BenzoNewsgroup Newsletter # 2
The Revival of the Market for Benzodiazepines Exercise During Withdrawal Recommended Books Recommended Websites Recommended Links A Personal Account of Withdrawal In the News A Note From the Editor Petition for Changing the Prescribing Guidelines for Benzos
Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America will be out on April 13th. Mr. Whitaker will be talking about his new book at the Harvard Bookstore, 1256 Massachusetts Avenue, Cambridge, MA 02138, (617) 661-1515, on April 13th at 7 pm.
The Revival of the Market for Benzodiazepines
When I was researching Anatomy of an Epidemic, a book that Crown will publish on April 13, I was curious, in particular, to see how psychiatry rebuilt the market for benzodiazepines in the 1980s. During the 1970s, both the U.S. and British governments concluded that benzodiazepines were addictive and thus capable of causing a great deal of harm, and for a time, the prescribing of these drugs in the U.S. did noticeably decline, from 103 million prescriptions in 1975 to 71 million in 1980. But then the prescribing numbers began to stabilize and eventually increase, such that 83 million prescriptions for benzodiazepines were written in 2007, which isn’t all that far from the number written at the height of the Valium craze in the early 1970s.
Here’s how the market for benzodiazepines was revived.
In 1981, Upjohn brought a potent new benzodiazepine to market, Xanax, and this helped stabilized use of the drugs for “anxiety.” Next, Upjohn conducted a study of Xanax as a treatment for panic disorder, which the American Psychiatric Association had newly identified as a discrete condition. Then, in May 1988, Upjohn investigators announced that the study had shown Xanax to be a safe and effective treatment for this newly identified “illness.”
At least at first glance, it seemed that science had indeed shown Xanax to be helpful. The FDA approved it as a treatment for panic disorder, and the American Psychiatric Association touted its benefits to the public. At the same time, NIMH identified panic disorder as a priority concern and in 1991 sponsored a conference on it, with its panel of experts designating “high potency benzodiazepines”—this would be Xanax—as one of the two “treatments of choice.”
Yet, a close look at the 14-week study conducted by Upjohn shows that this drug, rather than provide a benefit to patients, caused a significant amount of harm.
Benzodiazepines are known to work quickly, and at the end of four weeks, 82 percent of the Xanax-treated patients were “moderately improved” or “better,” versus 43 percent of the placebo group. However, during the next four weeks, the placebo patients continued to improve while the Xanax patients did not, and by the end of the eighth week, there “was no significant difference between the groups” on most of the rating scales, at least among the patients still in the study. The Xanax patients also experienced a variety of troubling side effects: sedation, fatigue, slurred speech, amnesia, and poor coordination.
At the end of eight weeks, the patients were tapered from their medication (Xanax or placebo) for four weeks and then followed while medication-free for another two weeks. Thirty-nine percent of those withdrawn from Xanax “deteriorated significantly,” their panic and anxiety skyrocketing to such an extent they had to start taking the drug again. Thirty-five percent suffered “rebound” panic and anxiety symptoms more severe than when the study began, and an equal percentage suffered a host of debilitating new symptoms, including confusion, heightened sensory perceptions, depression, a feeling that insects were crawling over them, muscle cramps, blurred vision, diarrhea, decreased appetite, and weight loss.
In sum, at the end of the 14-week study, the drug-exposed patients were much worse off than the placebo group. They were more anxious, more panic stricken, and doing worse on a “global scale” that assesses overall well-being. Forty-four percent had been unable to get off the drug, on their way to a lifetime of addiction.
So how Upjohn’s investigators turn this study into evidence that Xanax was a “safe and effective” treatment for panic disorders? In their published reports, the Upjohn investigators focused on the four-week results, when the drug-treated patients were doing better than the placebo group. They acknowledged that many Xanax-treated patients had fared poorly when the drug was withdrawn, but they reasoned that this showed that the drug had been used for too short a period, and the withdrawal done too abruptly. “We recommend that patients with panic disorder be treated for a longer period, at least six months,” they said.
