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Are the long term side effects of benzodiazepines over-exaggerated?

benzodiazepine cognitive decline cognitve benzo side effect benzos side effects detrimental long term use

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#1 Klonopin

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Posted 10 November 2014 - 02:51 AM


I am a Engineering student with an anxiety disorder who uses benzos daily. Given my situation currently withdrawing from my Klonopin is not a viable option for me since most medical literature states (and from my experience) that the withdrawal symptoms can be felt for 6 months or more. (i have tried quiting and just ended up being a setback due to the nature of the intensity of my major and the intensity of the withdrawal)

 

I have read about benzos causing memory problems, destroying sleep architecture the longer you use them, making anxiety worse in the long run and many other negative side effects. Which is why I have tried to quit.

 

What are your thoughts on the detrimental cognitive side effects of benzodiazepines? Are they real at the doses of 0.5mg-1mg of Klonopin which i have been taking daily during the semester with usually a 2 month break during vacations. 

Will they become worse if I develop tolerance and I start using higher doses. Will the cognitive detrimental side effects become more noticeable the longer i use them as well? I will probably need 1 or 2 years of more benzo usage before I can complete my major.

 

 

If benzo usage is a concern,

how do I stop this cognitive decline that will supposedly happen if I continue taking benzos. Does anyone suggest any nootropics, supplements or any other suggestions best suited to avoid the cognitive decline related to benzos?



#2 ovecta

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Posted 10 November 2014 - 11:42 AM

Have you considered alternative treatments to benzos for your anxiety ? Some anti-depressants such as ssri's have been used as long term treatments for a large spectrum of anxiety disorders. I found Tianeptine helpful in managing anxiety in the past and I'm currently using Lexapro for depression but`I've noticed a positive effect on my anxiety also in that I'm much more calmer than usual and more social as a result.

Some studies and anecdotal evidence has found that Memantine might be helpful also as it modulates the activity of Glutamate which is the main excitatory neurotransmitter, I really would advise you to get off the benzos sooner rather than later, In my view they should only be used in very short term durations for panic disorders and should never been used longer than 3-4 weeks.

They prevent you from properly processing trauma so I really can't see how they can be used as long term treatments for anxiety disorders.

I completely understand where you're coming from though but please just talk with your doctor about the many alternatives available, if you have the option of Cognitive behavioral therapy then take it as it's the gold standard in treatment options,  there are countless reports of people getting hooked on benzos and experiencing hellish withdrawals when trying to stop and while you might not feel like your dependent on them now you have ask yourself seriously can you imagine your life without them?


Edited by ovecta, 10 November 2014 - 11:45 AM.


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#3 Bateau

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Posted 10 November 2014 - 04:25 PM

Yes it will become worse as tolerance gets more significant and with longer duration of use, and no the effects are not overstated.

 

Try tapering down off the benzo's while trying some of the more proven anxiolytic supplements. There are essentially only 4 with really good evidence of potency: Kava, Lavender, Ashwagandha and Inositol (high dose, 18 grams). Lemon balm feels quite potent to me, but that's because it carries a sedative action that the others don't. None of these supplements have withdrawals.

 

If these aren't potent enough for you, there are some very promising russian anxiolytics without addiction issues, Tofisopam, afobazole and hydroxyzine are the most promising I can remember (can be purchased here, and i can confirm the validity of the webiste). Hydroxyzine is sedative like benzo's, so it will help with sleep more than the others, but might cause some daytime drowsiness that tofisopam and afobazole will not cause. Doesn't cause memory deficits like benzos do though (even when not going through withdrawal they cause memory issues)

 

From my personal experience the Kava/Lavender combo seems to be the most potent for anxiety reduction (but adding the rest will help), but the lavender/lemon balm combo will be the best to help you sleep, which is another big issue with benzo withdrawal. Never tried any of the russian anxiolytics (aside from bromantane), although i studied them quite a bit.

 

Best of luck geting off the benzo's. The sooner you do, the better you'll be. Sorry about the anxiety issues, social anxiety used to be a big thing for me. Kava seems to have completely obliterated that issue for me. Don't even take it anymore.


Edited by Bateau, 10 November 2014 - 04:42 PM.


#4 Klonopin

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Posted 10 November 2014 - 05:15 PM

I'll add more backstory: I have developed an anxiety disorder mainly due to the extreme stress due to a very competitive college and stimulant abuse specially caffeine (insane amounts) plus other life stressors that happened in succession.

