Aa
Aa
A
A
A
Close
Avatar universal

For people on benzos

I'm an organic chemist who in recent years, has been studying to become a developer for pharmaceuticals.  After reading this forum for a while, i realized that there is quite a bit of misinformation on the topic of these drugs.   Many people say it's mildly addicting, or that its a medication for treating withdrawals.  Lots of you guys are prescribed it for years, including my brother.

Some basic facts:

These medications stop working completely after administration for a few months, if you think it's helping your anxiety go away.. check again, it's making your withdrawals go away.

Anything that inhibits the P450 enzyme(like grapefruit or MAOIs) will increase the effects of any benzodiazipine.  As little as 250ml of grapefruit juice can make peak plasma levels of 10mg oral diazepam(valium) reach double the volume in the blood.(great for people who take it recreationally, horrible for people trying to quit)
This half life extension can be fatal for people with insufficient renal or liver function.

The addiction potential of the different medications is dictated almost soely on the medications half life.  The faster it reaches peak plasma levels, the more "rush" and addiction potential there is.

Ativan = Higher addiction potential
Klonopin = Very high addiction potential
Valium = Lower addiction potential
Xanax = Mid-High


To stop taking these medications, it can be extremely hard to lower the dose on some of the more addictive ones.  A great way to get off of the medication is to work out a switching schedule before a tapering one.   Switching to a less addicting drug in the same family before lowering the dose works great.

Valium is probably the easiest drug to switch to by slowly lowering your dose of whatever you are taking, and substituting with an equal dose of valium(the mg is not the same so see a doctor.. 10mg of xanax is ALOT more than 10mg valium)

Once you are using a drug with a longer half life,  you can start slowly lowering your dose accordingly.



Hope this clears up some misinformation.  


24 Responses
Sort by: Helpful Oldest Newest
1094370 tn?1317134825
I agree with Allison.  My doc told me the order of dependency and difficulty was in this order:

Xanax (hardest to get off)
Ativan
Klonopin
Vallium

Not sure if those are spelled right.
Helpful - 0
345079 tn?1299202476
I have been on xanax, ativan and Klonopin. I disagree with the OP's statements whether a chemist or whatever. Xanax was by far the hardest to come off #1. #2 I have been on Klonopin for 3 years. It does not just work for withdrawal symptoms. I take it nightly. If I happen to have a anxious day or a panic attack once in a blue moon I take it and it works. That dose is not just helping withdrawals or I would need to do the same every day.
It works, without Benzos I do not function. I have had many including a very large well known hospital for addiction and mental health tell me that the Benzos are what is best for me and what works. I think a post like this makes people that are in need of help and have been prescribed a benzo have many doubts.
Helpful - 0
1302779 tn?1287405029
Just wanted to add to all this
I am taking 05 klonopin since sept and it has been a life saver for me. I never took med's and believe that sometimes we need to do what we need to do. I also see a functional neurologist who works strictly with supplements and is against medication
yes dopamine, gaba progesterone ect is the chemicals in the brain to treat with anxiety/dep i also have chronic migraine and diet is very important too to treat both anx/dep migraine ect. My point is sometimes we need med's when the alternative method doesnt cut it and there is NOTHING wrong with it!! I respect the chemist's input for sure I also know that people with anxiety issues can get more anxious when being fed info about the negative of med's so that being said if whatever we all are doing to feel better God bless!!
peace all
Anthony
Helpful - 0
Avatar universal
I have been reading these postings and I have heard so much fear that it literally makes my anxiety go through the roof.  Places like this are great for comiserating and finding support, but this isn't the place to adjust your medications or decide not to take a potential life-saving medication.  Your doctors office is.  I take Klonopin.  I have tried Atavan and Vistaril. According to my script I can take 1mg of Klonopin every 4hrs prn anxiety.   Very rarely do I need that much.  I take it 2-3 times per week.  Yes it has potential for dependance, but so do a lot of meds.  Have you ever taken Prednisone?  It is considered a miracle drug by many, but you have a physical dependence in a matter of a couple of days.  

My advice...take your meds as directed.  If you have fears about them, talk to your doctor.  
Helpful - 0
Avatar universal
I am taking vistaril for anxiety what is your opinions on that? And also it makes me feel tired a little I feel it only helps in calming not mentally that starts the whole anxiety in the first place...and also If I was allergic to paxil, zoloft, and celexa is why my psychatrist put me on vistaril what do you suggest would be non allergic and helpful....
anna
Helpful - 0
Avatar universal
Don't forget progesterone.
Helpful - 0
Avatar universal
Since you are a researcher, you may want to look into Dopamine, Norepinephrine, GABA(a), and 5-HT, and their influence on behavior.

