nonbenzos vs benzos

[markshark]

...which are more dangerous. for example, are nonbenzodiazepines such as ambien/lunesta as dangerous as benzos such as klonopin/xanax? just curious.

 

[MikeMartial]

With benzodiazepines, you can have respiratory depression in an overdose.

Non benzos, you will get less respiratory involvement.

As an example: We were called out for an overdose a while back, lady took all her zopiclone in an attempted suicide. She was unconscious, unresponsive, but breathing at 12/min with SpO2 of 97%. Had she taken valium (an older benzodiazepine), she would have possibly been in respiratory arrest, and her SpO2 levels in the toilet.

With some of the second-generation benzos, the respiratory involvment may vary. Ativan has less respiratory involvment than Midazolam.

Keep in mind, ANY prescription drug is dangerous if taken either by someone it's not prescribed for, or taken in doseages that exceed what your physician has recommended.

 

[nokaoibeachgirl]

Benzos can be dangerously addictive. I started using Atavan innocently enough, however soon I began taking more and more to get the same effect. Near the end I had more than quadrupled my dosage and also used rye as a chaser. The rebound anxiety was hell, the more atavan I took the harder and harder it became to sleep and even to relax. I developed horrible restless legs syndrome. I realized I had a problem and stopped cold turkey, I will never ever again take a benzo. Zopiclone is milder but can have awful hangover like side effects. Depends on what you are using them for. I now use a micro dose of an anti-psychotic which slows my thought processes so that I cannot worry. I take it right before bed, and this slowing of my thought process allows me to fall asleep, as my insomnia is a direct result of anxiety. There have been no side effects and I have been using this for a year. (I am not "psychotic") The only side effect has been an increased craving for carbohydrates which caused some weight gain at first, but which I have learned to control over time.

I am not a doctor however, simply a person with experience in using these drugs.

 

[MikeMartial]

I now use a micro dose of an anti-psychotic which slows my thought processes so that I cannot worry. I take it right before bed, and this slowing of my thought process allows me to fall asleep, as my insomnia is a direct result of anxiety.

Interesting; I didn't know they rx'd micro doseages of anti-psychotics for this. It does make sense.

 

[nokaoibeachgirl]

Yes, the one I take is called Seroquel. People using it for the treatment of psychosis will take up to 900 milligrams/day. I take 25 mgs in the evening. It surprised me also when my doctor prescribed this as treatment for my insomnia. i was caught off guard and thought that maybe he was implying that I was psychotic. However he explained that psychosis is simply a result of the thought processes working overtime, so hards that in addition to processing reality they also began to process the imagination etc. Makes sense. So in someone who is not psychotic, but whose thought processes peak at night hindering them from falling asleep, slowing them down, even slightly can enable to person to fall asleep. Very interesting because as soon as I take the Seroquel, like clockwork I am asleep an hour later. It is not a sleeping pill, I fall asleep on my own it just works on my mind. My boyfriend think it's funny, because he can tell exactly the moment it kicks in because I start talking slower and slower and have trouble keeping my thoughts straight.

I would like to eventually come off of the Seroquel, however it works so well that I do not plan on trying for the time being. It is nearly impossible for me to sleep without it. Some say that it is bad to rely on medication, however I see it as the lesser of two evils, as my life is very difficult when I operate on no sleep. One day however I will have to train myself to relax, because I do plan on having children one day, and Seroquel is not recommended while pregnant.

 

[markshark]

Yes, the one I take is called Seroquel. People using it for the treatment of psychosis will take up to 900 milligrams/day. I take 25 mgs in the evening. It surprised me also when my doctor prescribed this as treatment for my insomnia. i was caught off guard and thought that maybe he was implying that I was psychotic. However he explained that psychosis is simply a result of the thought processes working overtime, so hards that in addition to processing reality they also began to process the imagination etc. Makes sense. So in someone who is not psychotic, but whose thought processes peak at night hindering them from falling asleep, slowing them down, even slightly can enable to person to fall asleep. Very interesting because as soon as I take the Seroquel, like clockwork I am asleep an hour later. It is not a sleeping pill, I fall asleep on my own it just works on my mind. My boyfriend think it's funny, because he can tell exactly the moment it kicks in because I start talking slower and slower and have trouble keeping my thoughts straight.

I would like to eventually come off of the Seroquel, however it works so well that I do not plan on trying for the time being. It is nearly impossible for me to sleep without it. Some say that it is bad to rely on medication, however I see it as the lesser of two evils, as my life is very difficult when I operate on no sleep. One day however I will have to train myself to relax, because I do plan on having children one day, and Seroquel is not recommended while pregnant.

ive taken seroquel as well. it made me extremely groggy the next day but did get me sleep. its very strange the way it makes you feel. the best sleep ive ever gotten though pill-wise was lunesta mixed with gabapentin. the lunesta put me asleep and the gabapentin put me in a deeper sleep similar to what ghb would do to you.