Such is the story of how the market for benzodiazepines was revived in the 1980s. Upjohn conducted a trial that told of drug-treated patients ending up much worse than the placebo patients by the end of the 14 weeks, but its investigators instead reported that the trial had shown Xanax to be safe and effective, a conclusion they supported by focusing on the four-week results. The APA and the NIMH echoed this conclusion, and so sales of Xanax took off, with this drug, in 1992, becoming the fifth most frequently prescribed medication in the United States.
Robert Whitaker is the author of four books. His first, Mad in America: Bad Science, Bad Medicine and the Enduring Mistreatment of the Mentally Ill was named by Discover magazine as one of the best science books of 2002, while the American Library Association named it one of the best history books of that year. His second, The Mapmaker’s Wife: A True Tale of Love, Murder and Survival in the Amazon, was named by the American Library Association as one of the best biographies of 2004. It was translated into eight foreign languages. In 2008, Crown published On the Laps of Gods: The Red Summer of 1919 and the Struggle for Justice that Remade a Nation, which the San Francisco Chronicle selected as one of the best 50 non-fiction books of that year. On the Laps of Gods was also awarded the Anthony J. Lukas work-in-progress prize. His newest book, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, will be published by Crown in the spring of 2010.
Prior to writing books, Robert Whitaker worked as the science and medical reporter at the Albany Times Union newspaper in New York for a number of years. His journalism articles won several national awards, including a George Polk award for medical writing, and a National Association of Science Writers’ award for best magazine article. A series he co-wrote for The Boston Globe was named a finalist for the Pulitzer Prize in 1998.
The question of exercise during psychiatric drug withdrawal comes up quite often on the support groups. There appears to be no specific research regarding exercise and withdrawal – whether it helps or not, so we can only go by what we know about exercise in general.
Firstly, unless medically contraindicated, there is no doubt that exercise in general has multiple benefits: physically, mentally, and emotionally. One has only to read any good article on the topic to know that exercise can improve cardiac output, lower blood pressure, prolong endurance, increase resistance to disease, and so on. But also mental acuity is sharpened, sleep patterns improve, and the benefits of exercise for helping depression have been proved time and again through scientific research.
Our real question is what people in withdrawal should do regarding exercise. One thing we often see on the support groups is people experiencing increased withdrawal symptoms during exercise. Exercise is undoubtedly important during withdrawal, when we want to do all we can to provide the body and brain with what it needs to heal. But doing something that increases withdrawal symptoms is probably not going to be helpful at the time.
So, what to do? Unless someone is used to exercise and has noticed no increased withdrawal when engaging in a program, it is always best to start off slowly and work up. Many people will say that they are simply too ill to exercise. This can often be quite true. But there is multiple health issues connected to lack of exercise, so it is probably best to do what you can as soon as you can if agreeable with your doctor.
Searches on the Internet will often yield sites like this: http://www.nlm.nih.gov/medlineplus/exerciseforseniors.html and http://nihseniorhealth.gov/exerciseforolderadults/toc.html
Most local junior colleges will have a Lifetime Wellness or Fitness class. The materials for these classes are usually an excellent way to get started with a basic program that includes stretching, strengthening, and aerobic exercise, all of which are important for optimum health benefits.
Don’t forget to start slow. If you experience increased withdrawal symptoms, it may be best to restart at a slower pace. Also, everyone does not have a problem exercising while still having withdrawal symptoms, so don’t look for problems that are not there. Exercise in one part of getting back into life and most people find it really helps. So, good luck with this important part of regaining your health.
Doctoring the Mind: Why Psychiatric Treatments Fail by Richard Bentall
A review is written here:
The Emperor's New Drugs: Exploding the Antidepressant Myth by Irving Kirsch
Kids Caught in the Psychiatric Maelstrom: How Pathological Labels and "Therapeutic" Drugs Hurt Children and Families
The Conscience of Psychiatry: The Reform Work of Peter R. Breggin, MD
Psychiatric Drugs and Your Child
More books, helpful for preparation and withdrawal from psychiatric drugs, are located at http://www.benzosupport.org/books.htm
There is none better in the world on the problems of benzodiazepines than this one owned and compiled by Ray Nimmo over the last decade.