Currently I am at a pivotal point in my life where I will transfer to a supposedly least demanding college due to problems in my performance as a student because of my anxiety and I need to take the decision if I should stay with benzos until I finish my college major or try to quit benzos for good before continuing with college. This is time around I will have a longer time to rehabilitate myself: 6 months without college.

 

I have tried Kava powder and is good. Did you use kava extract or the powder with the lavender?

 

As for SSRI's I have tried them and the side effects are terrible and they never solved my problems in the past.
But recently I had a genetic test done and apparently almost all antidepressants don't work on me except for Effexor which i haven't tried. So maybe i could try Effexor but the sexual effects that these antidepressants have are just horrible.

 

Also where can I get Memantine and Tianeptine. I have read about them before but didin't know how to get them.



#5 YoungSchizo

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Posted 10 November 2014 - 05:49 PM

IMO it's over-exaggerated, I've been on Klonopin ranging from 0.5mg to 2mg p/day (mostly 1/1.5mg p/day) for over 1,5 years and never had any tolerance issues, neither did I experienced serious cognitive decline or worsening of my already cognitive issues. If you look on drugs.com there many many people whom had never had any issues with Klonopin, even people whom are taking much larger dosages for over years.

 

I do experience some cognitive decline when taking a dosage but it's neglectable, I guess I rather be a little "dumber" and be OK than struggle with issues all day which nothing helps against. I've been experimenting with Aniracetam, Noopept and Bacopa lately to counteract cognitive issues and so far I'm satisfied with the results it gave me. As I "side-effect" of those nootropics it gave me quite some relieve of anxiety, which I didn't expect at all! (I'm only taking 0.5mg p/day ever since taking those nootropics)

 

However, I'm taking Klonopin for a whole different issue than you (primary psychotic symptoms, secondarily anxiety). As some of the above posters already pointed out, there are a lot of substances you can take for anxiety.

 

Memantine you can buy from online pharmacies, Tianeptine also but there are nootropic sites where you can buy it from, powdercity.com being one of them. 



#6 Bateau

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Posted 10 November 2014 - 05:57 PM

Ceretropic has memantine

 

Remember that you have to start low with memantine and slowly titrate up to prevent serious brain fog that will last for days.

 

Also drinking is a big no-no with memantine, blackouts will happen very easily.


Edited by Bateau, 10 November 2014 - 06:03 PM.


#7 Bateau

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Posted 10 November 2014 - 06:01 PM

IMO it's over-exaggerated, I've been on Klonopin ranging from 0.5mg to 2mg p/day (mostly 1/1.5mg p/day) for over 1,5 years and never had any tolerance issues, neither did I experienced serious cognitive decline or worsening of my already cognitive issues. If you look on drugs.com there many many people whom had never had any issues with Klonopin, even people whom are taking much larger dosages for over years.

 

 

Were you able to go off your Klon for days on end without serious withdrawal?

 

To imply that the effects of a drug-addiction aren't serious, as long maintain your dependency, seems a bit drastic.



#8 YoungSchizo

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Posted 10 November 2014 - 07:30 PM

TBH, no, I didn't and haven't tried. But that wasn't my point (even though you also have one), I meant it's over-exaggerated imo if you see how many people can use Klonopin for years on without building tolerance and having any adverse effects ever.

 

I also don't see Klonopin-users as drug addicts (I don't abuse it and I don't take it for fun nor am I addicted to it), I probably quit one day but for the time being I am depended on Klonopin indeed. That was my second point to the OP, if he looks for alternative treatments for only anxiety and/or the possibility of cognitive decline, he probably will be able to replace the Klonopin without going through a really really rough withdrawal or to a rehab-clinic or whatever, iow, I think it's over-exaggerated as long as you don't abuse this stuff or have been using very high dosages for a long period of time.  

 

But to come back at your point, yes, this may be optimistic talk from my end that's why I mentioned that I'm using Klonopin for a more serious issue than anxiety.


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#9 ovecta

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Posted 10 November 2014 - 07:51 PM

What are your anxiety symptoms? Are they physical or more mental? I understand your apprehensiveness to consider anti-depressants given the side effects but you generally don't have to take such high dosages to reach the therapeutic range for anxiety disorders compared with major depressive disorders.

If you find you can't tolerate SSRI's then consider Mirtazapine which isn't as activating and will help getting you to sleep, if that's an issue.

