Benzos Healthiest benzo?
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DEADPOOLx23
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Healthiest? That is a rather strange way too look at it as none of those drugs are in any way healthy. Do you just mean which dont cause as much short term memory loss or cause you to lose motor skills? Because they all effect people differently and its all VERY dose dependent/tolerence dependent. So im not really sure how to qualify the responses to that....
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AnythingEverything
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I don't associate any benzo with health. They are all terrible for you ?
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Memantine? Intersting handle, OP.
Benzodiazepines are remarkably healthy, really. In an acute setting, not combined with other substances (especiallys CNS depressants) you really can't go wrong. The lethal dose is going to be exponentially higher than what would be required for sedation/anxiolysis or whatever it is you're desiring.
The dangers of illicit or otherwise unsupervised use of Benzodiazepines come in a few different forms. Now, the anti-inhibitory nature of this class can cause you to do stupid, dangerous shit that you otherwise would not do, like driving a car, or punching a mounted-police officer's horse during a 4th of July parade. Also, when combining Benzo's with the aforementioned CNS depressants, like Alcohol or Opioids, your chances for an overdose increase significantly, as do your chances for dangerous inhibition.
In a chronic setting, dependence becomes dangerous when your supply runs out. "Cold-Turkey" withdrawal is acutely harmful to the brain and body, not to mention the fact that it's an extremely unpleasant process.
In short, if you're abusing Benzodiazepines chronically, you are asking for a lot of unnecessary trouble and hardship. The withdrawal syndrome of both Benzodiazepines and Alcohol is more traumatic than that of say, Opioids, with a lot less of the initial pleasure. If you're just dabbling occasionally, you should be fine, just don't go combining them with other drugs and make sure to avoid taking them everyday. The safety profile is pretty similar from Benzo to Benzo, the one factor that makes one more likely to be dangerous is the onset/duration of effect and to a lesser extent, the half-life. So, a short acting Benzodiazepine like say, Triazolam (Halcion) or Alprazolam (Xanax) is more likely to make you act a fool or OD, given the fast, hard punch they deliver.
Benzodiazepines are remarkably healthy, really. In an acute setting, not combined with other substances (especiallys CNS depressants) you really can't go wrong. The lethal dose is going to be exponentially higher than what would be required for sedation/anxiolysis or whatever it is you're desiring.
The dangers of illicit or otherwise unsupervised use of Benzodiazepines come in a few different forms. Now, the anti-inhibitory nature of this class can cause you to do stupid, dangerous shit that you otherwise would not do, like driving a car, or punching a mounted-police officer's horse during a 4th of July parade. Also, when combining Benzo's with the aforementioned CNS depressants, like Alcohol or Opioids, your chances for an overdose increase significantly, as do your chances for dangerous inhibition.
In a chronic setting, dependence becomes dangerous when your supply runs out. "Cold-Turkey" withdrawal is acutely harmful to the brain and body, not to mention the fact that it's an extremely unpleasant process.
In short, if you're abusing Benzodiazepines chronically, you are asking for a lot of unnecessary trouble and hardship. The withdrawal syndrome of both Benzodiazepines and Alcohol is more traumatic than that of say, Opioids, with a lot less of the initial pleasure. If you're just dabbling occasionally, you should be fine, just don't go combining them with other drugs and make sure to avoid taking them everyday. The safety profile is pretty similar from Benzo to Benzo, the one factor that makes one more likely to be dangerous is the onset/duration of effect and to a lesser extent, the half-life. So, a short acting Benzodiazepine like say, Triazolam (Halcion) or Alprazolam (Xanax) is more likely to make you act a fool or OD, given the fast, hard punch they deliver.
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muie
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Nitrobenzodiazepines Are Most Toxic
I don't know which are the safest but I can certainly will tell you which ones are the worst (IMO & IME) in terms of cognition and long term organ damage.