A website owned by Dr. Anne Blake-Tracy that focuses mainly on the serotogenic drugs like Paxil and Zoloft. However, she is expanding into other psychiatric drugs and other “regular” drugs that are also problematic.
Are Sleeping Pills Good For You? By Jerry Siegel
This article discusses why benzodiazepines and other sleeping pills such as Ambien and Lunesta are able to cause worsening sleep and other health problems:
Letter from Jim Dobbin MP to The Rt Hon Gillian Merron MP
This article is from a longer list of articles that are posted on Ray Nimmo’s site. The article not only lets us know what is happening in the UK with the issue of benzo dependency as an iatrogenic illness, but also gives a perfect example of how many people in the world were made sicker when their physician put them on these medications:
Withdrawal from benzodiazepines is probably the most difficult challenge that I have faced in my life thus far.
I was in my early thirties, working full time with my first child, and life was great! Then I went to the doctor for a tight chest muscle from waterskiing; I was prescribed Ativan (Lorazepam). I trusted the advice given to me by this medical expert and proceeded to take the prescription.
Before long, I was having difficulty with my digestive system. I was unable to escape the constant heartburn and nausea that I felt. I was so sick at one point that I lost 30lbs over the course of 2 months. After constant testing, doctors were unable to determine what the cause was. I under went some exploratory surgery and as a result did not take my nightly dose of Ativan. The next day I was in withdrawal and had no idea what was happening to me. I became anxious, depressed, experienced insomnia and my life was turned upside down; I truly thought that I was going crazy. Eventually my doctor told me that I was a mess; he referred me to a psychiatrist. Before long he had me taking 10mg of Ativan a day and wanted me to take antidepressants for the suicidal thoughts that plagued me day in and day out. I had to take a leave of absence from my job.
After spending countless hours in various doctor’s office without any help, I was desperate! I went to a health food store and God was there with me. One of the employees took the time and asked the right questions. She inquired “Do you not know what Ativan is and does to you?’ I was naive and never suspected that I had been given an anti-anxiety drug for a muscle related problem. She provided me with a wealth of information regarding benzodiazepine withdrawal, including a wonderful support group. I was so relieved to finally find someone cared and that could help me! Little did I know that the road to withdrawal would be so difficult.
My withdrawal was not typical; I became so toxic that the drugs turned against me. I ended up taking my 2 year old daughter to live with my parents so that they could look after me. At some points, I was unable to even feed myself. I was suicidal for almost a year, rarely slept and I felt sensations like bugs were crawling in head and that my brain was constantly moving. I truly thought that this was it for me.
Then one day, I woke up and the severe depression had lifted and the suicidal thoughts NEVER returned. I went through several more years of withdrawal; but nothing to the extent that I had felt prior. I was able to return to my work, my home, my life. I still would get bad days, but they were tolerable and the windows of good days were getting more and more. The only symptom I am left with after 10 years is strange feeling in my head when electrical storms are approaching and occurring; all the other symptoms are gone!
I share my story not to scare you, but to offer you HOPE. These drugs are nasty, but NEVER think for one moment that you will not recover. I was an extreme case, I suffered many withdrawal symptoms and I do have my life back. Our bodies have been created to heal and yours will, just like mine. You will NOT be stuck in withdrawal.
When I first recovered, I did not have the emotional strength to help others through withdrawal, now I am able to deal with it and not feel dragged down or pity for myself. I offer several suggestions to you to help you with your recovery.
• Be patient; recovery takes time, but it WILL happen.
Since my withdrawal I have moved up into management, have had two more children, water-ski, go camping and have a very full life. Thanks for all those who supported me including my loving husband, Geraldine Burns, Madelon Albulet, Shagg Rothwell, my family and to God for providing me with strength.
