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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Kon on December 8, 2003, at 12:57:11
I thought some might find this recent piece by Dr. Healy interesting:
http://www.socialaudit.org.uk/58092-DH.htm#SSRIs%20&%20WITHDRAWAL
Some interesting quotes:
"As of 1988 the CSM produced a clear statement saying that benzodiazepines cause dependence. The warnings derived from this statement are still in force today. These warnings use a version of the word dependence, which, if it were applied to the SSRIs now, would have to lead to the SSRIs being regarded as dependence producing."The statement regarding the benzodiazepines was not based on laboratory experiments, nor was it based or animal research demonstrating drug dependence nor on clinical trial evidence demonstrating a severe, long-lasting, or serious condition. The statement regarding the benzodiazepines was not based on any of the points pharmaceutical companies now insist be demonstrated for SSRIs before they can be regarded as dependence producing."
"There is in fact no basis for distinguishing clinically between the normal dose dependence produced by benzodiazepines and the normal dose dependence produced by the SSRIs. There almost certainly will be some differences between the two in various animal models, just as there are between different antidepressant groups, but at present there is no systematic set of clinical criteria to distinguish the two phenomena."
Posted by jay on December 9, 2003, at 7:53:35
In reply to SSRI versus benzodiazepine withdrawl/dependency, posted by Kon on December 8, 2003, at 12:57:11
I am always hesitant to believe far-reaching statements regarding dependence, addiction, etc. It seems quite often, and likely for political reasons, it's always "blame this med...or that med" and suggested people are "dependent" on it. You can pretty much become "dependent" on *anything* out there, especially if used repeatedly, and when dispensed with care and sense, benzos and SRI's can be weaned on and off. The real problem comes when people either stop and start, again and again, or do not taper properly under a doctor's supervision. There are millions of very successful people out there, living happy lives, who are on an SRI and/or benzo, or any type of antidepressant. I've worked as both a detox and an addictions counsellor, and I can easily spot when there is a problem with dependence and/or addiction. Issues regarding both mentioned psych meds are way overblown...in my years of experience.
Best,
Jay
Posted by Kon on December 9, 2003, at 12:32:53
In reply to Re: SSRI versus benzodiazepine withdrawl/dependency » Kon, posted by jay on December 9, 2003, at 7:53:35
Actually I agree with most of what you say. The problem and what I believe the main point of the article was, is that given very similar potential risks/problems between SSRIs and benzos;
1. Why are benzos singled out over SSRIs as being potentially more problematic. This occurs not only in the UK but also in many other countries. For instance, in Canada, federal legislation singles out Benzodiazepines in a separate class that supposedly has a higher potential of abuse, etc,. SSRIs are not. What this does is to make docs more likely to prescribe SSRIs over benzos when in fact, benzos would have been a better choice for many patients.
2. Why do most studies that initially praise clonazepam for it's usefulness in a number of disorders including Social anxiety disorder, still do not recommend it as first line therapy in such disorders because of potential for dependency. Don't SSRIs have the same risk potential. In fact, judging from the UK and WHO data, the SSRIs are more likely to cause problems (see the article).
So the issue is not so much potential for dependency, etc. but objectivity in evaluating, legislating the different medications.
This is the end of the thread.
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