00:04 there has been little clinical progress
00:06 in the benzo dapin world since 2002 when
00:09 the last edition of benzo diazines how
00:12 they work and how to withdraw appeared
00:17 g. benzodiazapines are still
00:20 overprescribed globally often in
00:22 excessive Doses and frequently for too
00:25 long prescriptions for benzodiazapines
00:27 and the similar Z drugs are actually
00:30 increasing in many countries there is a
00:33 tendency to prescribe the more potent
00:34 agents such as clonazepam clopin and in
00:38 the US particularly alzalam Xanax and
00:42 zulam ambian while lorazapam Adavan is
00:46 still the most commonly prescribed drug
00:49 anxiety the availability of benzo aines
00:52 on the internet has increased their use
00:53 as self-medication in the general public
00:55 who are often unaware of their adverse
00:57 effects and dependence potential this
00:59 this availability has also added to
01:01 benzodiazapine use in multi-drug
01:04 abusers many doctors have little
01:06 knowledge of or expertise in the
01:09 management of benzodiazapine withdrawal
01:11 in long-term users and skilled
01:13 psychological support is hard to obtain
01:16 due to a shortage of clinical
01:17 psychologists good advice on withdrawal
01:20 is available for doctors in the UK for
01:22 example from Clinical knowledge
01:24 summaries or the British medical
01:25 formulary and in the US from the main
01:28 benzia aine study group mbsg but few
01:34 information detoxification centers which
01:36 also deal with alcohol and illegal drugs
01:38 are not appropriate for prescribed benzo
01:41 ofan users such clinics tend to withdraw
01:44 patients too rapidly apply rigid rules
01:46 and contract methods and provide
01:48 inadequate support or followup there are
01:51 no longer any dedicated Hospital
01:53 withdrawal clinics in the UK although
01:55 there are few NHS supported Charities
01:57 and support groups devoted to benzaa
01:59 Pine problems clinical research on
02:02 optimal benzodiazapine withdrawal
02:04 methods is limited the results from meta
02:07 analyses of clinical trials are
02:09 difficult to interpret because different
02:11 trials use different rates of withdrawal
02:13 different methods of psychological
02:15 support often used different adant drugs
02:18 many of which have not been tested in
02:19 controlled studies of withdrawal and
02:21 allow only for short-term
02:23 followup there are no studies examining
02:26 long-term effects of benzodiazapines
02:28 such as protracted symptoms or possibly
02:30 permanent effects the question of
02:33 whether benzodiazapines can cause
02:34 permanent damage to the brain or other
02:36 systems as many EX users claim remains
02:40 unanswered by science basic Research
02:42 into the molecular mechanisms underlying
02:45 tolerance withdrawal symptoms and
02:47 anxiety and on the interactions of
02:49 benzodiazapines with various
02:50 neurotransmitter systems has yielded
02:53 some interesting results but these are
02:55 not readily translated into clinical
02:57 practice although they may lead to
03:00 advances the advice given to prescribed
03:03 benzodiazapine users and their doctors
03:06 in the Ashton manual remains relevant
03:08 today and requires little updating this
03:11 supplement adds further information in
03:13 response to questions that have
03:14 frequently been asked by benzo aipan
03:16 users during and after withdrawal such
03:19 questions are difficult to answer
03:21 because like most benzo aipan problems
03:24 they depend on many individual factors
03:27 such factors include personality and
03:29 genetic makeup reasons for
03:31 benzodiazapine prescription dose
03:34 duration and type of benzodiazapine use
03:37 present symptoms environmental stresses
03:39 and others individuals seeking answers
03:41 from the general information provided in
03:43 this supplement need to work out which
03:45 factors apply to them personally
03:51 damage many long-term benzoa pan users
03:55 who have stopped taking the drugs
03:56 complain of a variety of seemingly
03:58 irreversible psycholog iCal Andor
04:00 physical symptoms which they attribute
04:02 to permanent brain damage caused by the
04:05 drugs however the question of whether
04:07 benzodiazapines cause brain damage is
04:10 still unsolved in 1982 Professor Malcolm
04:13 later and colleagues reported the
04:15 results of a small study using cat
04:18 computerized axial tomography brain
04:21 scans in 14 long-term benzodiazapines
04:24 users compared with control subjects two
04:27 of the benzodiazapine users had definite
04:29 itical brain atrophy and there was a
04:31 borderline abnormality and five others
04:34 the rest were normal in a 1984 study by
04:37 Professor later involving 20 patients
