More on Benzos and Cognitive Damage

Philip Hickey, PhD
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On September 9, 2014, the BMJ published an article by Sophie Billioti de Gage et al.  The article was titled Benzodiazepine use and risk of Alzheimer’s disease: case-control study, and concluded:

“Benzodiazepine use is associated with an increased risk of Alzheimer’s disease. The stronger association observed for long term exposures reinforces the suspicion of a possible direct association, even if benzodiazepine use might also be an early marker of a condition associated with an increased risk of dementia. Unwarranted long term use of these drugs should be considered as a public health concern.” [Emphasis added]

On October 17, I wrote a post on this topic.  In that post I noted that I had not been able to find an APA comment on the BMJ article.  In fact, on October 15, Psychiatric News, the APA’s online publication, had posted Long-Term Use of Benzodiazepines May Be Linked to Alzheimer’s, by Vabren Watts, PhD.  The article is pure damage control.

The problem for the APA is that the evidence implicating benzos as a causative factor in the development of Alzheimer’s disease is mounting.  The APA can’t ignore this reality, but at the same time they can’t afford to alienate either pharma, or their own members who are prescribing these products.  So they’re having to walk a tight line.

Here are some quotes from the Psychiatric News article, interspersed with my comments.

“Researchers caution physicians to take more care when prescribing benzodiazepines.”

Strictly speaking, this is accurate.  Dr. de Gage et al did indeed write:  “…treatments [with benzodiazepines] should be of short duration and not exceed three months.”  But they also wrote:

“Our study reinforces the suspicion of an increased risk of Alzheimer type dementia among benzodiazepine users, particularly long term users, and provides arguments for carefully evaluating the indications for use of this drug class.  Our findings are of major importance for public health, especially considering the prevalence and chronicity of benzodiazepine use in older people and the high and increasing incidence of dementia in developed countries. In such conditions, a risk increased by 43-51% in users would generate a huge number of excess cases, even in countries where the prevalence of use of these drugs is not high.” [Emphasis added]

“Carefully evaluating the indications for use” of a drug class, is light-years beyond taking “more care when prescribing.”  The former denotes a complete re-appraisal of the status quo.  The latter is little more than platitudinous encouragement.

. . . . .

“‘Prevalence of [benzodiazepines] use among elderly patients is consistently high in developed countries … [ranging] from 7 percent to 43 percent,’ noted the researchers.”

This is the first quote that Dr. Watts provides from the de Gage et al study, and although it provides an important demographic reality, it is not the main issue.  This is a nice example of the spin tactic known as deflection, and watch how skillfully Dr. Watts uses it.  His next sentence reads:

“International guidelines recommend short-term use of the drug, mainly because of withdrawal symptoms that make discontinuation problematic; however, the study noted, use of benzodiazepines is often long term in older people.”

The issue here is that benzodiazepines, for decades one of the mainstays of psychiatric prescribing, are almost certainly causing AZD in millions of victims world-wide.  But Dr. Watts has adroitly shifted to a discussion of the over-use of those drugs and the potential for addiction when used long-term.  Again, these are important issues, but they are not central to the de Gage findings.  It is also worth nothing that people can become thoroughly hooked on these products even with very short-term use, and that the overuse of these drugs was fuelled primarily by psychiatrists, who for years assured the public, and other medical practitioners, that these drugs were benign and non-addictive.

. . . . .

Having found a safe angle, Dr. Watts stays with it.

“‘Somewhere along the way, the message got lost, and patients were allowed to use benzodiazepines for months and years,’ said Mohit P. Chopra, M.D., a member of APA’s Council on Geriatric Psychiatry. Chopra, who was not involved with the study, told Psychiatric News that guidelines recommend that the anxiolytic and insomnia medicines are to be used on a daily basis for no longer than four to six weeks.”

This is a slick rewriting of history.  In fact, the message didn’t get lost.  The original message, as propagated by psychiatrists, was that benzos were safe and non-addictive.  “Patients” weren’t just allowed to use benzos for months and years.  They were actively encouraged to do so, and in many cases were told the standard psychiatric lie that these products would correct non-existent anomalies in their brains.  The promotion of benzos by the psychiatry-pharma alliance is one of the great commercial success stories of this business.