The absolute worst especially for cognitive function & for long term organ damage:
1. Lorazepam (with small to medium tolerance, any dose above 2mg+ will provide extreme amnesia). I've tried more benzos than I care to admit and I've never encountered another benzo that produces this much amnesia at a medicinal dose.
Something to look out for is the class of benzodiazepines called 'nitrobenzodiazepines' which are carcinogenic and much more dangerous than other benzos. I've been taking 4mg/day clonazepam, without skipping a day for the last 12years, ever since 2004!
Below is a direct quote from a very reliable source that I saved and if pestered with comments to give the reference, although I don't know it, it shouldn't be a problem finding it...in case there are skeptics
"Nitrobenzodiazepines such as nitrazepam, nimetazepam, flunitrazepam, and clonazepam are more toxic to the liver than other benzodiazepines as they are metabolically activated by CYP3A4 which can result in cytotoxicity. This activation can lead to the generation of free radicals and oxidation of thiol, as well as covalent binding with endogenous macromolecules; this results, then, in oxidation of cellular components or inhibition of normal cellular function. Metabolism of a nontoxic drug to reactive metabolites has been causally connected with a variety of adverse reactions. Nitrazepam has been associated with severe hepatic disorders, similar to other nitrobenzodiazepines. Clonazepam is a chlorinated derivative of nitrazepam and therefore a chloro-nitrobenzodiazepine."
I hope this helped!
BTW, Keif' the reason it is said benzos are 'healthier' is because of their therapeutic index, and that reason alone!!! More dangerous drugs like barbiturates, or worse (methaqualone) which have a very narrow therapeutic index meaning that their medicinal dose is very close to their lethal dose/overdose. The comment made by Keif' can be very mislead as far as harm reduction goes! Benzos are still physically and mentally addictive and produce both physical and psychological withdraws. With time benzos not only destroy the body's organs but significantly interfere with the brains day to day operations such as memory or cognitive performance. Barbiturates on the other hand have never gotten in the way of memory or learning, even though their therapeutic index is much narrower. Therefore, Keif' no, benzos are not healthier!
I don't know which are the safest but I can certainly will tell you which ones are the worst (IMO & IME) in terms of cognition and long term organ damage.
The absolute worst especially for cognitive function & for long term organ damage:
1. Lorazepam (with small to medium tolerance, any dose above 2mg+ will provide extreme amnesia). I've tried more benzos than I care to admit and I've never encountered another benzo that produces this much amnesia at a medicinal dose.
Something to look out for is the class of benzodiazepines called 'nitrobenzodiazepines' which are carcinogenic and much more dangerous than other benzos. I've been taking 4mg/day clonazepam, without skipping a day for the last 12years, ever since 2004!
Below is a direct quote from a very reliable source that I saved and if pestered with comments to give the reference, although I don't know it, it shouldn't be a problem finding it...in case there are skeptics
"Nitrobenzodiazepines such as nitrazepam, nimetazepam, flunitrazepam, and clonazepam are more toxic to the liver than other benzodiazepines as they are metabolically activated by CYP3A4 which can result in cytotoxicity. This activation can lead to the generation of free radicals and oxidation of thiol, as well as covalent binding with endogenous macromolecules; this results, then, in oxidation of cellular components or inhibition of normal cellular function. Metabolism of a nontoxic drug to reactive metabolites has been causally connected with a variety of adverse reactions. Nitrazepam has been associated with severe hepatic disorders, similar to other nitrobenzodiazepines. Clonazepam is a chlorinated derivative of nitrazepam and therefore a chloro-nitrobenzodiazepine."
I hope this helped!
BTW, Keif' the reason it is said benzos are 'healthier' is because of their therapeutic index, and that reason alone!!! More dangerous drugs like barbiturates, or worse (methaqualone) which have a very narrow therapeutic index meaning that their medicinal dose is very close to their lethal dose/overdose. The comment made by Keif' can be very mislead as far as harm reduction goes! Benzos are still physically and mentally addictive and produce both physical and psychological withdraws. With time benzos not only destroy the body's organs but significantly interfere with the brains day to day operations such as memory or cognitive performance. Barbiturates on the other hand have never gotten in the way of memory or learning, even though their therapeutic index is much narrower. Therefore, Keif' no, benzos are not healthier!