04:40 the results were again suggestive but
04:42 there was no relationship between CAT
04:43 scan appearances and the duration of
04:46 benzodiazapine therapy the study
04:48 concluded the clinical significance of
04:52 unclear subsequent CAT scan studies in
04:55 1987 1993 and 2000s failed to find any
04:59 con consistent abnormalities in
05:00 long-term benzodiazapine users and
05:03 concluded that benzodiazapines do not
05:05 cause structural brain damage death of
05:08 neurons brain shrinkage or atrophy Etc a
05:11 later more accurate development in brain
05:13 scanning MRI magnetic resonance imaging
05:17 does not appear to have been
05:18 systematically studied in benzodi as a
05:20 pine users however MRI like cat only
05:24 shows structural changes and it is
05:26 unlikely that the use of this technique
05:28 would clarify the picture many still
05:30 symptomatic long-term expens adipine
05:32 users have had normal
05:34 MRIs functional damage it is more likely
05:38 that any long-term brain changes caused
05:40 by benzoin are functional rather than
05:43 structural in order to show such changes
05:45 it would be necessary to examine
05:47 abnormalities of brain activity in
05:49 long-term benzo ofan users techniques
05:52 for such studies are available fmri
05:55 functional MRI measures Regional blood
05:58 flow pet positive Ron emission
06:00 tomography inspect single Photon
06:02 emission tomography measure
06:04 neurotransmitter and receptor activity
06:09 electroencephalography and Meg
06:11 magnetoencephalography measure Regional
06:13 electrical activity none of these
06:15 techniques has been utilized in
06:17 controlled studies of long-term
06:19 benzodiazapine users cognitive
06:21 performance could indicate impairments
06:23 in certain brain areas but no Studies
06:26 have extended for more than 6 months
06:28 finally postm studies could show
06:30 abnormalities in brain receptors and
06:33 animal studies could show changes in
06:36 expression none of these studies has
06:38 been undertaken nor have there been any
06:40 studies examining abnormalities in other
06:42 tissues or organs in long-term benzoo
06:46 users a controlled study of long-term
06:48 benzodiazapine users using brain
06:51 function techniques would have to be
06:52 carefully designed and would involve a
06:54 large number of age and sex match
06:56 subjects probably over 100 in both
06:59 control and user groups in the
07:01 benzodiazapine group it would have to
07:03 take into account dose type of
07:05 benzodiazapine duration of use
07:08 psychiatric history symptoms use of
07:11 Alcohol and Other Drugs and a number of
07:13 other factors such a study would be
07:15 expensive and funding would be difficult
07:17 to obtain drug companies would be
07:19 unlikely to offer support and to date
07:22 independent bodies such as the medical
07:24 research Council the welcome foundation
07:26 and the Department of Health have shown
07:28 little interest thus the question of
07:30 whether benzodi aspenes cause brain or
07:33 other organ damage remains
07:35 unanswered long-term effects of
07:39 one mechanism which might be involved in
07:41 long-term and possibly permanent effects
07:44 of benzodiazapines is an alteration in
07:46 the activity of benidipine receptors in
07:49 brain Gaba neurons these receptors
07:52 downregulate become fewer as tolerance
07:54 to benzodiazapines develop with chronic
07:57 use such downregulation is is a
07:59 homeostatic response of the body to the
08:01 constant presence of the drugs since
08:03 benzodiazapines themselves enhance the
08:05 actions of Gaba extra benzo aspine
08:08 receptors are no longer needed so many
08:11 are in effect discarded these
08:14 downregulated receptors are absorbed
08:16 into neurons where over time they
08:19 undergo various changes including
08:21 alterations in gene expression when
08:23 these receptors are slowly reinstated
08:26 after drug withdrawal they may return in
08:28 a slightly Al aled form they may not be
08:31 quite so efficient as before in
08:32 increasing the actions of Gaba the
08:36 neurotransmitter as a result the brain
08:39 may be generally less sensitive to Gaba
08:42 and the individual is left with
08:43 heightened central nervous system
08:45 excitability and increased sensitivity
08:47 to stress molecular biologists point out
08:50 that changes in gene expression can be
08:52 very slow or even unable to
08:55 reverse some people appear to be
08:57 naturally more prone to anxiet than
08:59 others brain Imaging and pharmacological
09:02 Studies have shown that there is a
09:03 decreased density decreased numbers and
09:06 subsensitivity of brain Gaba benidipine
09:09 receptors in patients with generalized
09:11 anxiety disorder and panic disorder and
