Hey Scott,
glad you’re still with us
It seems to me that there is not much hotter topic, drug-wise, than benzos. Many people demonize them and just as many casually claim that they are “as safe as aspirin.” And the two camps debate heatedly. You’d think it was a holy war.
I also did a ton of research (google scholar and Ashton’s work - you know of her work, right?) as well as discussions with my psychopharmacologist friend, and could find nothing better than this: Short-term use, one month daily dosing, no sweat. But in order to avoid tolerance, for long term use, take the lowest dose possible to relieve your symptoms. So where does that leave us ? The lowest dose possible to relieve my symptoms a year ago would have knocked out a horse.
Regarding a study on cognitive dysfunction, I found a quote in Julien’s Primer of Drug Action:
Stewart (2005) stated:
Meta-analyses found that cognitive dysfunction did in fact occur in patients treated long-term with benzos and although cognitive dysfunction improved after benzos were withdrawn, patients did not return to levels of functioning that matched benzo-free controls
The thing I worry about most is tolerance and tolerance withdrawal. The other issue is depression. Benzos eat up your serotonin.
it’s incredible how different each of us is. I heard a story of a man who went into tolerance withdrawal after one week on Ativan and another story of a woman taking Valium for 36 years, same dose.
That said, i take Klonopin 1.5 every day. I used to be a Valium user, but my doc likes Klonopin better so I tried it. What I like about it is that it doesn’t make me feel tired/dopey the way Valium does, so i made the switch. My other reasoning was that Klonopin is on the preventative list (not sure why) and the fact that Klonopin has stronger anti-seizure properties than any other benzo aside from Tranxene. Klonopin is more potent and is said to do more things in the brain than Valium - so i went with it. On the other hand, i fear that the issues of neural damage, tolerance and withdrawal could be harsher. Who knows. I’m just trying to get through the day.
It’s really striking to me that although i cannot find anything scholarly that recommends longer than one month daily dosing, I’m not sure how many docs are prescribing using those guidelines.
If anybody has any better information than this it sure would be helpful.
Julie