And the APA continues to promote these drugs, albeit indirectly.  In their online section on anxiety disorders, under the heading “For more information” they give links to Anxiety Disorders Association of America (ADAA) and National Institutes of Mental Health (NIMH).  Here’s a quote from the ADAA site (under the heading Finding Help: Treatment):

Benzodiazepines
This class of drugs is frequently used for short-term management of anxiety. Benzodiazepines (alprazolam, clonazepam, diazepam, and lorazepam) are highly effective in promoting relaxation and reducing muscular tension and other physical symptoms of anxiety. Long-term use may require increased doses to achieve the same effect, which may lead to problems related to tolerance and dependence.”

And here’s a quote from the NIMH link:

“High-potency benzodiazepines combat anxiety and have few side effects other than drowsiness.”

These quotes are in marked contrast to the statement of Eric Lenze, MD, a geriatric psychiatrist, et al:

“Benzodiazepine risks, whether short-term or chronic, include cognitive impairment, delirium, respiratory insufficiency, falls, fall-related injuries such as hip fractures, motor vehicle crashes, and death.  Most patients are not warned of these risks before starting these medications.  The main risk factor for chronic benzodiazepine use is any previous use, so an intended short-duration prescription of these habit-forming medication is likely to lead to their long-term use.” 

. . . . .

Eventually, of course, Dr. Watts has to provide some information from the BMJ study.  He gives a very brief description of the research design and the results.  He mentions the finding that benzodiazepine use six years earlier was associated with an increased risk for AZD, and that this association was maintained after adjustment for anxiety, depression, and sleep disorders.

And then another PR gem:

“The researchers concluded that benzodiazepines are ‘indisputably valuable tools for managing anxiety disorders and transient insomnia,’ but warned that treatment with these medications should be used within the time parameters set by international guidelines.”

The researchers did indeed write this, but it was a sideline to the main issue, and the quote did not come from their conclusions section, which I have quoted in full above.  The primary conclusion is that the evidence for a direct causal link between benzo use and AZD is steadily mounting.

Dr. Watts’ primary concern throughout the article is to dispel any suggestion that benzos are inherently dangerous and damaging, and to promote the notion that they are only problematic when over-used.  To this end, he now introduces the very eminent psychiatrist Davangere Devanand, MD, director of geriatric psychiatry at Columbia University.

“‘These findings emphasize the importance of restricting the use of benzodiazepines in the elderly population,’ said Devanand in an interview with Psychiatric News.  ‘Benzodiazepines are known to be associated with an increased risk of worsening cognition … even in cognitively normal elderly subjects.’ Devanand said that in such situation, it would be best to taper and cease patients’ use of the benzodiazepine while reevaluating cognition functioning.”

And then, Dr. Devanand continues with a truly perfect piece of spin:

“‘If the cognitive decline is due to benzodiazepines, and the patient does not have an underlying dementia such as Alzheimer’s disease, the cognitive decline should reverse after stopping the treatment.'” [Emphasis added]

In other words, he is saying:  Yes, benzos can cause some cognitive impairment, but it’s temporary, and will clear up if the pills are stopped.

And if it doesn’t clear up, then the individual must already have had AZD or some other dementia.  The benzodiazepines couldn’t have caused permanent cognitive impairment.  Dr. Devanand provides no evidence or references to support this contention, but he’s an eminent psychiatrist, so I suppose his assertion should be evidence enough.  Besides, who ever heard of a psychiatric drug causing damage?

But then, wanting to have his cake and eat it too:

“Devanand stressed that in order to ensure that prescribers are not putting their patients at risk for the onset of neurocognitive disorders, ‘benzodiazepines should be prescribed sparingly and for short periods.'”

So benzos don’t cause permanent cognitive impairment, but to avoid putting patients at risk, they should be used  “…sparingly and for short periods”!

