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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Jim Bob on September 16, 2002, at 10:05:18
Hey all,
I have a question for all of you. You may have seen my earlier post asking about benzo. tolerance. I realize that all benzos. work differently for different people, but why is it that most pdocs. seem to more readily use klonopin than valium?? Isn't klonopin far stronger and therefore more addictive than valium? I read somewhere that 0.5 mg. klonopin is equivalent to around 12mg valium. For me, valium is the only benzo. that works well without having a "crashing" feeling on the come-down. My pdoc. first put me on 0.5 mg. klonopin 3 times a day for chronic anxiety. This would be equivalent to about 36 mg. valium daily if the conversion is correct.
When I told him that the klonopin was making me crash into depression as it wore off, and that valium never gave me that feeling, he withdrew the klonopin and put me on only 5-10 mg. valium daily. Why the sudden yank?? Is my conversion not correct? Is there some reason why pdocs. hesitate in prescribing valium? Now, since 5 mg. valium does nothing for me, I'm forced to ration my 10 mg. of valium once a day during my most anxious period. What should I do??? The only other med. I'm on is Ritalin LA 20 mg. daily.
Thanks,
Jim
Posted by fachad on September 16, 2002, at 12:13:34
In reply to Valium Underused Benzo. -- Why??, posted by Jim Bob on September 16, 2002, at 10:05:18
I would suspect that Valium is underused for several reasons.
First, it has a high profile as a "drug of abuse". Like Xanax, this makes some docs more reluctant to RX for it.
Part of the reason why it has this reputation is based on a pharmacological fact: it has a more rapid onset than onther BZDs because of it's lipophilicity. It is absobed more rapidly, and produces more of an onset euphoria than other BZDs.
Finally, when Valium is metabolized, other BZDs with very long half lives are produced in the process, and the end result is that they build up in the system over time. Klonopin has no active metabolites, so it is considered a "cleaner" med.
Just some posssible explanations.
> Hey all,
>
> I have a question for all of you. You may have seen my earlier post asking about benzo. tolerance. I realize that all benzos. work differently for different people, but why is it that most pdocs. seem to more readily use klonopin than valium?? Isn't klonopin far stronger and therefore more addictive than valium? I read somewhere that 0.5 mg. klonopin is equivalent to around 12mg valium. For me, valium is the only benzo. that works well without having a "crashing" feeling on the come-down. My pdoc. first put me on 0.5 mg. klonopin 3 times a day for chronic anxiety. This would be equivalent to about 36 mg. valium daily if the conversion is correct.
>
> When I told him that the klonopin was making me crash into depression as it wore off, and that valium never gave me that feeling, he withdrew the klonopin and put me on only 5-10 mg. valium daily. Why the sudden yank?? Is my conversion not correct? Is there some reason why pdocs. hesitate in prescribing valium? Now, since 5 mg. valium does nothing for me, I'm forced to ration my 10 mg. of valium once a day during my most anxious period. What should I do??? The only other med. I'm on is Ritalin LA 20 mg. daily.
>
> Thanks,
> Jim
Posted by Squiggles on September 17, 2002, at 15:45:49
In reply to Valium Underused Benzo. -- Why??, posted by Jim Bob on September 16, 2002, at 10:05:18
I've wondered that myself. I think it's
because Valium is an old drug. New drugs
are popular in drug marketing. Replacements
are made every year, presumably targeting
neuronal receptors more accurately.Squiggles
Posted by Seamus2 on September 17, 2002, at 22:31:15
In reply to Re: Valium Underused Benzo. -- Why?? » Jim Bob, posted by Squiggles on September 17, 2002, at 15:45:49
>Replacements are made every year, targeting >neuronal receptors more accurately.
Or pocketbooks...
I have Valium and Xanax lying around, and though rarely take either, I take them for different reasons. The Valium is longer acting, slower onset, and seems to have a more physical effect.I wonder if anyone is still using meprobamate (Miltown?) at all any more.