Don't keep trying to justify reasons to yourself for taking benzo's, atleast try and refrain from daily usage and give yourself a couple days each week off the medication.



#10 Bateau

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Posted 10 November 2014 - 07:58 PM

@YoungSchizo So just to get a confirmation, you don't consider taking klon every day for a year and a half to be improper use (abuse)?

 

I've seen the effects of 0.5mg of klon on people who are benzo naive (never done benzo's myself but had/lived with a girlfriend who was prescribed klon and depakote), and simply because the mg amount looks so small does not mean that its not a big deal to be taking that for 18+ months.

Dependence refers to the compulsion to take a drug to produce a desired effect or to prevent unpleasant effects that occur when the drug is withheld. Dependence develops in almost one-third of patients who are treated with BZDs for ‡4 weeks (173). A withdrawal syndrome upon BZD discontinuation (see Tolerance and withdrawal section) is a common manifestation of BZD dependence (173). High BZD dosage and potency, short duration of BZD action, long duration of therapy and premorbid dependent personality traits are risk factors for the development of BZD dependence

→ source (external link)


Edited by Bateau, 10 November 2014 - 08:00 PM.

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#11 ovecta

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Posted 10 November 2014 - 09:00 PM

@YoungSchizo So just to get a confirmation, you don't consider taking klon every day for a year and a half to be improper use (abuse)?

 

I've seen the effects of 0.5mg of klon on people who are benzo naive (never done benzo's myself but had/lived with a girlfriend who was prescribed klon and depakote), and simply because the mg amount looks so small does not mean that its not a big deal to be taking that for 18+ months.

Dependence refers to the compulsion to take a drug to produce a desired effect or to prevent unpleasant effects that occur when the drug is withheld. Dependence develops in almost one-third of patients who are treated with BZDs for ‡4 weeks (173). A withdrawal syndrome upon BZD discontinuation (see Tolerance and withdrawal section) is a common manifestation of BZD dependence (173). High BZD dosage and potency, short duration of BZD action, long duration of therapy and premorbid dependent personality traits are risk factors for the development of BZD dependence

→ source (external link)

Glad someone else isn't taking daily klonopin usage lightly, can't highlight the dangers enough, thankfully doctors are beginning to see the error in over prescribing benzodiazepines, they have a bad name for a very good reason.

The longer you stay on it the more prolonged and difficult the tapering process so why not sooner rather than later?



#12 YoungSchizo

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Posted 10 November 2014 - 09:35 PM

I've weight the positive and negative side of Klonopin and at this point I pretty much have no other choice than staying on Klonopin, even if it means I have to go through a really tough withdrawal in the future. Look at it from my side maybe you'll understand, I'm forced to stay on antipsychotics (Klonopin is the first 'antipsychotic' of my choice and of my psychiatrist, one that works, I'm also taking a low dose of Zyprexa), possibly antidepressants too for the rest of my life. Does that make me a abusing "junkie"? Don't think so(!), my brain is just too fucked up and I have to compensate it with these kinds of chemical nasty medications to function properly and have a normal life.

 

To sum it up, the dangers of benzo's are not exaggerated, but from my point (and I guess many others whom have a hard to treat disease) of view it's definitely over-exaggerated.

 

Anyway, this topic isn't about me and I already mentioned to the OP that there are many options for anxiety alone. 



#13 Bateau

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Posted 10 November 2014 - 09:52 PM

Just to clarify, klon (clonazepam) is not considered a neuroleptic (antipsychotic) by any stretch of the imagination. Its a basic benzo that can be acutely useful for manic episodes and panic attacks.  Having personally seen it be quite effective at obliterating panic attacks in a person with bipolar disorder, I'm not trying to argue its acute therapeutic potential, but there is no magic-bullet anti-psychotic effect of Klon. Its a potent anxiolytic, that's it. If it works for you, then other less addicting anxiolytics that work through positive allosteric modulation of the GABA-A receptor (e.g. Kava, Magnolia, Chinese Skullcap) should work as well.


Edited by Bateau, 10 November 2014 - 09:55 PM.


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#14 YoungSchizo

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Posted 10 November 2014 - 10:22 PM

Believe it or not, for me it works as a really potent 'antipsychotic' (especially for hallucinations) but I know it's not one, that's what the ' is for.

 

"Kava, Magnolia, Chinese Skullcap"

 

Thanks for the heads-up, noted these!

 

 







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