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Re: [psychiatry-research] News: Anti-Anxiety Drugs Raise New Fears

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  • Roger Lass
    Chittaranjan: It s nice to see some quiet and unhysterical discussion as you say rather than polemic. I m simply following my psychiatrists prescription
    Message 1 of 66 , Jun 30, 2009
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      Chittaranjan:
       
      It's nice to see some quiet and unhysterical discussion as you say rather than polemic. I'm simply following my psychiatrists' prescription (obviously), and my GP's before that.
       
      I may be one of the lucky ones. In 15 years I have only developed marginal tolerance, and as long as I keep my routine in place (.5mg bid, with an occasional extra .5mg if needed) I seem to be fine. I know about its addictiveness, and I see your point. I have tried dothepin, and in general I do not react well to tricyclics, though in a few crises my doctor has prescribed imiprimine which was splendidly anxiolytic, but threatened to kill me from uremia.
       
      My problem with a sedating drug (note that I take Wellbutrin) is that I'm a working academic who cannot afford any cognitive depression or sedation, so have always taken activating drugs. Also the reason I have not taken mood stabilisers even though I'm bipolar with rapid cycling. Rather take my chances, and (you will probably be horrified, and my psychiatrist at least raises an eyebrow) use alcohol as a fine-tuner of mood.
       
      Anyhow thank you for responding at all, and in such a civilised way. We need more of this on this group, and less hysteria about whether mental illnesses are real diseases (a reifying non-question) and Scientology
       
      R
      ----- Original Message -----
      Sent: Wednesday, July 01, 2009 6:12 AM
      Subject: Re: [psychiatry-research] News: Anti-Anxiety Drugs Raise New Fears

      Roger:
      That's a nice testimony to a group where most of the postings gripe about psychiatry in general and medications and pharma companies in particular.

      My two bits on this subject are, with apologies, in line with the tenor of the average posting. My first-line treatment for anxiety is actually a tricyclic drug; dothiepin 25-75 mg/day is very well tolerated, effective, and offers sedation at the higher dose for patients with insomnia.

      I think that alprazolam should be taken off the market because it is one of the most addictive of the benzodiazepines. I agree that benzodiazepines are the best anxiolytics available; they beat the SSRIs and venlafaxine hollow in the speed of action and the magnitude of response. Among the BDZP, clobazam tops because it is a good anxiolytic with a low propensity to sedate, impair psychomotor functioning, and addict. A disadvantage is that clobazam does not induce muscle relaxation, which can be a problem in patients with associated tension headache and other muscular and somatic complaints associated with anxiety. For such patients, the much maligned diazepam works wonders, even in refractory cases.

      I don't prescribe pregabalin for anxiety because of the risk of weight gain.

      That was a bit more than two bits, wasn't it?
      Best wishes,
      CA


      On Tue, Jun 30, 2009 at 7:56 PM, Roger Lass <lass@...> wrote:


      Let's not get too hysterical. There's another side to this story.
       
      Benzodiazepines can be true life-savers for the right people, and many doctors (correctly in my estimation as patient) prescribe them for life. I've been taking alprazolam (Xanax) for 15 years, have only raised my dose slightly and not every day, and find no sedation, distinct withdrawal of course if I miss a dose, no interaction of note with alcohol or sleeping pills, above all no loss of mental acuity and a distinct mood-brightening effect. As far as I know alprazolam is the only benzo that does this.
       
      If it is possible to have a personal relationship of deep affection for a drug I have it for Xanax. It fights anxiety and panic, and as important, it defuses some of the effects of the very activating antidepressant I take (Wellbutrin).
       
      Different countries have different habits of prescribing. In South Africa anyhow, it is common to prescribe benzodiazepines and hypnotics for life, I think correctly. Severe anxiety is a chronic and serious disease that should be treated with drugs like Xanax the way diabetes should be treated with insulin.
       
      I also take a benzodizepine hypnotic (only a few months, before I took zopiclone for a decade and a half), and the only problem I find is rebound insomnia if I accidentally fall asleep before I take the pill); have taken hypnotics for over 20 years.
       
      If anybody wants background information my diagnosis is Bipolar II with rapid cycling.
       
      Anyhow, thought I'd give the other side, and come out with a little applause for the benzodiazepines, one of the great inventions of the drug manufacturers, and a bright spot in my life.
       
      R

    • Dixie Dean
      Message 66 of 66 , Jul 22, 2009
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        <Whereas 'matter is the only thing that exists' (a) allows a 3-rd person perspective for looking at the mind, (b) makes it an organ like the liver that medicine can treat, and (c) coheres with what we know about the world through western reductionist science>

        Is this not convenience rather than rigorous search for truth?  Hence does it not exclude truth from your interests Roger?