09:14 in patients with tentis even if they
09:16 have never been treated with
09:17 benzodiazapines perhaps these
09:20 individuals with genetically fewer Gaba
09:22 benidipine receptors are those more
09:24 likely to experience long-term effects
09:26 of benzodi aines protract symptoms after
09:30 withdrawal and apparent recurrence of
09:32 withdrawal symptoms benzo aspine
09:35 receptors is there a natural
09:38 benzodiazapine readers May well ask why
09:42 do we have specific benzodiazapine
09:44 receptors in our brain they have clearly
09:47 not evolved over thousands and millions
09:48 of years just to sit there and wait
09:50 until Valium arrived most drugs that
09:53 affect the brain act on receptors that
09:55 are already there and all of these drugs
09:57 have subsequently been found to take the
09:59 place of natural substances synthesized
10:01 within the body for example The
10:04 receptors for morphine react with
10:06 natural endogenous endorphins and en
10:08 cilins the physiological painkillers The
10:11 receptors for cannabis are normally
10:13 stimulated by natural substances called
10:15 anandamides named after the Sanskrit
10:18 word Ananda which means Bliss nicotine
10:21 in tobacco reacts with nicotine
10:23 receptors for the natural
10:24 neurotransmitter acetylcholine all the
10:27 psychotropic drugs like antidepressant
10:29 and anticho discs affect the receptor
10:31 for natural neurotransmitters such as
10:34 serotonin noradrenaline and
10:36 dopamine the conclusion from such
10:39 discoveries is that there must exist a
10:40 natural benzodiazapine which normally
10:43 modulates the activity of Gaba at Gaba
10:45 benidipine receptors like diazapam and
10:48 acts as an inborn calming sleep inducing
10:52 and anti-convulsant
10:53 agent a search for The elusive natural
10:56 benzo dipene has been going on for about
10:59 20 years natural benzodiazapines have
11:02 been found in plants including potatoes
11:05 wheat corn rice valaran and Poppy and
11:08 have also been demonstrated in animal
11:10 tissues diazapam and its metabolite Nord
11:13 aapam have been found in human blood and
11:15 brain but these could have been derived
11:17 from dietary sources however some
11:20 substances which are not chemically
11:22 related to benidipine drugs but combined
11:25 with Gaba benidipine receptors have been
11:27 found in the brain and other tissue of a
11:29 variety of animals including rats cattle
11:33 frogs fish and humans and in isolated
11:36 rat brain slices these agents which are
11:39 small polypeptides have been termed
11:41 osines and are thought to be the body's
11:43 natural benzo aines they have a number
11:46 of actions among which is the ability to
11:49 react specifically with the
11:50 benzodiazapine site of the Gaba a
11:52 receptor and to modulate Gaba
11:54 neurotransmission in the brain osip
11:57 probably interact also Al with other
11:59 types of Gaba receptors which are
12:01 distributed all over the body and have
12:04 functions there is still much to
12:06 discover about benzodiazapines some
12:08 inhibit diazapam binding and may
12:10 therefore be anxiogenic While others
12:12 appear to act like diazapam and enhance
12:15 Gaba activity it seems likely that the
12:17 balance between different endopin acting
12:19 at the Gaba a receptor May determine an
12:22 individual susceptibility to anxiety and
12:24 response to benzo a pain drugs by acting
12:26 as fine- tuners of Gaba a function
12:29 the role of ospin is still controversial
12:32 but in my opinion natural
12:33 benzodiazapines certainly exist and they
12:36 may already have been tracked down their
12:38 presence adds to the complexity and
12:40 sophistication of the brain we know so
12:42 little about what goes on in the brain
12:44 which makes it difficult to give advice
12:46 on individual benzodiazapines
12:49 recurrence of symptoms after successful
12:52 withdrawal it is not unusual to
12:55 experience recurrence of apparent
12:56 benzodiazapine withdrawal symptoms years
12:59 after a successful withdrawal and a
13:01 return to normal Health the particular
13:04 pattern of symptoms is unique to the
13:05 individual depending on his physical and
13:08 psychological makeup and no doubt on the
13:10 innate density of his herzo aspine
13:13 receptors and the balance of his ospin
13:16 above the experience of benzodiazapine
13:19 withdrawal is deeply etched into the
13:21 mind and memory of those who have been
13:22 through it and is actually physically
13:25 present in the strength and connections
13:26 of their neural synapses as all me
13:28 memories are these recurrent symptoms
13:31 are all signs of Gaba underactivity with
13:34 its accompanying increased output of
13:37 neurotransmitters resulting in a
