Dear Dr. Eskapa there are several of us who are on benzo's. We know that you feel we should get off of them because they are addictive. You say that they may hamper this process but not that it will not work. I for one, can not get off of the small dose that I take daily. I know you do not have time for my story but I am doing well with the anxiety disorder that I am plagued with on .5mg. daily of Klonipin and do not want to fool with that. There are others here who have also posted for a direct answer to this question see headings on Benzo's here. I have tried Topamax and it did not work causing depression and personality issues. I am desperate for a cure and hoping you can clear this up once and for all. Maybe it will take us longer? It will not work unless we get off the benzo's entirely? You aren't sure? Please respond and thanks.

There is currently no practical way to extinguish addiction to benzodiazepines. (There are GABA antagonists but these are very unchartered waters.)

Now for the good news. There are several 'experts' who have published their approaches to reducing benzodiazepines GRADUALLY. I recommend one approach which ultimately involves making a switch from the BDZ you are on - under careful medical supervision - to diazepam (valium).

Prof Heather Ashton in the UK has a site I recommend.

http://benzo.org.uk/manual/index.htm

Prof Ashton is by no means the only way to come off BDZs ...... but she seems to have had years of experience with this.

Sinclair informs us that there is promising research afoot to identify several potential markers of naltrexone efficacy for alcohol de-addiction. These include:

the +118A form of the mu opioid receptor
GG and AG forms of the T921C alle for the mu receptor
positive family history
no current use of BDZs

among others. (MORE LATER)

However, it is clear that heavy drinking influences the GABA system ... makes the brain 'lazy' at making its own GABA. BDZs work in a similar fashion ... make the brain a 'lazy GABA producer' .... You have to keep faith and follow gradual reduction of your BDZs under medical supervision and of course if you drink take naltrexone 1 hour to at least 30 minutes before you do.

My thoughts / theories are this. If your brain is 'lazy' at making GABA after years of drinking AND you take medications (BDZs) which worsen this condition by artificially raising GABA in the brain - even though you benefit from extinction / de-addiction as far as the opioid system goes (in the brain) you will crave - and drink heavily - for its GABA effects. Many of the clinical trials listed in The Cure for Alcoholism would have screened out 'other drug' users - including benzodiazepine users.

How did you first get onto BDZs? For anxiety, withdrawal from alcohol?

The other good news is that you will still benefit from the opioid aspects of the naltrexone + drinking extinction. So try to come off your BDZs and continue with the Sinclair Method - naltrexone + drinking = reduced craving and drinking levels = safe drinking or abstinence = cure.


Best wishes

I know I am breaking the rule about posting on the Ask Dr. Eskapa thread, but I expect he will not mind as we have discussed this. Dr. E and I have had dialogue about Ashton. She is a saint in that she identified the need to taper from benzos slowly to avoid the agony of withdrawal. She also has great practical info re: half-life of various benzos and the need to switch to a longer half-life benzo for the taper. She endorses valium; many others recommend klonipin (clonezapam). She has an excellent schedule to cross over from a shorter half-life to a longer half-life benzo. Many m.d.'s are familiar with her. Her taper schedule is what I told Roy some have called the "cut-and-suffer" method. I will post when I have more energy about a very slow taper -- with no side effects. Meanwhile, Ashton is certainly better than cutting your benzo dose by 25 % or more. Cutting too fast can do some neurological harm. The effects do not show up until two weeks after the cut sometimes. Ashton says never more than 10%.

Again, I will start a new thread later. We benzo "GABA drinkers" are pumping alcohol into the same chloride channels that we pump benzo to the receptors in our brain. This causes confusion about how much GABA our body should make and causes our alcohol cravings to be higher than non-benzo users. WE WILL GET THERE ANYWAY so stick to your TSM!!!!

Remember I am the lay person so start with Ashton as Dr. Roy says. For those of you (e.g. Bob) who medically cannot stop benzo's -- we will haul you through TSM on our backs if need be but you will get there as well.

Lena, didn't see this before I posted. I too must take the benzo's for the disorder that has plagued my life. I did go through a three week taper of Xanax while hospitalized and was not o.k. for over a year after that. I lost 20 years of my life to those meds and hate them but the dose of klonipin I am on now is greatly needed for me to function in this world. I continue to try but my hope is on the wain.

LaBear, I'm looking at your signature line. It is evident that during weeks 2 and 3 you had the typical 'honeymoon' effect from naltrexone. Then you had/have the typical spike in drinking that follows that. This seems to indicate that naltrexone is working in your brain just as it is working in those of us who do not take benzos.

C'mon now, you've got a long way to go - you can't give up when you've hardly even started!

Oh, don't you worry I won't give up, but will try the taper and you are slowly convincing me to try that baclofin even though I am terrified because of my past. I wish that we had more local people involved where we could compare notes and bond a little more but I don't think we will see anything like that in our time! Again, thank God for everyone here who posts. I am just home from the gym and this is the first place that I come to hear of miracles, hopfullness and advances. The doubts are also good because one knows they are not alone with them.