        <Arguments start from premisses, and premisses start from what? We don't know yet>

        Surely we mustn't knowingly start from any shaky or false premise?  Is not search for truth the oldest and greatest effort of humanity underpinning ALL research and serious thought?

        Richard Dawkin's thought is militant, self-limited and of closed mind since he admits refusing to consider emotion saying they're no more than "the outcome of brain activity".  A bit lame and certainly not philosophically sound, don't you think?

        dixie
        -----

        Roger Lass wrote:
         

        Thank you. All I was arguing was that in mainstream neuroscientifically informed philosophy it is the case that the usual position is anti-dualist and materialist, and that this too is a position that is legitimate, and can be argued for on epistemological grounds (parsimony among other things). And that the position as argued in 1992 by Dennett in Consciousness Explained and by Damasio later in Descartes' Error has not been 'refuted' or falisified, and one is entitled to believe it.
         
        It's important to realise that different people have different tolerances and abilities to believe or even understand things. I find 'consciousness is the only thing that exists' incomprehensible, sufficiently so that I don't feel inclined even to pursue the notion. Whereas 'matter is the only thing that exists' (a) allows a 3-rd person perspective for looking at the mind, (b) makes it an organ like the liver that medicine can treat, and (c) coheres with what we know about the world through western reductionist science. And to me personally that's the only way of knowing. Arguments start from premisses, and premisses start from what? We don't know yet. Only that in this context mine, which are accepted by people I respect intellectually like Dennett and Richard Dawkins and Nicholas Humphry and Francis Crick and Steven Pinker are as legal as anybody else's, and philosophically sound.
         
         
         
         
        ----- Original Message -----
        Sent: Tuesday, July 21, 2009 11:33 PM
        Subject: RE: [psychiatry- research] News: Anti-Anxiety Drugs Raise New Fears

        Apology accepted, IF you were trying to label me as religious. Otherwise, an apology is not necessary.
         
        Consciousness is NOT a material object. Basically, consciousness is the only thing that exists, and all else is constructed from it. No, I can't "prove it scientifically, " although I can point to evidence to support the assertion. And, no, you would never accept the evidence. I did not explicate my idea of the new science, precisely because you would reject it out of hand. I'm not into wasting my time.

        The correct title of the book by Popper and Eccles (OOPS!) is "The Self and its Brain," rather than what i said before. You knew it anyway, thankfully. I agree that it's a bit fluffy and very short on details that I would have like to see addressed. I merely cited it as an example of alternative thinking by a couple of famous people.
         
        I agree that your benzo posting was legit, and I think that this one is, too. As I said to Jim G (not related to Ali G), I think your perspective, with which I almost always disagree, is valuable, and I encourage you to continue. (I'm not sure it's my place to encourage you, but here it is anyway.)
         
        ka

        To: psychiatry-research @yahoogroups. com
        From: lass@iafrica. com
        Date: Sun, 19 Jul 2009 08:07:58 +0200
        Subject: Re: [psychiatry- research] News: Anti-Anxiety Drugs Raise New Fears

         
        Sorry if I mislabelled you. At the moment I am philosophically unhappy in what purports to be an empirical arena worrying about qualia and first-person uniqueness. I don't see why consciousness, if it is (as I think necessarily) a  material object, requires special epistemic procedures.
         
        I'm not sure I know what your new science is, but I would probably reject it.
         
        As for that silly book by Popper and Eccles, I lost my respect for Popper when I read it. I think it's mystical and soft. Popper was a great philosopher, a clarifier of the domain of epistemology; even when he became a kind of caricature of himself at times back in the days when he was tangling with Imre Lakatos and being a self-conscious Wise Man.
         
        But That Book is an embarrassment. In the dialogues  he talked about things 'that exist but exist nowhere'. Frankly this might be acceptable in the ontology of one of the more philosophical Church Fathers, but it has to me all the depth and conviction of Tertullian's 'certum est quia absurdum est'.
         
        As promised, and because of (correctly taken) comments that people have made about the change in character in this list, a change I have have, I regret, helped to foster, I will bow out of philosophical/ polemical discussions, or try very hard, and get back to postings on the issues that belong to the list. I think my postings on benzodiazepines were legitimate; I rather doubt this is.
         
        R
        ----- Original Message -----
        Sent: Saturday, July 18, 2009 9:11 PM
        Subject: RE: [psychiatry- research]
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