From: mdkline@rodan.acs.syr.edu (Mark D. Kline)
Subject: Re: Getting off Xanax
Organization: Syracuse University, Syracuse, NY
Date: Sun, 20 Dec 92 09:54:54 EST

In article <1992Dec16.212706.0905072@locus.com> yazz@locus.com (Bob Yazz) writes:
>
>| The unsolicited testimonies about what a wretched drug Xanax is
>| continue unabated here on sci.med.  And notice that none of the
>| other benzodiazepines seem to be generating the same kind of stories.
>
>mdkline@rodan.acs.syr.edu (Mark D. Kline) writes:
>| Ask around, there are plenty of people who are quick to bad mouth
>| Valium.
>
>Mark, I haven't seen a single withdrawal-from-hell story about Valium
>here on sci.med, and I've seen loads of them about Xanax.  Not to suggest
>anything silly like Valium lacks addictive potential.  I'm just saying
>story after story here on the net.

This is a market share phenomenon.  People had problems with Valium,
it became unfashionable, Xanax was introduced; it has somewhat different
pharmacokinetic properties, was demonstrated effective in panic disorder,
it has some antidepressant efficacy - zingo, big money maker for Upjohn.
LOTS more people are taking Xanax than Valium now. 

>
>| Prescribing docs have better sources of information.  There is nothing
>| wrong with Xanax.
>
>With all due respect, I don't think you know what you're talking about.
>Let me be more clear.  I think that those who specialize in addiction
>recovery (some docs, some not) generally know much more than prescribing
>physicians do about this whole issue.  

With all due respect, I think I disagree with you.  I'm all in favor of
people getting their lives together, but 12 step program people are a
bit of a biased sample of information when it comes to drugs such as
Xanax.

>
>| We [ prescribing docs ] should prescribe Ativan?  Takes a slighter
>| higher milligram
>| dose, but duration of action, potential for rebound/withdrawal
>| phenomena are the same as Xanax.  
>

>How about duration and severity of that withdrawal?  I don't have an answer
>for you.  A lot of people seem to think that short duration of action is
>what's responsible for withdrawal, so maybe all short duration anxiolytics
>are the problem.  But we also know that Xanax, as opposed to the other
>benzos, works better in Panic Disorder, so there's got to be something
>different about it.

Actually, Xanax probably does not work better in panic.  
Klonopin works, valium works - its just that you have to 
use high doses.  The duration of action is similar between 
Xanax and Valium - its that Valium has a longer half life.

>
>I suggest you find a colleague whose opinion you trust (this here is
>just "the net", after all), whose specialty is in addiction recovery,
>and ask his or her opinion of Xanax in comparison to the other benzos.
>You may change your prescribing practices as a result.

I've talked to 'em.  Believe me, I've talked to 'em.  I've also read
the journals, talked to lots of patients, and prescribed lots of 
medication.

>| Its almost never correct to say never. 
>
>Absolutely.  (:-{)>
>

Glad we agree about something. 
>== Bob Yazz ==
>-- 
>
>Welcome to Sci.med -- where-school-of-thought bashing is as old as
>sickness itself.
>