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Znegative
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Shit, that's interesting ^. I really need to get my liver checked out, unfortunately I don't see my newly assigned UNHC doctor until the 28th. I'll keep this thread open and in OD, but if the OP could please rephrase the first post to be a little more specific, I would appreciate it. I think this could lend some good HR information, I've already learned something new. I think I'll ask my psych to switch me to Diazepam if that's the case with clonazepam because I have to taper off anyway and with an impaired liver it sounds like a good reason/excuse .
.
Solipsis
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Yes there are a few factors that you could associate with 'healthy' or 'least unsafe', and they are hard to compare - apples and pears:
- The therapeutic index was mentioned
- Side-effects and toxicity were also mentioned: some benzo's come with additional toxic properties other benzo's may not have.
- Selectivity: if you take something like pyrazolam for anxiety, it's possibly one of the best ways to target it since you can avoid both the direct side-effects like sedation as well as the inverse when you withdraw from the drug. So if you 'must' take a benzo it is best that it does as little as possible while meeting the requirements for being effective for your needs. I really hate psychiatric medications that are like carpet bombing when you only need a sniper. Also you probably want the least affinity for the gamma2 GABA subtype since that is associated with physical dependency. You also want benzo's that don't act (much or at all) on IIRC alpha5 since that mostly fucks with your cognition / memory. (That may be answer to question in the OP but unfortunately I can find no information about different benzo affinities for alpha5, or alpha3 and 5 together - which would be the measure for association with effects on cognition etc). This could be mentioned under the previous bullet: side-effects since I don't think your cognition or memory being fucked with is EVER desirable unless you abuse benzo's to forget shit.
You can't very well suggest benzo's that properly follow the above criteria without stating what you need the benzo for.
For anxiety pyrazolam seems great because it is so selective for that (but it is not a prescription drug), for sleep arguably the Z-drugs are better because they are selective (however they may also be slightly carcinogenic although not so seriously that a significant number of subjects get that - everyone would be outraged and e.g. the FDA would shut it down - same goes for those nitrobenzodiazepines: the harmful effect may be there but I can't imagine the odds of getting cancer from it to be but slim.
Also pretty much all the hypnotic benzo's also have high potential for physical dependency having both high alpha1 AND gamma2 affinity.
Like Z-drugs such as zolpidem/ambien, benzos are not meant to be taken long-term anyway and if you do that regardless, minor carcinogenicity will probably one of the least of your worries to be honest.
For anti-convulsant effect I think I would say diazepam since it has high alpha3 (anticonvulsives) affinity without having the bad high gamma2 (physical dependency) affinity like many of the others that have high alpha3 affinity, for muscle relaxation nitrazepam is very effective (most of all I tried) despite being a nitrobenzodiazepine. I'd say it's sort of selective for that.
- The therapeutic index was mentioned
- Side-effects and toxicity were also mentioned: some benzo's come with additional toxic properties other benzo's may not have.
- Selectivity: if you take something like pyrazolam for anxiety, it's possibly one of the best ways to target it since you can avoid both the direct side-effects like sedation as well as the inverse when you withdraw from the drug. So if you 'must' take a benzo it is best that it does as little as possible while meeting the requirements for being effective for your needs. I really hate psychiatric medications that are like carpet bombing when you only need a sniper. Also you probably want the least affinity for the gamma2 GABA subtype since that is associated with physical dependency. You also want benzo's that don't act (much or at all) on IIRC alpha5 since that mostly fucks with your cognition / memory. (That may be answer to question in the OP but unfortunately I can find no information about different benzo affinities for alpha5, or alpha3 and 5 together - which would be the measure for association with effects on cognition etc). This could be mentioned under the previous bullet: side-effects since I don't think your cognition or memory being fucked with is EVER desirable unless you abuse benzo's to forget shit.