13:39 hyperactive hypers sensitive central
13:41 nervous system the mechanism is exactly
13:44 the same as that of benzodiazapine
13:46 withdrawal which is why the symptoms are
13:48 the same in nearly every case of
13:50 apparent recurrence the precipitating
13:53 cause for the return of symptoms turns
13:55 out on close inspection to be an
13:57 increase in Environmental stress the
13:59 trigger may be a new stress or worry
14:02 which may be unrecognized so that the
14:04 return of symptoms seems to occur out of
14:07 blue contributing factors can be an
14:09 infection surgery dental problems work
14:13 problems fatigue bereavement family
14:16 problems loss of sleep adverse reaction
14:19 to a drug change of environment almost
14:21 anything it may also be that with
14:24 increasing age and long-term worries the
14:26 brain simply gets less efficient coping
14:29 with stress in addition there may still
14:32 be some lingering old disturbing worries
14:34 thoughts memories that have been buried
14:36 in the unconscious mind but are
14:37 resurfacing now because the brain has
14:39 not been able to deal with them
14:42 past for those who have experienced a
14:45 traumatic benidipine withdrawal an
14:47 element of post-traumatic stress
14:49 disorder PTSD may be involved this is a
14:53 recurrent condition that can be
14:54 triggered by small reminders of the past
14:56 trauma it is as if any new stress pushes
14:59 the individual over the limits of his
15:00 stress coping abilities as discussed
15:03 above some people who have been on
15:05 long-term benzo a pain treatment have a
15:07 lowered tolerance to stress even after
15:10 they have stopped taking the drug and
15:12 are therefore more vulnerable to new or
15:15 stresses it is not clear why many people
15:17 report experiencing adverse effects from
15:19 new drugs or drugs they have tolerated
15:21 before taking benzodiazapines the drugs
15:24 involved are so disperate from skin
15:27 ointments to eye drops to local
15:28 anesthetics to anti-depressants steroids
15:31 and many others that it is difficult to
15:34 attribute these reactions to metabolic
15:36 effects allergies or other known
15:38 effects presumably the general hypers
15:41 sensitivity of the nervous system
15:43 magnifies the reaction to any foreign
15:46 substances but no clear explanation has
15:48 yet emerged an exception is quinolone
15:51 antibiotics which displace
15:53 benzodiazapines from their binding sites
15:56 and should not be taken by patients on
15:58 or re recently on benzo aines
16:03 abducting a dilemma faced by some people
16:06 in the process of benzodiazapine
16:08 withdrawal or after withdrawal is what
16:11 to do if they have intolerable symptoms
16:13 which do not lessen after many weeks if
16:16 they are still taking benzodiazapines
16:17 should they increase the dose if they
16:20 have already withdrawn should they
16:22 reinstate benzodiazapines and start the
16:24 withdrawal process again this is a
16:27 difficult situation when which like all
16:29 benzodiazapine problems depends to some
16:32 degree on the circumstances and the
16:33 individual and there are no hard and
16:36 rules reinstatement after
16:39 withdrawal many benzo aine users who
16:42 find themselves in this position have
16:44 withdrawn too quickly some have
16:46 undergone cold turkey they think that if
16:48 they go back on benzo diazines and start
16:51 over again on a slower schedule they
16:52 will be more successful unfortunately
16:56 things are not so simple for reasons
16:58 that are not clear but perhaps because
17:00 the original experience of withdrawal
17:02 has already sensitized the nervous
17:03 system and heightened the level of
17:05 anxiety the original benzodiazapine dose
17:08 often does not work the second time
17:10 round some may find that only a higher
17:12 dose partially alleviates their symptoms
17:15 and then they still have to go through a
17:16 long withdrawal process again which
17:19 again may not be symptom
17:21 free abducting during
17:24 withdrawal some people hit a sticky
17:26 patch during the course of benzodi as a
17:28 withdrawal in many cases staying on the
17:31 same dose for a longer period not more
17:34 than a few weeks before resuming the
17:36 withdraw schedule allows them to
17:37 overcome this obstacle however
17:40 increasing the dose until a longed for
17:42 plateau of stability arrives is not a
17:45 good strategy the truth is that one
17:47 never stabilizes on a given dose of
17:49 benzodiazapine the dose may be stable
17:52 but withdrawal symptoms are not it is
17:54 better to grit one's teeth and continue
17:56 the withdrawal true recovery cannot
17:58 really start until the drug is out of
18:01 system pharmacologically neither
