Thank you Dr. Lasich for your excellent article on the use of benzodiazepines; I always enjoy reading your thoughts.  Also, the follow-up comment was a good one.

One thing that I have found with benzodiazepines is that for treating a anxiety/panic disorder there just isn't much available as far as medications that are effective.

I think they do have their place but need to be used prudently and only as directed.  Hopefully something better will come out but as of today, I have found nothing that works for these types of disorders.

Having intractable pain in itself causes anxiety for many and trying to counteract that can be difficult.  Along with anxiety from intractable pain can come insomnia from opioid usage and that brings up another issue that needs to be addressed.

I do agree that we need to come up with some new medications for anxiety related disorders and sleep disorders though at the present there just isn't much out there that is effective.

For some, trazadone works well for sleep but with others; it does nothing.  I think it is worth a try if it will mix well with the medications that a person is taking but I always worry about possible interactions and side effects so it is important to discuss all of this with your physician and your pharmacist just to be safe.

Doxepin is another medication (tricyclic antidepressant) that can be helpful for sleep problems for some.

At one time I thought that possibly buspirone might be a good alternative to traditional benzodiazepines however I saw one person that had a very difficult time stopping that medication and had severe side effects when trying to stop though was finally successful after about 10 days.

Quetiapine can have some extremely nasty side effects and I would be very judicious about it's use except for treating some of the major mental illnesses where the use is justified.

It doesn't seem as though their is an easy answer to any of these questions whether it be treating an anxiety disorder, insomnia or intractable pain.  With all three, I think we have a long way to go but hope that eventually we will find medications that are safer to use and actually do what they should do with few side effects.  That day is not today and most likely will not be tomorrow but I hope that their will be some good breakthroughs in those areas soon.

robin

4/21/11 7:42pm

I appreciated your comments. It's so true that everyone has a different set of circumstances and a different physiological makeup. The reccommendation to take Elavil concerns me, as it too can have many distressing side effects. But, if it works, use it. "Ambilify" as the doctor calls it, is actually Abilify. It is an antipsychotic that is now sometimes used in conjunction with antidepressants if positive mood changes have not occured after several weeks of a traditional anti-d. It is not a "mood stablizer". It is a serious drug that can have any other side effects that antipsychotics have.Benzos can be addictive but are also used by plenty of people in a reasonable manner; they work on Gaba receptors too, Dr. And if you have chronic pain, I say, you have every right to use what works. Bottom line: the drugs mentioned all have benefits and drawbacks and should all be discussed with a competent, empathic doctor.

randy100

4/22/11 9:49pm

Hi Robin,

 

Thanks for sharing your comments.

 

I agree, if it works it is worth trying and all medications have side effects of one kind or another.  Sometimes it gets down to which is worse; the condition being treated or the side effects of the medication one is using.

 

I do think that being prudent with medication use is best and the least that will take care of the problem is probably the best way of going.