You can't very well suggest benzo's that properly follow the above criteria without stating what you need the benzo for.
For anxiety pyrazolam seems great because it is so selective for that (but it is not a prescription drug), for sleep arguably the Z-drugs are better because they are selective (however they may also be slightly carcinogenic although not so seriously that a significant number of subjects get that - everyone would be outraged and e.g. the FDA would shut it down - same goes for those nitrobenzodiazepines: the harmful effect may be there but I can't imagine the odds of getting cancer from it to be but slim.
Also pretty much all the hypnotic benzo's also have high potential for physical dependency having both high alpha1 AND gamma2 affinity.
Like Z-drugs such as zolpidem/ambien, benzos are not meant to be taken long-term anyway and if you do that regardless, minor carcinogenicity will probably one of the least of your worries to be honest.
For anti-convulsant effect I think I would say diazepam since it has high alpha3 (anticonvulsives) affinity without having the bad high gamma2 (physical dependency) affinity like many of the others that have high alpha3 affinity, for muscle relaxation nitrazepam is very effective (most of all I tried) despite being a nitrobenzodiazepine. I'd say it's sort of selective for that.
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Okay, I don't want to be misleading in any way. Benzodiazepine dependence is a life threatening, altering thing. In severe cases, loss of life, loss of freedom, etc. etc. And, they are especially prone to misuse for a variety of reasons. All I was trying to imply, is that Benzodiazepines are very effective drugs when used properly and there are many who use Benzodiazepines in on way or another for their entire life, without it leading to addiction or severe dependence.
So yea, it's worth reiterating that Benzodiazepines are very effective medicine and for this reason are highly addictive as well. For somebody with addictive personality traits, Benzo's can easily become a big problem, quickly.
Apologies if I mislead.
So yea, it's worth reiterating that Benzodiazepines are very effective medicine and for this reason are highly addictive as well. For somebody with addictive personality traits, Benzo's can easily become a big problem, quickly.
Apologies if I mislead.
Solipsis
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I honestly wonder about people who seek out continous benzo use in the first place, and believe that the people most susceptible are not necessarily those looking for a high, but rather "self-medication" or you could also judge it as a form of escapism.
A lot of people find benzo's pretty boring, sure a few benzos can hit like a truck but most of them primarily relax you mentally and/or physically which is mostly interesting if you have problems with doing that naturally. If loosening up is not a big deal to you and just something welcome as an extra from time to time that is a world of difference from having structural problems with anxiety.
I pretty much never took benzo's recreationally, but I do have an addictive personality - and I used/abused them for a while with little consequence (meaning I was already gradually bailing, being able to cope less and less) until I had a huge crisis in my life generally and in the aftermath started using them "self-prescribed" so daily as medication to cope.
Also I had to eventually kick them which was a majorly painful and super long process and I don't wish that on anyone.. now / since then I just realize that using them cannot be sustainable so I don't take them that way anymore, but can occasionally take a benzo. I don't see an issue with it that is nearly as significant as my general polyuse tendencies since my PDD/NOS and probably or soon-to-diagnose ADD can sometimes have me reeling. But fortunately I have a prescription that fills in a big part of that day-to-day problem, so I am not bothered anymore every second of the day like I once was. Cause in that state it is hard to reject things that (temporarily) fix it, especially if you have a poor view of the dangers of taking a benzo indefinitely.
Also apparently some people do recreationally like becoming utterly disinhibited, but I never had much like for that. I've on occasion done it with alcohol but I have very little desire to high-dose benzos for that purpose barring some isolated exception perhaps.
But no: DO NOT EVER start taking benzo's self-prescribed for self-medicating purposes. Psychiatrists can be a pain in the ass and some are not very good, but the supervision is necessary to avert disaster that you yourself cannot, especially in a sensitive state and disinhibited from taking a benzo prescribed for a short while in the first place. I wish I had never started taking benzo's on my own accord but I would have taken them prescribed and supervised during that critical time!
