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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by KaraS on February 5, 2005, at 17:12:42
My pdoc said that the longer acting benzos are more apt to produce tolerance. My previous pdoc said it was the opposite. Which is it?
Posted by med_empowered on February 5, 2005, at 17:19:13
In reply to short or long acting benzos produce more tolerance, posted by KaraS on February 5, 2005, at 17:12:42
from what I understand, no one really knows for sure which (short or long acting) is more likely to produce tolerance. It has been noted that abuse is more common with some short-acting benzos such as xanax than some longer-acting ones, such as Klonopin...this, however, doesn't mean all short-acting benzos tend to be more habit-forming. RIght now, benzos (especially Klonopin) are back in vogue for anxiety, and mostsly in long-acting form--the shorter-acting forms had their day when Ativan and Xanax dominated the landscape. Sooo, psychiatrists tend to believe that longer-acting is better..the idea being that there's less re-dosing during the day, hence less exposure=less tolerance. Who knows, they may be right. Then again, one could easily use a short-acting benzo PRN w/o major problems or even dependence.
Posted by jasmineneroli on February 5, 2005, at 18:11:49
In reply to Re: short or long acting benzos produce more tolerance, posted by med_empowered on February 5, 2005, at 17:19:13
I think it has more to do with the action the benzo's have, and the purpose for taking them.
For instance, there might be more of a tolerance issue to the sedating benzo's, OR benzo's taken in higher doses for sleep. For some reason, people seem to need more and more to achieve the same sedating quality. Sedation is the first side effect to go away when starting on a benzo, in my experience. I just think it's a temporary effect, until the body adjusts. I'm wildly guessing that this mechanism is not so much to do with GABA as something else!
Also, Xanax and Ativan, seem to give an uplifting, or slight "kick" effect, as well as an anxiolytic effect. People then get to enjoy this added bonus, but it wears off, as they adjust to it, like the sedation SE. So, people "want" a higher dose to maintain the bit of euphoria. This may be more a "psychological" tolerance, than a physiological one, too. Again, I think there's something else involved in these benzo's effect, than just GABA. Anyone know??
It seems to me, that those same people are still getting an anxiolytic effect from the drug. Just not the "lift".Whereas, Klonopin, is not particularly sedating in the average dose range (especially after the first week), nor does it have the "kick" of Xanax. I know that it has a weak serotonergic effect, in addition to GABA. This may account for it's different qualities, and the fact that a lot of people do not seem to build up a tolerance as much to Klon. as to some other benzo's.
Just my thoughts.
Jas
Posted by Phillipa on February 5, 2005, at 18:25:33
In reply to Re: short or long acting benzos produce more tolerance, posted by jasmineneroli on February 5, 2005, at 18:11:49
How well I know! But, what explains the fact that xanax used to just "relax" me and not it makes me tired? Or it did the last time I took it during the day. Wait a minute! This tappering thing has me taking .25mg in am. Then all those drugs at bedtime. Again, I'm a pdoc's addict. Fondly, Phillipa
Posted by CareBear04 on February 5, 2005, at 18:34:38
In reply to short or long acting benzos produce more tolerance, posted by KaraS on February 5, 2005, at 17:12:42
i think it's both, but the effect is more noticable with the short-acting. i take xanax 1mg four times a day. after about a year and a half, i'm so used to feeling the crash from one dose and popping in the next. take away a dose and i don't know what to do with myself.
i've also taken 2mg of klonopin, ativan, or something along with ambien and other sleeping meds at night. i don't feel the need for them in a physical way, but when i don't take that 2mg, i feel my sleep is less good.
Posted by FaithT on February 6, 2005, at 7:29:44
In reply to short or long acting benzos produce more tolerance, posted by KaraS on February 5, 2005, at 17:12:42
Hi Kara~
I've taken Xanax along with Effexor for close to 3 years now. I personally prefer the fast relief that the regular Xanax provides, over Klonopin or Xanax XR. It helps if you have panic issues along with clinical depression, which I do. Most Docs. will try a longer acting benzo, if you're going to stay on it long term, but they just didn't work for me.As far as builing up a tolerence, I guess that I'm not the best person to answer that because I had to start at 4 mg. per day for panic issues, which obviously isn't a low dosage. The maximum that you can take in a day is 10 mg. for panic, and yes, I have had to take that much on very bad days, like when I've had CAT scans, MRI's etc.
I can't say that I've built up an actual tolerence, because the medicine still has the same effect on me, in that it takes away the panic. I never felt high on it, or sleepy. It just does what it's supposed to do.
Best wishes, Faith~
Posted by KaraS on February 6, 2005, at 14:32:04
In reply to Re: short or long acting benzos produce more tolerance » KaraS, posted by FaithT on February 6, 2005, at 7:29:44
This is the end of the thread.
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