And besides, there’s a beautiful little catch to the notion of prescribing benzos for short periods.  When discontinuation is attempted, the client, as often as not, experiences withdrawals, and becomes agitated.  And agitation, of course, calls for medication.  And what medication is remarkably effective for suppressing agitation?  Benzos!  Isn’t psychiatry just wonderful.  Not only can it damage people with its drugs, it can “treat” the damage with the very same drug – and do it all with a straight face!

. . . . .

Discussion

The gist of Dr. Watts’ article is:

  • Benzos are generally safe if used for short periods (i.e. up to 3 months);
  • If they are used for longer periods, they may cause some cognitive impairment, but it’s unlikely to be permanent

But there is no mention of what, at least in my view, is the most important point in the de Gage et al report:

“Our findings are congruent with those of five previous studies, two of which explored the modifying effect of the dose used.  In four studies, the role of a putative protopathic bias could not be ruled out because an insufficient duration of follow-up; a lack of statistical power in subgroup analyses; and no consideration of the most relevant time window for exposure and ascertainment of confounders.  The most recent study found a similar 50% increased risk within the 15 years after the start of benzodiazepine use (average length of follow-up 6.2 years).  This excess risk was delayed and thus not indicative of a reverse causality bias. Another study found a positive association, though lacked significance because of its limited sample size.”

In other words, there is mounting evidence that benzodiazepines are causing AZD.  I cannot imagine any genuine medical specialty ignoring or downplaying information of this sort.  But psychiatry, with the perennial defensiveness of those with something to hide, promotes the idea that they are safe when used for short periods, knowing full well that a huge percentage of users become “hooked” after a week or two, and stay on the drugs indefinitely.

In the 80’s, I knew a psychiatrist who used to quip:  “The difference between Xanax and true love is that Xanax is forever.  You don’t take people off Xanax.”  I wonder how many of his “patients” have Alzheimer’s disease today?  And remember, Alzheimer’s is a truly devastating disease.

. . . . . 

In addition, the notion that the drugs are safe if used for 3 months or less is questionable.  There is no magic dividing line between three months and four months.  If a drug causes damage when used for four months, then it is reasonable to infer that it causes damage when used for three months.  The degree and scope of the damage for most people will probably be less, but it won’t be zero.

The relevant figures from the de Gage study are:

Relative Risk of AZD:  Benzodiazepine Users vs. Non-Users

Benzos and AZD.

The point about the 1.08 risk ratio for the 1-90 days individuals is that, given the sample size, it is too close to 1 to say definitively that it represents a real increase in risk.  There is a 95% probability that the risk for all 1-90 day users lies between 0.92 and 1.27.  So it could be just a random fluctuation in the data.

But when all these risk ratios are considered together, the most obvious interpretation of the table is that the risk is trending upwards as the cumulative dosage increases.  And bear in mind that the 1.08 ratio represents an average of people who have taken the pills for just a few days as well as people who took them for the full three months.  For the latter, the risk will almost certainly be considerably higher than 1.08.  The only thing we can say for sure about the 1-90 day users is that we can’t say anything for sure.  There is nothing in the de Gage et al data to suggest that the drugs are safe for use up to three months, and in fact, strong grounds for thinking otherwise.

Designing a randomized controlled trial to check for a causal link poses enormous problems, not the least of which is that almost all participants will be able to tell if they’ve received a benzo or a placebo.  In addition, an RCT has to be done prospectively.  So we wouldn’t have the results for another 10 or 15 years!  By all means this study should be undertaken, but meanwhile, shouldn’t we go with the best data that we’ve got?

The overall picture here is a steady accumulation of evidence that the drugs are causing AZD in some people, that the risk is dose-contingent, and that for people who have taken the drugs for 6 months or longer, the risk is approaching two-fold.  It is also particularly noteworthy that of the 894 study participants who used benzos, 66% took them for 6 months or more.

Certainly, less use is better than more use, but promoting the message that use up to 3 months is safe strikes me as irresponsible.  Given the numbers of people taking benzos and the number of people contracting AZD, risk ratios as low as 1.1 or even 1.05 represent an enormous additional burden of preventable disease. This is particularly relevant in that neither anxiety nor depression is an illness, and although popping a benzo may provide a temporary sense of relief, there are better ways to cope with these problems, that don’t entail any increased risk of AZD.