Don't fuck around yourself. Please do yourself a favor and don't ruin years of your life or more.
A lot of people find benzo's pretty boring, sure a few benzos can hit like a truck but most of them primarily relax you mentally and/or physically which is mostly interesting if you have problems with doing that naturally. If loosening up is not a big deal to you and just something welcome as an extra from time to time that is a world of difference from having structural problems with anxiety.
I pretty much never took benzo's recreationally, but I do have an addictive personality - and I used/abused them for a while with little consequence (meaning I was already gradually bailing, being able to cope less and less) until I had a huge crisis in my life generally and in the aftermath started using them "self-prescribed" so daily as medication to cope.
Also I had to eventually kick them which was a majorly painful and super long process and I don't wish that on anyone.. now / since then I just realize that using them cannot be sustainable so I don't take them that way anymore, but can occasionally take a benzo. I don't see an issue with it that is nearly as significant as my general polyuse tendencies since my PDD/NOS and probably or soon-to-diagnose ADD can sometimes have me reeling. But fortunately I have a prescription that fills in a big part of that day-to-day problem, so I am not bothered anymore every second of the day like I once was. Cause in that state it is hard to reject things that (temporarily) fix it, especially if you have a poor view of the dangers of taking a benzo indefinitely.
Also apparently some people do recreationally like becoming utterly disinhibited, but I never had much like for that. I've on occasion done it with alcohol but I have very little desire to high-dose benzos for that purpose barring some isolated exception perhaps.
But no: DO NOT EVER start taking benzo's self-prescribed for self-medicating purposes. Psychiatrists can be a pain in the ass and some are not very good, but the supervision is necessary to avert disaster that you yourself cannot, especially in a sensitive state and disinhibited from taking a benzo prescribed for a short while in the first place. I wish I had never started taking benzo's on my own accord but I would have taken them prescribed and supervised during that critical time!
Don't fuck around yourself. Please do yourself a favor and don't ruin years of your life or more.
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morphine-dreams
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There's no such thing as a benzo without cognitive impairment, especially with long term use. Maybe I'm particularly sensitive, but I felt brain damaged when I used benzos (though I did abuse them, but I didn't usually take them daily). To put it in perspective, I'm a pianist and could not even begin to play songs I've known for years when I was using benzos (and that was only for maybe a 3 month period MAX-I don't really remember, lol). My speech was pretty bad too. I'm back to normal now, but I'm turned off of benzos forever. I was addicted to opiates for a while and still smoke way too much weed but nothing has messed me up cognitively as bad as benzos had. Btw I'm not saying that benzos will affect everyone this way, but they certainly have the capacity to.
What about alprazolam and temazepam. Are they bad in terms of gamma2 and alpha5 affinity? Or maby clobazam?
I am looking for strong anxiolysis and anticonvulsant action for my aspergers syndrome. And not just temporary but for the long term.
XANAX XR
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Glad you posted this, was really curious as to why people were claiming benzos were unhealthy. They're virtually harmless to your physical body at therapeutic dosage and even beyond that as long as they're not taken for too long of a period.
Bluesbreaker
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Didn't read all but oxazepam is a good benzo, it doesn't get metabolized by the liver, comes in 10mg pill = around 5mg valium.
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Memantine, could you possibly elaborate as to what you're looking for relief from? Why do you need a strong anticonvulsant specifically?
Long-term treatment wih Benzodiazepines is where tolerance and dependence can come into play and screw you two-fold in that your medicine can stop working, while you require more medicine just to get yourself normal. I'm not saying every chronic Benzodiazepine user becomes a shaky, convulsing mess, but you can become reliant on them.
Alprazolam is great, sure. It's strong, with a fast onset and powerful anxiolysis. Temazepam has a lot of the same qualities; fast, strong, etc. but, I would think that if you wanted a more constant "level" you would want a longer-acting drug, like Diazepam or Clonazepam for instance.