If this doesn’t scare you, nothing will. The FDA is lifting the ban on pilots taking (4) antidepressant medications. As if these particular ones, Prozac, Celexa, Zoloft, and Lexapro do not impair judgement, cause a slowing of reflexes, or produce tolerance withdrawal symptoms; withdrawal symptoms that include suicidal and/or homicidal ideations and more. One may want to rethink the idea of flying, even more than we already have.
SSRI Side effects:
It is truly a crime that the FDA has allowed doctors to create addicts for almost 50 years now. And it is a worse crime that the doctors then turn around and blame the patient for “getting addicted.” It has long been known that benzodiazepines are highly addictive and therefore, should not be prescribed longer than a few days at most. It has long been known that people who become addicted to these drugs need long-term care while being slowly withdrawn from these drugs. While the UK has set up Clinics to deal with this problem, the US is still denying there is a problem.
There are many resources written by doctors all over the world on the topic of benzodiazepine dependency, as it relates to an iatrogenic illness. The most notable paper written and researched is authored by Dr. Heather Ashton in the UK. Her paper, Benzodiazepines: How They Work and How to Withdraw, is utilized all over the world as a resource for doctors helping their patients off these drugs. I strongly suggest that this paper be made available to every doctor and pharmacist in the US and they be encouraged to use it. Her paper is available for free on this site: http://www.benzo.org.uk as is her Curriculum Vitae and contact information.
The aforementioned site likely contains more information on benzodiazepine dependency as an iatrogenic illness than any site in the world. I suggest the FDA reads it, in particularly this little note by Dr. Ray Baker located here: http://www.benzo.org.uk/can-drb.htm
“Physical dependence is simply a neurobiological phenomenon due to continued exposure to a drug. It happens to all human brains exposed to drugs such as benzodiazepines and opioids. It is not addiction.”
Changes in the prescribing guidelines of this class of drugs should help stop some of the headlines we are continuing to see wherein a doctor has prescribed these drugs for so long that the patient is unable to sleep without being given an anesthesia drug. This is due to a very high state of tolerance to the benzodiazepines that can occur within weeks of taking these drugs.
I must ask, “How long will it take until the FDA, which is supposed to protect the public, stops doctors from creating addicts and then acting like it is the patient’s fault?”
How long? Until we stand up and say “no more.” You can say “no more” by reading and signing the Petition below, now before the FDA.
We are pleased to announce a formal benzo petition is now on the docket of the US Food and Drug Administration (FDA) and is open for public comment from everyone (not just US citizens).
Public comments WILL affect how the FDA rules on our requests--this is your chance to be heard!!
Please make the FDA aware of how benzodiazepine withdrawal has impacted your life.
To READ the petition click here:
- scroll down to 'Views' and click on the pdf image next to it.
To COMMENT on the petition click here:
To get MORE INFORMATION, instructions, a summary of the petition and a sample
comment click here:
Please encourage family, friends, and others who care about this issue to comment. Feel free to spread the word and this link--the more public comments, the better.
The FDA will rule within six months on our requests, but we don’t know for sure when they will close the comment period. We deeply appreciate you making the effort to have your voice heard on this issue with a timely response. We hope with everyone's help, there will soon be some much needed change in benzodiazepine drug labeling.
Emily, Shirley, and Anthea
PS: In order to track how many responses the FDA gets, we would appreciate you sending a quick email to: email@example.com after voicing your support of this petition.
Please participate in this important undertaking. We cannot change how
doctor’s RX these drugs if we do not take action. You are welcome to cross-post
this information to any other groups or individuals.
Disclaimer: The Benzo Newsgroup newsletter is for informational purposes only and is not to be considered as an endorsement for anyone to discontinue their medications. This newsletter is also not intended to replace the examination, diagnosis and treatment of a licensed physician and no such claims are inferred. Before making ANY medication changes, you should confer with your physician and it is always assumed that you will do so.
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Disclaimer: The information contained in this website was not compiled by a doctor or anyone with medical training. The advice contained herein should not be substituted for the advice of a physician who is well-informed in the subject matter discussed. Before making any decisions about your health or treatment you should always confer with your physician and it is always assumed that you will do so.
Last updated 23 May 2013