And Incidentally

Vabren Watts’ specialty is cardiology research.  He has a PhD in biomedical sciences from Meharry Medical College, and he completed his training in cardiology research at Johns Hopkins.  He has worked as a Science Expert Ambassador and as a Health Science Leader and Spokesperson for the American Heart Association.  He is the founder of The Science Journalist, where he provides freelance science/health reporting and technical writing services to various media outlets.  Since 2013, he has worked for the APA as a Senior Staff Writer on Clinical and Research News for the APA.

On his bio summary, he describes himself as a:

“Biomedical researcher and health science communicator dedicated to making scientific findings and policies more comprehensible to medical experts, stakeholders, and lay audiences.”

Two things strike me as noteworthy:  firstly that the APA has hired a professional writer (rather than a psychiatrist) to broadcast the de Gage result; and secondly, that the writer’s specialty is biomedical research.  So much for psychiatry’s recent attempts to persuade us that they have always espoused a biopsychosocial approach.

Also, I am reminded of a paragraph in Jeffrey Lieberman’s final Psychiatric News article as APA President.

“Mindful of the continuing stigma associated with mental illness and psychiatric treatment, we retained an outside consultant agency (Porter Novelli) to review APA’s communications capabilities, needs, and opportunities. Based on its report, we are now moving forward with an initiative to enact a sophisticated and proactive communications plan that will be directed both internally to APA members and externally to the media, mental health stakeholder groups, and the general public.”

So, to counteract stigma (which, incidentally, is largely a product of psychiatry’s spurious medicalization of human problems), the APA, with the help of a prestigious PR firm, has set up “a sophisticated and proactive communications plan.”  And presumably the hiring of Vabren Watts, and other talented young writers, is an integral part of this plan.

So here’s my question:  If everything one is doing is honest, above-board, and clearly beneficial, why would one need “a sophisticated and proactive communications plan” to communicate with one’s own members, the media, and the general public?

And why does the APA need to re-package the eminently clear message of the de Gage et al report?

* * * * *

This blog appears as well on Philip Hickey’s website,
Behaviorism and Mental Health

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45 COMMENTS

      • I was on Klonopin for some seven or eight years, starting at age 14. Definitely longer than 90 days. When I finally got off of it, suddenly my panic attacks virtually vanished—the “antianxiety” drug was largely causing (or at least exacerbating) my anxiety! I feel very fortunate that I was able to wean off a benzo in a matter of months, whereas so many out there suffer for years on end with the withdrawal. Hang in there, humanbeing.

      • I was on Xanax for approx 10 years, prescribed by a psychiatrist who told me my brain had a “benzo shortage” that taking Xanax would correct. I deteriorated over that 10 year period and finally had the wherewithal to wean myself off of them. There are a lot of us long-term users out there.

        I wish there was a way we could publicly name and shame these death-dealing fiends but not without risk of being exposed and sued.

  1. ‘Somewhere along the way, the message got lost, and patients were allowed to use benzodiazepines for months and years,’
    Oh, I love that one. A perfect example of blame-shifting. It’s not the psychiatrists who prescribe drugs irresponsibly against their own guidelines and best medical practice, it’s the patients who are allowed to take the drug because they didn’t get the message. Patients don’t write their own prescriptions in where I live and I believe not anywhere else in the developed world.

  2. Another note on:
    ‘If the cognitive decline is due to benzodiazepines, and the patient does not have an underlying dementia such as Alzheimer’s disease, the cognitive decline should reverse after stopping the treatment.’
    They make this claim about side effects of anti-psychotics too and also without (or simply against) any available evidence. I was assured that the restless leg syndrome cannot be caused by Zyprexa and Seroquel because it persisted after I stopped the drugs which is complete bs. similar claims were made about tardive dyskinesia. These people are criminals.