Long-term treatment wih Benzodiazepines is where tolerance and dependence can come into play and screw you two-fold in that your medicine can stop working, while you require more medicine just to get yourself normal. I'm not saying every chronic Benzodiazepine user becomes a shaky, convulsing mess, but you can become reliant on them.
Alprazolam is great, sure. It's strong, with a fast onset and powerful anxiolysis. Temazepam has a lot of the same qualities; fast, strong, etc. but, I would think that if you wanted a more constant "level" you would want a longer-acting drug, like Diazepam or Clonazepam for instance.
AnythingEverything
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Interesting re the annesia and lorazepam. It explains to me why I cannot remember a single detail about one of my psych ward stays in particular. I was already taking 400-500mg of valium a day plus xanax and had my own stash in hospital along with my oxy but they were giving me lorazepam and other psych drugs and this is the first time I've experinces any blackouts ( let alone a whole week followed by a train trip to my first ever suhoxone ALOT, of which I can also remember NOTNING.
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Haha, I'm sorry, but I think I know why you couldn't remember that particular hospital stay, and yea, the Lorazepam probably played a part in that...
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I don't think you'd be able to find that answer at all, much less with pharmacodynamic theory. You'd need a meta-analysis of double-blind, placebo controlled longitudinal studies comparing all the kinds of benzos. This doesn't exist. Also, if all drugs affected all people the same, there would be no need to synthesize and market multiple drugs for the same basic illness. I'm kind of surprised that you're asking this, as (if I recall right) some of your previous posts appreciated the complexity of this whole thing.
Generally speaking, hypnotic benzos are more toxic (alpha1 ligands). So, restoril, halcion, and some others. Valium isn't really used anymore because clonazepam is therpeutically active for longer, less abusable, is active at a lower dose, and deals with anxiety related to mania.
Oxazepam is less addictive than most of the others.
When it comes down to it, if you're on any benzo for decades, there is going to be some brain morphology that could be labeled as "damage". This is along with the fact that benzos do tend to "poop out".
There's debate about whether the shorter-acting benzos are better than the longer-acting ones or not. Xanax and ativan may not always be in one's system, so perhaps tolerance accrues less fast. But maybe the spike in activity isn't good, and creates more panic attacks than if one keeps levels more steady. In my opinion, longer-acting ones have worked better for me. I don't take benzos anymore though.
For cognition, those hitting the alpha1 and alpha5 subunites are probably worse, so long as you're taking small therapeutic doses of something like xanax (which mostly binds to alpha2/alpha3), and not doses that would cause a blackout. But again, imo the shorter-acting benzos tend to cause anxiety when they're not in your system.
If I were in your position, I'd try a real anticonvulsant before taking the risk of being hopelessly dependent on something that could damage your mind and brain while working as little more than a sugar pill, in the future.
Generally speaking, hypnotic benzos are more toxic (alpha1 ligands). So, restoril, halcion, and some others. Valium isn't really used anymore because clonazepam is therpeutically active for longer, less abusable, is active at a lower dose, and deals with anxiety related to mania.
Oxazepam is less addictive than most of the others.
When it comes down to it, if you're on any benzo for decades, there is going to be some brain morphology that could be labeled as "damage". This is along with the fact that benzos do tend to "poop out".
There's debate about whether the shorter-acting benzos are better than the longer-acting ones or not. Xanax and ativan may not always be in one's system, so perhaps tolerance accrues less fast. But maybe the spike in activity isn't good, and creates more panic attacks than if one keeps levels more steady. In my opinion, longer-acting ones have worked better for me. I don't take benzos anymore though.
For cognition, those hitting the alpha1 and alpha5 subunites are probably worse, so long as you're taking small therapeutic doses of something like xanax (which mostly binds to alpha2/alpha3), and not doses that would cause a blackout. But again, imo the shorter-acting benzos tend to cause anxiety when they're not in your system.
If I were in your position, I'd try a real anticonvulsant before taking the risk of being hopelessly dependent on something that could damage your mind and brain while working as little more than a sugar pill, in the future.