Seamus
Posted by shar on September 18, 2002, at 18:00:18
In reply to Re: Valium Underused Benzo. -- Why??, posted by Seamus2 on September 17, 2002, at 22:31:15
Y'all must have more flexible pdocs than mine.
I've always thought the backing off Valium in the U.S. was because of Big Brother. Xanax, too. Almost like brand ID or something. Docs I've known have always been very uneasy about scripts for valium, though no worries about clonazepam.
Shar
Posted by IsoM on September 18, 2002, at 20:06:57
In reply to Re: Valium Underused Benzo. -- Why??, posted by Seamus2 on September 17, 2002, at 22:31:15
From what I seen with Miltown & heard from one doctor too, it's VERY addictive, Seamus. A person may have the sort of make-up that tends to get addicted easier than others but not be aware of it from never having abused anything before. Put them on Miltown for longer than a very brief stint & they could get hooked too easily.
Stopping it is a nightmare - literally too. I saw it in one person & they went through hell coming off it & they'd not even been on it long or on more than a low dose. They had nightmares & horrid sleep for a loooong time afterwards. There's many meds far, far better than having to take Miltown.
Posted by utopizen on September 18, 2002, at 21:50:48
In reply to Re: Miltown -- Why?? » Seamus2, posted by IsoM on September 18, 2002, at 20:06:57
Miltown, made famous in the '50's by Milton "Miltown" Berle at the time, was discontinued in 1994 after the FDA "advised" the company who made it to stop selling it. (If an FBI and their SWAT team are behind your door, can you consider the command "open the door" as an advisement, too?)
Anyway, after it became the best-selling drug at the time (I believe) in the 50's, it was found in the 60's as addictive. Ironically, it came on the market with the selling point that it was not addictive, and seen as a replacement to the barbs.
To no surprise, Milton Berle eventually switched to Valium, since he's known for remarking, "you're only addicted to Valium if you take more than your doctor."
People claim (or like to think) we live in an over-medicated society, but I wouldn't be surprised to find that more psychotropics were taken in the 50's and 60's. It seemed everyone was on Miltown, barbs or barb and amphetamine concoctions...
As if Methedrine (injectable methamphetamine, today only allowable in hospitals as an antidote to anesthetic overdoses) ever had a legitimate use in retail pharmacy sales! Or what about Dexamyl, which was Methamphetamine (also considered Desoxyephederine) and Phenobarbital (a barbituate)!
Worse yet, Dexamyl syrup was available, and widely (ab)used...
Dexamyl syrup. Maybe the FDA was take too much Miltown at the time to bother noticing its existence! : )
> From what I seen with Miltown & heard from one doctor too, it's VERY addictive, Seamus. A person may have the sort of make-up that tends to get addicted easier than others but not be aware of it from never having abused anything before. Put them on Miltown for longer than a very brief stint & they could get hooked too easily.
>
> Stopping it is a nightmare - literally too. I saw it in one person & they went through hell coming off it & they'd not even been on it long or on more than a low dose. They had nightmares & horrid sleep for a loooong time afterwards. There's many meds far, far better than having to take Miltown.
Posted by Seamus2 on September 19, 2002, at 9:37:52
In reply to Re: Miltown off-market in 1994, posted by utopizen on September 18, 2002, at 21:50:48
Walgreen's has meprobamate for sale.
Dexamyl contained amobarbital, not phenobarbital.
Posted by pfinstegg on September 19, 2002, at 11:10:41
In reply to Re: Miltown off-market in 1994, posted by Seamus2 on September 19, 2002, at 9:37:52
As one of the "old-timers" on the board, I have used meprobamate on an occasional basis for both anxiety and sleep for many years. It is no longer a controlled substance, and is available only as a generic. I have found it to be a mild, safe drug, with no withdrawal problems or tendency to need to increase the dose. The benzodiapenes are too strong for me- I find this just right, when needed.
Pfinstegg
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