  3. Thanks for this frightening but necessary article, Philip.

    When I was first prescribed Xanax, 15 years before I tapered off from it, it was because the psychiatrist I was assigned had a problem with me taking a tiny dose of Atenolol as needed. They didn’t like that some musicians supposedly use it illegally to calm stage fright! Imagine my surprise when an acquaintance visited me the following year and stole a fistful of Xanax from me. Prior to that, I don’t think I knew that it had a street value.

    I heard later, from a different psychiatrist, that yes, Xanax, is addictive, but not if one suffers from panic attacks! I believe that story had something to do with “chemical imbalances,” which, contrary to current psychiatric spin, I have been told about by every psychiatrist I’ve ever met with, except one. (I’m not sure if this one disbelieved the story or thought that it just did not apply to me.) I never did become addicted – not in the sense of a person who takes more than is prescribed. But there was still hell to pay when I tapered off.

    I noticed during my last period of contact with “community mental health” that a new story had become popular. According to this story, benzos were very dangerous when taken by themselves, but not when taken along with one or more other psychiatric drugs.

  4. Neuroplasticity unfortunately does not allow healing. Once damaged you are damaged, particles and tissue cannot be put back into place. . You will have brain damage, but the brain can function and you will have a hard time noticing the effects of the damage unless it gets extremely severe and effects may appear later like dementia. Will there be differences, yes, but because the brain is not digital you will have difficulty telling each deficit or flaw .. Its why drug companies get away with f***ing people up , because the brain can withstand damage and the person won’t die immediately. They found in tests for example, in rats, that they can cut rat brain up and put it back in, the rat will still live and memories remain intact. In a human it will destroy intellect, but they will still live. Unfortunately there is hardly a way to accurately measure intellect and memory and function loss, and doctors have been covering up the obviously mutilating long term consequences for decades in favor of protecting their own asses and profits. You can even have loss like differences in learning, color and vision and hearing changes, sensation changes, muscle activation and coordination changes, energy level and efficiency changes and you will try to live w/ them or never even consciously be able to tell they are there thinking its just you or it is passed off as mental or physical illness or personality issues or life problems. Others might even notice the flaws more than you. . once scarred, the brain is scarred, antipsychotics were shown to cause the same level of damage: scar tissue , swelling of brain, vein swelling , fluid build up, brain shrinkage, etc. Yet somehow doctors are still allowed to prescribe these drugs like candy by force and they don’t have to admit to any of it? http://www.obamasweapon.com/

  5. Dr. Hickey,

    “Safe for a short period of time” is a recurring theme with these drugs.
    The question to be answered for each class is: What constitutes a “short period of time?”
    Especially neuroleptics.

    You state that Benzodiazapines can become addictive within a week or two of their use, and yet psychiatrists fail to point this out. Unbelievable!

    This topic came up on a recent blog post by Corinna. Specifically that taking a benzo for a day or two might be an option for much-needed sleep. Is a day or two a safe period of time?

    Some *fully* informed consent is needed, it appears. As difficult as it is, I think we need to allow people to make their own decisions with these drugs… to err on the side of individual liberty, if you will. The challenge, IMO is making sure people are *fully* informed.

    The FDA, NIMH and other federal agencies have failed in this area. So have private practitioners. This leaves individuals in the position to make these decisions…. hopefully, we’ll get to the point where they are *fully* informed to do so…

    Hopefully, most will make smart decisions; unfortunately, there will always be those who make not-so-wise decisions…. I’ve made a few along the way. I guess we all have. Live and learn.

    • Good points. A friend of mine has taken these drugs a few times for a period of 2-3weeks each to calm her down for a stressful work period and never suffered any immediate side effects. Nonetheless, I’m always worried for her since I know the feeling of being on benzos (it feels much too good – I knew they were addictive as soon as I took the first dose without anyone telling me). I think giving them to people who “need them” is the most irresponsible thing because these are the very same people who are most likely to get psychologically hooked up. It’s like prescribing marihuana or alcohol for anxiety – it’s a shortest way to a drug addict/alcoholic. Add their dangerous side effects on top of that and here are the reasons why they should not be prescribed almost (?) at all.

