Posted by yxibow on March 26, 2006, at 4:11:19
In reply to Re: benzo's for anxiety (which one?) » yxibow, posted by special_k on March 26, 2006, at 2:08:25
> Ah. thanks for jumping in. we crossed posts just then.
>
> > diazepam exceeds a 24 hour half life...
>
> that means that half of it goes away (or is metabolised or whatever) in 24 hours (or longer) but the rest of it is still hanging on in there?Correct. In medicine, it is generally assumed that a medication is "flushed" from the body after 5 half lives -- I believe averaged from mathematical curves, I don't remember where that figure came from. Which means that Prozac will not leave your body for more than one month.
>
> geez. that is a long time. i was checking out the equivalence charts last night (though I was falling asleep rather...) and i noticed it had a very long half life...Yes -- the equivalence charts vary slightly but dr-bob's one that is listed first on this site is mostly accurate.
>
> > I take it twice daily...
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> So given the long half life and your taking it 2x daily... you would have a bit of a cumulative effect... Because your morning dosage is still in effect when you take your evening dosage. and because half of your morning dosage is still in effect when you take the next mornings dosage
>
> morning----evening----morning.. (and then half is gone)
> ................evening----morning.. (and still going strong)
> ...........................morning.. (and still going strong)
>
> or am i misunderstanding the notion of 'half life'?No, you're building a table, you could draw a bell curve, and eventually all the bell curves start to flatten out, but you might get a spike here and there due to some idosyncratic reasons.
>
>
> >as it has three metabolites -- nordiazepam, temazepam (Restoril), and oxazepam (Serax.)A medication typically has metabolites, the breakdown of the medication in your bloodstream. Valium happens to break down into nordiazepam (main and most prevalent metabolite, I forget if it is marketed anywhere), and smaller quantities of temazepam (Restoril), and oxazepam (Serax.)
>
> sorry i lost you with that bit
>
> but what did you start out on?
> what sort?
> how often?
> how much?
Oh, that would have to date back 4 years, but the disorder reared is ugly head (I take a polypharmacy of other medications) and it was gradually uptapered to 4+ mg (Klonopin), eventually close to 8, when we decided to switch to Valium. But there were a lot of complicated reasons why the medication was increased, and other medications were added as well, including Neurontin and various antipsychotic trials leading to Seroquel and a whole host of things which leave my life under guarded control shall we say (I'm not pyschotic btw, I just take neuroleptics for the D2 antagonist -- visual pathways), but make for some disconnection from life as I knew it before this all came to pass more than 4 years ago. Of course a lot of the disassociation is from the main disorder too.I don't feel anxiety any more -- not mostly, though there are breakthrough periods. Things are at a semi-manageable but not cured situation so far. A lot of things are also psychological in nature too, though I have a lifelong history of OCD (this is not anything like OCD).
So, what do I take for breakthrough periods -- Xanax, and I try to take it as little as possible.Otherwise, the Valium and indirectly the Neurontin manage GABA. The Seroquel of course has some roles in this too, but they're more complicated pathways.
If I ever have to go down on Valium because something else has worked, it will take quite a while... there's always time, its usually about 10% a week or less.
I believe benzodiazepines are the safest psychiatric medicines prescribed, with a caveat that each persons metabolism is different, and though they're not barbiturates, large quantities of them for people not used to that especially, can cause respiratory (lung) depression (after all, they relax... everything).
So that's not a good situation. I would say that if you were asking a psychiatrist for a long term benzodiazepine and you explained your reasons and the long half life and made some promise because of your prior history of abuse that there would be a limit, something like Valium would probably be a good maintenance drug at a small reasonable dose, with something like Ativan or Xanax for uncontrollable panic episodes. I've never taken Serax though I've been told it would be somewhat disappointing compared to Xanax for emergency use. But all the above is just my opinion and my experience. You could say, a case report. In fact most postings on here are, which are valuable, but you have to take in account your own body and brain.
Tidings and Cheers
-- J
poster:yxibow
thread:624663
URL: http://www.dr-bob.org/babble/20060322/msgs/624745.html