18:04 reinstating nor abducting is really
18:06 rational if withdrawal symptoms are
18:09 still present it means that the gabab
18:11 benza dipane receptors have not fully
18:13 recovered C above further
18:15 benzodiazapines cause further down
18:17 regulation strengthen the dependence
18:20 prolong withdrawal delay recovery and
18:22 may lead to protracted symptoms in
18:25 general the longer the person remains on
18:27 benzo the more difficult it is to
18:30 withdraw on the whole anyone who
18:33 remained benzoo aine free or has
18:35 remained on the same dose for a number
18:37 of weeks or months would be ill advised
18:39 to start again or to increase dosage it
18:42 would be better to devote the brain to
18:44 solving individual symptoms and to
18:46 finding sources of advice and
18:48 support nutritional supplements added
18:52 2012 there is no evidence that
18:54 nutritional supplements such as vitamins
18:57 minerals amino acids Etc are helpful in
19:00 benzodiazapine withdrawal excessive
19:03 doses of some can be toxic and others
19:05 may even contain benzol likee substances
19:08 that have the same adverse effects as
19:10 benzo diazines themselves nor is there
19:13 any evidence that suggests benzoo ofine
19:15 withdrawal causes vitamin mineral or
19:19 deficiencies no one should take
19:20 supplements without clear evidence of a
19:22 specific deficiency those who Advocate
19:25 multiple supplements should first show
19:27 evidence of any deficien
19:29 and then conduct proper controlled
19:30 trials in particular taking Gaba
19:33 precursors does not increase Gaba
19:35 concentrations in the brain benzoo aines
19:38 do not decrease Gaba concentrations
19:40 instead they alter Gaba receptor
19:42 Affinity this slowly reverses without
19:45 the need for supplements and there is no
19:47 evidence that supplements speed the
19:49 process people taking or withdrawing
19:51 from benzodiazapines should eat a normal
19:53 healthy diet which after all consists of
19:57 natural substan is and contains all the
19:59 ingredients necessary for the body some
20:02 products which people have tried and
20:04 found to be at best useless at worst
20:06 harmful include mineral and vitamin
20:09 supplements valaran CTI Johns Wart kavak
20:13 Cava melatonin Rescue Remedy becalmed
20:17 Coline non juice 5htp same and Gaba most
20:22 recently someone reported adverse
20:23 effects from a product called
20:26 ailin metabolism of benzodiazapines
20:29 added November 21st
20:32 2013 it has long been known that there
20:34 is a wide variation between individuals
20:37 in the rate at which they metabolize
20:38 psychotropic drugs including
20:42 anti-depressants and
20:44 antipsychotics people can be poor or
20:46 slow metabolizers normal metabolizers or
20:49 extensive metabolizers for these drugs
20:52 depending on the genetically determined
20:54 activity of certain drug metabolizing
20:56 enzymes C 450 T6 enzymes in particular
21:02 there appear to be more poor and slow
21:04 metabolizers among Asian patients than
21:06 in European populations according to an
21:08 important us study this means that Asian
21:11 patients respond to lower Doses and
21:13 experience more serious side effects on
21:15 standard doses of benzodiazapines than
21:18 groups these days when multiethnic
21:21 populations including many people of
21:23 Asian extraction exist worldwide doctors
21:27 and psychiatrist s may need to be
21:29 reminded that in Asian patients
21:31 benzodiazapine and anti-depressant or
21:33 anticho prescriptions if considered
21:36 necessary should be started at half the
21:39 standard dose in case they are poor or
21:44 conclusion the advice and explanations
21:47 given in the supplement may seem
21:48 inadequate they no doubt illustrate how
21:50 much more we still need to know about
21:53 however it is important to remember that
21:56 by far the greatest majority of long
21:58 long-term benzodiazapine users do
22:00 recover from withdrawal given time even
22:03 protracted symptoms tend to decrease
22:05 gradually sometimes over years the
22:07 individual needs to know that the actual
22:09 drug withdrawal is only the first step
22:11 towards recovery it may be followed by a
22:14 prolonged period of convalescence during
22:16 which the damage caused to the person's
22:18 body and often to his whole life needs
22:21 to be repaired as far as possible but
22:23 the brain like the rest of the body has
22:26 an enormous capacity for ad adapting and
22:28 self-healing that is how life survives
22:30 and how ex benzodiazapine addicts can be
22:33 optimistic about their
![Welp, Here's what the Fed *Just* Said [Fed FOMC Minutes]](/_next/image?url=https%3A%2F%2Fi.ytimg.com%2Fvi%2Fl8u23oq1E9E%2Fhqdefault.jpg&w=3840&q=75)