Quote^

That's all of the things that involve behavior and emotion.. all of the neurotransmitters involved in psychiatric disorders. Ive been actually looking into the actual legal technicalities of alexander shulgins clever idea of adding a N-hydroxyl to any active amine.. allowing u to get past patent protection.. basically if you make a n-hydroxyl analog of any active amine chemical.. it will pretty much always have the same pharmacological effect.. so you could create variations of just about any medication out there that contains this type of structure and it's technically unique :P



Did klonopin actually keep helping? I would like a daily solution but instead i just take valium or xanax as needed.. once or twice a week ..physical dependence is scary

Helpful - 0
Avatar universal
Well I qualify as the anxiety person with the drug phobia. The doc wants me to take more ativan than I am. Im always afraid of meds. The doc wanted me to start out with 1mg of ativan twice daily and I cut in half. So I take .05mg twice daily then he told me to bump it up to three times daily. Yes I tried the klonopin and I got a really bad gut ache and nauseua.. So I quit it. But I do know if I take a drug and know that im ok will take it if it works. Its just getting me to take it. I went to a gastro doc for stomach pain and chest pain,different than the pain from the klonopin I have had this pain for a couple of years on and off.Besides my costochrondirits. its called Zegerid (omeprazole) which can cause palps, or aciphex, which can cause vt, so therefore I wont take it cause I already have that problem and I dont need anymore help there. It really sucks cause im sure the meds would help me but once again im a big chicken to take it.
Helpful - 0
Avatar universal
I am sorry for posting again - but I wanted to add that my biggest thing to overcome is my health anxieties.  I was spending alot of time on the internet looking up health problems and associating that problem with me. I have not looked up anything on the 'net' in about a week. I forced myself to stop doing that. I am forcing myself to re-think my thinking. I used to really like watching Mystery Diagnosis and those other simular programs and didn't have any problems with it - until I had that bad reaction to that wellbutrin - then that is when I started to focus on health issues. I do notice that the Klonopin makes me "not care about it anymore" after a while when I take it - usually about 30 minutes, I start to "not care" attitude about my anxieties. I am wondering if I should maybe just take 1/2 mg everyday sometime during the day hours.
Helpful - 0
Avatar universal
I am sorry - i guess I am confused, but what does a person feel, when they have a physical dependency on Klonopin? I might take Klonopin about 3 different times during the course of a week. During this time, I will take 1/2 mg each occasion. I only took 1MG (which is a full tablet) only one time since the Doctor prescribed this to me 2 weeks ago.  I am not taking this on a regular basis, only when I start feeling panicky or some unwanted thoughts come in.
Thanks
Donnie
Helpful - 0
Avatar universal
Yes Im on ativan. Sorry I just skipped over what kind I was on. I thought it but didnt write sorry
Helpful - 0
Avatar universal
I read a article by Stevie Nicks she took klonopin for many years and she said that klonopin was hell getting off of. She said it was worse than the cocaine she had been on. It was a intresting article. I also know people who have a hard time getting off of xanax.  But maybe it just depends on the person and their personality some people have more addictive personalities than others and maybe that makes it harder who knows. Im on 0.5mg  twice daily for over a year now I dont even think it really does anything for me thinking about upping the dose but nervous to do so the doc wants me too. But I too have an addictive personality. But for those of us who have anxiety really need something for it what else are we to do??
wmac
Helpful - 0
200828 tn?1209917975
Okay, now can you guys repeat all of that but in English.  

Just kidding, you guys are very intelligent people.  I have respect for all of you.  
Helpful - 0
193245 tn?1189989722
I have a lot of interesting agents in my sponge, too.
Helpful - 0
Avatar universal
What type of organism do you isolate the compounds you study from?  My ex used to work with sponges - lots of interesting agents in those.  
Helpful - 0
Avatar universal
BTW:  since chemistry is being discussed and I too, am an organic chemist, I would like to add out that either neutralization of the 0.017 M NaOH solution of pH 12.23, that is described up-thread, or dilution such that an appropriate alkalinity is attained will not make the solution "safe" to drink.  Phenolphthalein has known carcinogenic properties and is a laxative!
Helpful - 0
Avatar universal
First of all, Benzodiazepines are not addictive, unless they are being abused. All of them lead to *dependency* by altering GABA(a) receptor sites in the brain. Dependency and addiction are NOT the same. Any drug that alters brain chemistry will lead to dependency, including the Tricyclics, Tetracyclics, MAOI's, and SSRI/SNRI's.

^

Benzos will always create physical addiction given enough time if they are taken every day.

As for the individual chemicals actual half lives, that's off the top of my head.  Xanax possibly is more addicting partially because of it's action in the 5-HT receptor sites in the brain(which is arguable)

Wow.. this is starting to feel like school.. i did this in basic nonorganic chem... i believe the starting liquid was green and turned a pinkish purple..

----

sodium metal is usually kept with mineral oil.. but anyways.. if you reacted sodium metal with water it'd react and release hydrogen gas[sodium hydroxide] as well as sodium ions... phenolphthalein(just say universal indicator or you will **** your chemistry colleagues  off.. but you're probably just trying to be more confusing)... either way it wouldn't be safe to drink... sodium metal will destroy your digestive tract.. but assuming you removed it, you would need to react it it until it had a neutral PH balance.  