        • I believe it’s both. The chemical imbalance these drugs induce will cause all the withdrawal syndrome and tolerance but there’s also a psychological component which comes from getting high on them (which is basically not the side effect but the intended “anti-anxiolytic” affect). It also causes people to take these drugs for longer when they are more likely to get physical addiction you’re talking about.

          • No, I don’t agree…I don’t *crave* the drug AT ALL! I never did! I jsut took the tiny amount I was prescribed like a good patient for years without ever updosing. I recognize now the many problems I had during those years as tolerance withdrawal, but you still expound a bunch of stuff that you don’t know anything about…there is a huge difference in the definition of addiction vs dependency!

            I’ve tried getting support at NA meetings, but found it to be a poor ‘fit’ since I never participated in ‘drug seeking’ behavior (didn’t have to, my health care practioner just renewed my ‘scripts routinely), I never CRAVED the drug…and while it did, ultimately, ruin my life, my biggest mistake was not having access to the information to make an informed decision.

          • It may not be true for everyone. Some people get high on marihuana and some not so much. I personally had a full blown high on a single supposedly small dose and had tolerance on the second dose (so they upped me of course). Plus the relaxation the drug produces is pleasant when compared to the cramped stiffness of muscles. In any case I totally see how it can create psychological addiction in some people.
            I don’t distinguish addiction and dependency – I think the distinction is irrelevant. The only relevant part is psychological addiction and physical addiction (the one you’re describing).

  6. As dangerous as these drugs are, and as irresponsible as the people are who prescribe them by the handfuls like candy, the drugs need to be banned from the market. They need to quit making them, period. People are being permanently damaged or killed because of these drugs and absolutely nothing is being done to stop any of it.

    • Stephen,

      I hate these drugs as much as you do.
      I hesitate however to allow the government to become the nanny state of the people.

      It has failed miserably in making sure the public is aware of the dangers of these drugs. I have no faith in their ability to eradicate their use.

      I would be for outlawing them for children.
      Children cannot give legal consent.

      Duane

      • I would be for making all psychotropic drugs illegal for children – starting with foster care and Medicaid in each of the states.

        And for requiring a form be signed showing that a person has received *fully* informed consent – the good (if any); the bad, and the ugly – starting with federal programs – ie, VA, Medicare. Duplicating this for patients seeing private practitioners, required by federal law.

        Duane

  7. Can someone please tell me what class of drug Sonata is? I’ve been told that it’s not a benzo but from what I see when people use it you could sure fool me. It lowers inhibitions, just like Xanax does with many people. I would appreciate it if someone could answer my question for me.

    • From Wikipedia:
      “Zaleplon (marketed under the brand names Sonata, Starnoc and Andante) is a sedative-hypnotic, almost entirely used for the management/treatment of insomnia. It is a nonbenzodiazepine hypnotic from the pyrazolopyrimidine class.”

        • Thanks B and John

          This was a big help. The people that I know that are using Sonata as a recreation drug keep touting that it’s not a benzo so it’s ok to “chill out” with it. I’m not to sure myself. I have a feeling that it’s not going to lead to anything good when being used for “chilling.”

          Thanks again for your help. I didn’t even think of Wikipedia; I’m kind of technology challenged because of my age and don’t know where to go to find a lot of answers.

          • Here is a bit more from the Benzo site I mentioned:

            ““The three Z’s”
            Later drugs have been introduced which are often claimed to be free of the problems which the benzodiazepines have. The key drugs are Zolpidem, Zopiclone and Zaleplon (see drug identification). It is difficult to be certain how addictive they are but indications suggest that they should be treated at least as cautiously as benzodiazepines. Many more adverse reactions have been reported for Zopiclone, for example, than for the much older diazepam. It should be noted that the “three Z’s” are taken up at some of the same, very specific, receptor sites in the brain used by the benzodiazepines. Their action is therefore similar. Prescribing advice (BNF) is that they should not be used long term.”
            http://www.bataid.org/whatarethey.aspx

          • Personally I’d stay away from all these drugs just as I would stay away from most illegal drugs. There are all essentially narcotics. There may be some health benefits for taking some of them in some instances as it may be for alcohol or marihuana but I have not seen much evidence so far. And no I don’t consider tranqulisation or high or any of the psychological effects medicinal.