 

[NFG123]

With benzodiazepines, you can have respiratory depression in an overdose.

Non benzos, you will get less respiratory involvement.

As an example: We were called out for an overdose a while back, lady took all her zopiclone in an attempted suicide. She was unconscious, unresponsive, but breathing at 12/min with SpO2 of 97%. Had she taken valium (an older benzodiazepine), she would have possibly been in respiratory arrest, and her SpO2 levels in the toilet.

I think you are referring to narcotics. BZ have a very high therapeutic index, e.g. it is difficult to accidentally OD on them, also, their main effects are not characterized by respiratory depression, that is more along the lines of opiates.

BZ are characterized by: dizziness and prolonged reaction time, motor incoordination, ataxia, mental confusion, dysarthria, anterograde amnesia, somnolence, vertigo, and fatigue

Basically, think of what getting drunk does to you, and BZ do the same thing. They act on the same receptors (GABA), as EtOH does.

BZ are not dangerous, but if you need to sleep, they (BZ) can be habit forming, as they have addictive potential. Studies with newer sleep agents (lunesta, et al) initially showed they were not as habit forming (addictive), but there is some debate as to whether or not this is really the case.

If you are worried about side effects, stay to < 1 mg ativan qhs, otherwise, you should be ok. You can still go much higher than this, but this is not needed.

 

[MikeMartial]

I think you are referring to narcotics. BZ have a very high therapeutic index, e.g. it is difficult to accidentally OD on them, also, their main effects are not characterized by respiratory depression, that is more along the lines of opiates.

No, I'm not referring to narcotics. I'm well versed in the pharmacology of both benzodiazepines and narcotics. I've been a paramedic for 10 years; I routinely give both, and have seen too many overdoses of both.

Narcotics are well known for their actions on the opioid receptors; While benzos have clinically proven respiratory depressing effects, it's through a different mechanism, as you stated, GABA transmission.

I've seen patients hypovetilate and desat themselves down into the 70% range with just an IV administration of 2.5mg midazolam. While this isn't the norm for all benzos, diazepam and midazolam are probably the worst for respiratory depression.

And, to re-quote myself for clarity, some of the second generation benzos will have much less respiratory involvement, such as lorazepam.

Some FYI:

Drug Induced Resiratory Depression

Benzodiazepine Toxicty

 

[markshark]

I think you are referring to narcotics. BZ have a very high therapeutic index, e.g. it is difficult to accidentally OD on them, also, their main effects are not characterized by respiratory depression, that is more along the lines of opiates.

BZ are characterized by: dizziness and prolonged reaction time, motor incoordination, ataxia, mental confusion, dysarthria, anterograde amnesia, somnolence, vertigo, and fatigue

Basically, think of what getting drunk does to you, and BZ do the same thing. They act on the same receptors (GABA), as EtOH does.

BZ are not dangerous, but if you need to sleep, they (BZ) can be habit forming, as they have addictive potential. Studies with newer sleep agents (lunesta, et al) initially showed they were not as habit forming (addictive), but there is some debate as to whether or not this is really the case.

If you are worried about side effects, stay to < 1 mg ativan qhs, otherwise, you should be ok. You can still go much higher than this, but this is not needed.

i agree that they are habit forming but i disagree that they are not dangerous. i went cold turkey off xanax (2mg/night) for 6 months and nearly had a seizure. i was so shaky and panicky i had to walk around in circles all day and couldnt even go to social functions, and ive heard too many tales of peopel haveing seizures and coma from these drugs. but they can be godsends for others.

 

[MikeMartial]

i agree that they are habit forming but i disagree that they are not dangerous. i went cold turkey off xanax (2mg/night) for 6 months and nearly had a seizure. i was so shaky and panicky i had to walk around in circles all day and couldnt even go to social functions, and ive heard too many tales of peopel haveing seizures and coma from these drugs. but they can be godsends for others.

Acute withdrawl can lower the seizure threshold. In that regard, they can also be dangerous.

 

[NFG123]

i agree that they are habit forming but i disagree that they are not dangerous. i went cold turkey off xanax (2mg/night) for 6 months and nearly had a seizure. i was so shaky and panicky i had to walk around in circles all day and couldnt even go to social functions, and ive heard too many tales of peopel haveing seizures and coma from these drugs. but they can be godsends for others.

I was referring to safety with regards to Overdosing. Certainly rebound anxiety is a problem with quick discontinuance of BZ, necessitating a taper.