This is more basic chem, pharma r&d is more geared towards isolation of active alkaloids, and studying the pharmacokinetics for medical benefit.(yes you were right spade22.. thanks)

Either way, try contributing rather than correcting.  Most of the numbers you threw out there were accurate though.

All of these drugs lose efficiency after time,  even the ones with long half lives.  The reason some may appear to lose it quicker is because the ones with shorter half lives are more prone to dose escalation :).


As for the addiction comparison to SSRIs and MAOIs .. it's not the same.  I'm guessing you don't have experience directly from this drugs based on that comparison in addiction potential.  Inhibition of neurotransmitter breakdown is different than modulation of a brain receptor site like GABA.


This is a really simple question, which could have been phrased much better, but I appreciate the challenge, as most people who post on forums rebuttle with absolutely no sources.

i'm not trying to back with my knowledge of chem.. moreso because I dealt with this problem helping my brother to get off of them, using valium as a switch over medication.  And yes, you are right.. valium does take a while to switch over to.. but these drugs are all cheap and most people are on them for years..

Posted it to help people, not to get a lesson in begginning chemistry.
Helpful - 0
Avatar universal
Alprazolam is a substrate of CYP3A4, and may be subject to similar increases in AUC and clinical effects as seen with the other CYP3A4-metabolized benzodiazepines.

Triazolam AUC was increased 48% and Cmax increased 30% in healthy volunteers given triazolam with grapefruit juice. Drowsiness was significantly increased when triazolam was given concurrently with grapefruit juice. (Source: Hukkinen SK, Varhe A, Olkkola KT et al.,  Clin Pharmacol Ther 1995; 58: 127-31).
Helpful - 0
Avatar universal
Eight healthy subjects were given diazepam 5mg orally with either 250 mL water or grapefruit juice. The mean AUC of diazepam was increased 3.2-fold and the peak concentration was increased 1.5-fold by the grapefruit juice. Grapefruit juice postponed the time to reach peak concentration of diazepam from 1.5 hours to 2.1 hours. (Reference: Ozdemir M, Aktan Y, Boydag BS.,  Eur J Drug Metab Pharmacokinet 1998 Jan-Mar;23(1):55-9.)
Helpful - 0
Avatar universal
I agree completely.  Sometimes it is the medication, along with therapy that can help you live.  Existing is not living.  I was existing for a long, long time.  I am slowly slowly starting to live again.  It has been a long road for me.  Is it wrong to need meds?  My honest opinion is no.
Helpful - 0
Avatar universal
"Plus, organic chemists don't develop pharmaceuticals."

Sure they do!  Numerous pharmaceutical agents are not available in "nature" - they are synthetic in origin and are prepared in the laboratory.  Moreover, synthetic organic chemists routinely work in the pharmaceuticals industry modifying structually (derivatizing) known pharmaceuticals (that may be natural), developing novel "potential" drug candidates, and devising synthetic strategies to prepare biologically active molecules that are only available in small quantities from natural sources.

Helpful - 0
193245 tn?1189989722
That's exactly the way I feel about it.  I feel the risks are overstated, but even if they're not they are far outweighed by the benefits.  Quality of life is very important, and Klonopin (not by itself, but it's been an essential part) has helped me get things under control.  I went from "existing" to "living" pretty quickly by using the Klonopin, and "living" is the only real remedy for anxiety/panic, in my opinion.
Helpful - 0
Avatar universal
I did not read just every word of all of this as I am not a chemist, but I just had a neurologist two days ago tell me that Klonopin is a pretty safe medication. I told him that I was instructed by my internal med to take just one tablet when i an having an anxiety attack and shortly I will feel more calm. I have been doing this only from time to time and this method works for me. I don't think that I have any tendency to have an addition to this and I probably would not know it if I was. If I feel restless, I might take a half a tablet which a whole is 1MG.  
For whatever it is worth. For whatever it is worth, it is not worth freaking folks out that are being helped for once in there life if they take something to help.
Helpful - 0
Avatar universal
Can I slowly taper off xanax. I only take half of 0.5 at bedtime. What kind of withdraws are we talking about?I do not want to become addicted to this drug.
Thanks,
Chadry
Helpful - 0
Have an Answer?

You are reading content posted in the Anxiety Community

Top Anxiety Answerers
Avatar universal
Arlington, VA
370181 tn?1595629445
Arlington, WA
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Find out what can trigger a panic attack – and what to do if you have one.
A guide to 10 common phobias.
Take control of tension today.
These simple pick-me-ups squash stress.
Don’t let the winter chill send your smile into deep hibernation. Try these 10 mood-boosting tips to get your happy back
Want to wake up rested and refreshed?