        • Oh so it’s an “atypical”… Lovely. If it targets the same receptors it’s going to work in much the same way. Changing a few active groups usually does not improve anything much because most of side effects are mediated by the same biochemical pathways as the “desired” effects.
          I looked up the target receptor (GABAa) and the chemical structure ( a similar aromatic core) and it’s likely they will be all essentially the same…

  8. B-here is a comment by one of the moderators on BenzoBuddies;

    After personally experiencing the aftermath of chemical dependence on benzodiazepines I’m not sure why anyone would think that it is not important to differentiate between a physical condition and a psychological one. Every time someone perpetuates the idea that these two conditions are one and the same they are perpetuating the problem.

    It IS important to distinguish the difference between the two! Unless you’ve lived it, you can’t go around expounding your ‘viewpoint’!

    • I do differentiate between the two. My point is – when you get psychological addiction first (which can happen fast if someone is in a mental s**thole) then it just facilitates physical addiction which can take longer. Although for many psych drugs I believe that it can happen pretty fast too (the withdrawal I experienced from Zyprexa was after one dose only so I guess if I stayed on it for a few weeks I’d be physically addicted).

  9. Excellent work. The trouble with truth in medicine is that the money stream dries up. Unfortunately, as I am sure you know, the whole world now functions around finance. Still it is a shock to see men and women who are respected as doctors deliberately making their patients sick in order to have a good income. A bad dream for me; a nightmare for those on these drugs and I suppose for those who have quit but have a history of their usage. The latter group worry me as this is very bad news indeed. On the other hand good nutrition and meditation may undo the negative consequences.

  10. I have now been on Klonopin for 20 years. I was first put on it when I was 14 for vertigo and then later for panic attacks. I then developed a physical addiction and psychological addiction where I was taking up to 15mg a day (in combo with ativan, which my doctor was prescribing in addition to the Klonopin). I started having seizures after multiple times trying to withdraw myself and ten years later still haven’t stopped (even while being back on it. I’ve been on a maintenance dose (1mg) for the last few years for seizure control (which I believe is just keeping me from going through withdrawal) and am not trying to titrate over to Onfi. Does anyone know much about Onfi? I really do fear I’ll never be free of Klonopin no matter how hard and what I try to do.

  11. I took Xanax for ten years in my teens and stopping it was a living hell. It took 2 years. With that said, I use klonopin only for thunderstorms. I also take Lamictal and Dexedrine and have been on those for years… Lamictal isn’t the hard one but the Dexedrine is one I have to do very slow and learn skills before dropping the dose because I have taken it since age 5… I went from 115 mg/day to 60 so far. I can do cold turkey but I am like a 15 year old without it and I am going the slow route

  12. I spent 16 ignorant years on clonazepam (1mg. +/- daily) until the worsening side effects convinced me to research this drug. I am devasted that I very likely have Alzheimers disease at 58 years old. I did a semi-rapid withdrawal from the drug about 15 months ago and my memory loss and brain fog have not improved. My only hope lies in the new molecule being developed by Roche as a GABA-A a5 inverse agonist (this drug is being targeted towards Downs Syndrome), but that drug is likely years away (at best) from being released to the public, so my life is probably over….. RIP

  13. Dr Hickey – I took Xanax for 3 years and stopped when it no longer worked. I was prescribed Klonopin, took 1mg for 8 years and stopped 6 months ago. It has been difficult. The memory problems and foggy thought patterns are, if anything, worse than when I was on the medication. And that is not all. I also have shortness of breath, accurately described by a friend as ‘scary breathing’. Back in 2014, after reducing my Klonopin dosage by half, I had the same problem and saw two different pulmonologists and a heart specialist who found no problems whatsoever. After a hellish few months, I was at wits end and went back to my full dosage of Klonopin. The breathing problems ceased. I recount my history to bolster my feeling that the medication separation 6 months back is the cause of my breathing issues. For me, going back on Klonopin is not an option. I’m 67 and otherwise healthy. Does anyone have any suggestions that may relieve me scary breathing? Thank you.