassman, posted by Squiggles on September 1, 2006, at 16:31:47
My Ph.D. is in chemistry. :>}Really. But you're right, we're getting nowhere fast. Sorry for the last post.
Posted by Phillipa on September 1, 2006, at 21:14:31
In reply to Re: Clonazepam dosing, posted by bassman on September 1, 2006, at 17:46:31
Squiggles what exactly are you looking for? I think all meds are tolerant ad's included and all thake withdrawal except lucky people. Maybe the type of med you need effects withdrawal as ad's I just stop. Benzos I require per all pdocs. Love Phillipa
Posted by Squiggles on September 2, 2006, at 8:10:18
In reply to Re: Clonazepam dosing, posted by Phillipa on September 1, 2006, at 21:14:31
> Squiggles what exactly are you looking for? I think all meds are tolerant ad's included and all thake withdrawal except lucky people. Maybe the type of med you need effects withdrawal as ad's I just stop. Benzos I require per all pdocs. Love Phillipa
Phillipa, i don't quite understand your message--
maybe it's early.What am i looking for? The answer to the question
"what is different about clonazepam" -- is there
a history of the chemical manufacture of benzos
that might shed light on this question. I am
convinced by my experience that this is not a benzo like all the others. This does not mean
i have any intentions of changing my prescription,
or anything in my treatment with it.
Posted by Squiggles on September 2, 2006, at 8:17:04
In reply to Re: Clonazepam dosing » Phillipa, posted by Squiggles on September 2, 2006, at 8:10:18
Is clonazepam unique? (i'm searching)
here is one article:
A unique effect of clonazepam on frontal lobe seizure control.
* Obeid T,
* Awada A,
* Sayes N,
* Mousali Y,
* Harris C.Neurology Sections, King Khalid and King Fahad National Guard Hospitals, Jeddah, Kingdom of Saudi Arabia.
In a 16-year-old female, clonazepam (CZP) changed randomly occurring intractable tonic seizures of frontal lobe origin to a few sleep seizures when used as an adjunctive therapy. The significance of this change in the seizure pattern is discussed with an explanation of possible pathophysiologic mechanism. Copyright 1999 BEA Trading Ltd.
PMID: 10600586 [PubMed - indexed for MEDLINE]
Posted by Squiggles on September 2, 2006, at 8:17:20
In reply to Re: Clonazepam dosing » Phillipa, posted by Squiggles on September 2, 2006, at 8:10:18
Is clonazepam unique? (i'm searching)
here is one article:
A unique effect of clonazepam on frontal lobe seizure control.
* Obeid T,
* Awada A,
* Sayes N,
* Mousali Y,
* Harris C.Neurology Sections, King Khalid and King Fahad National Guard Hospitals, Jeddah, Kingdom of Saudi Arabia.
In a 16-year-old female, clonazepam (CZP) changed randomly occurring intractable tonic seizures of frontal lobe origin to a few sleep seizures when used as an adjunctive therapy. The significance of this change in the seizure pattern is discussed with an explanation of possible pathophysiologic mechanism. Copyright 1999 BEA Trading Ltd.
PMID: 10600586 [PubMed - indexed for MEDLINE]
Posted by Squiggles on September 2, 2006, at 8:36:37
In reply to Re: Clonazepam dosing » Squiggles, posted by Squiggles on September 2, 2006, at 8:17:20
My apologies for hitting the button twice
on my previous post.
i need more coffee - if Dr. Bob or his
assistants wich to remove it, please do
so.I found many article under the key words
clonazepam unique
in the PubMed selections - various reasons
from pharmacological structure to interaction
with benzo receptors are cited.This one is from a therapeutic point of view
and comes from Dr. G. Chouinard - Montreal
of all places (what a small world), discussing
the advantage of using clonazepam in bipolar
disorder and other psychiatric disorders,
as it seem to reduce the need for
neuroleptics. It is stated that even without
lithium, K (clonazepam) by itself can reduce
the manic state.I would like to cite my own experience not long
ago, when i took a corrupted (low, or counterfeit or whatever) dose of lithium. Over
six months the symptoms of manic depression
arose for the first time in 25 years. I was
able to correct this at the most suicidal and
agitated depression phase, by switching to another pharmacy and the old lithium.I would like to point out, that at the time of
this incident i had never stopped taking the
regular dose of clonazepam.You might consider the pharmacological import of that according to anyone understaning its
significance. Perhaps an increase in K would
have confirmed Dr. Chouinard's hypothesis.Here is the abstract:
The use of benzodiazepines in the treatment of manic-depressive illness.
* Chouinard G.
Clinical Psychopharmacology Unit, Allan Memorial Institute, Royal Victoria Hospital, Montreal, Canada.
The benzodiazepine clonazepam was approved for the treatment of epilepsy in 1976. To study its use in acute mania, the author compared clonazepam with lithium in a crossover trial. Clonazepam proved more effective than lithium in controlling the symptoms of mania and caused fewer manifestations of parkinsonism. Associated side effects included ataxia, drowsiness, and behavioral changes. No treatment-emergent depression was observed. Neither clonazepam nor any other benzodiazepine is recommended in schizoaffective or schizophrenic disorders because of the high risk of dependence in those patients, in contrast to manic-depressives. For the maintenance treatment of bipolar disorder, lithium is recommended as the initial agent, with L-tryptophan added if concomitant medication is needed. Clonazepam can then be added as the anticonvulsant, if necessary. In the treatment of acute mania, clonazepam is recommended for the first week of treatment, and lithium is added in the beginning of the second week, thus avoiding the use of neuroleptics.
PMID: 2903143 [PubMed - indexed for MEDLINE]
Squiggles
Posted by SLS on September 2, 2006, at 9:05:38
In reply to Re: Clonazepam dosing » Squiggles, posted by Squiggles on September 2, 2006, at 8:36:37
I experienced a manic reaction to antidepressant medication while taking Ativan 2mg concurrently for sleep. The addition of lithium did not help much. The addition of Klonopin did.
Klonopin is unique among benzodiazepines in that it exerts serotonergic effects (as does lithium). The exact mechanisms remain obscure.
- Scott
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