Benzos Does tolerance build to the anxiolytic and antipanic effects of benzodiazepines?

[CuriosityMonster]

I've read that in the case of long-term usage of benzodiazepines that a tolerance becomes established fairly quickly in regards to the sedative and hypnotic effects of these drugs. However in regards to the substances' anxiolytic and antipanic properties, authoritative sources are conflicting as to whether tolerance develops. I'm interested in hearing some anecdotal accounts. To those with experience with the long-term usage of benzodiazepines, would you say that the drug continued to work with efficiency in relation to its anxiety-inhibiting properties or did a tolerance build? If so, how long did it take for tolerance to build?

 

[dood42069]

I believe as the anxiety reducing properties tolerence goes up, that would be the tolerance of the whole drug (if that makes any sense?)

 

[CuriosityMonster]

I believe as the anxiety reducing properties tolerence goes up, that would be the tolerance of the whole drug (if that makes any sense?)

Do you mean to say all the different effects are proportionate in regards to how effected they are by tolerance? If I take a benzo for a few days it'll stop making me drowsy, but in terms of the anxiolytic effects, they persist. Wouldn't this suggest that there are different levels of tolerance for different aspects of the drug?

Thank you for your reply.

 

[Jekyl Anhydride]

The anxiolysis seems to fade a little with time but doesn't necessarily vanish like the sedative properties do IME. I don't mean to set an example but I have 18 years with Alprazolam and Opioids/ates of varying kinds, usually oxy but occasionally MS. The alprazolam enhances the Oxy but with such long term use it causes an excitory effect in me and taking a mg or two in the late evening can keep me up which seems paradoxical to it's intended effects. I'm seriously trying to get a hold of some Ultra Low dose Naltrexone or even Naloxone which seems crazy being in the "Fentanyl Age" and still having some difficulty obtaining it.

Inverse agonists and antagonists should be handed out like business cards at pharms in my opinion.

 

[Jabberwocky]

Naloxone is still super hard to get, mostly due to supply side and distribution related issues now (cost also used to be a big factor). Getting a prescription for it is a lot easier and harm reduction clinics are a great place to find it, but most pharmacies don't have it in stock and finding one that does can be challenging (I think I had to visit like five major pharmacies in a major city before I was able to get a reasonable order time).

I have to essentially agree with the above, as I've heard from many people that even after years on their meds they still do their job. This doesn't seem like a hard and fast rule though, and should be determined - whether a treatment is still viable - on an ongoing, case by case basis.

 

[Phenpsycho]

What i've gathered from reading is the anxiolysis effects can persist for years if you stay at the lowest effective dosage and don't abuse them.

I used to take more of them than I needed and got rebound anxiety and tolerance withdrawal but now i'm finding when using them as needed and the lowest dose possible my tolerance to the anti-anxiety effects hasn't really been impacted much. Making a choice to cut out alcohol if you need the benzos is a good idea too and never increase the dosage, if it becomes ineffective for anxiety then you should take a break.

There is definitely a huge difference in the pace that tolerance to the hypnotic effects develops as opposed to the anti-anxiety effects, you would be lucky to get rest off of a low dose of a benzo for a two week period, not so for their other indications.

 

[stillkickin]

Here's my 2 cents on the topic. When taking benzos daily, I'm very hard to convince that tolerance does not build fairly rapidly, especially if using for panic type scenarios. If they're just taken PRN and only a couple times a week or less, I believe tolerance can stay steady and the dosing can remain stable and efficacy isn't diminished.

However, the shorter half life varieties I find to be much more difficult to manage when it comes to tolerance and dependence, i.e. Ativan/Xanax. It's too much of a roller coaster and rebound anxiety becomes a real issue daily if you're trying to spread your dosing out. This is regarding daily dosing though and not PRN as mentioned above.

source: I took benzos for 7 years and didn't realize how addicting they are physically. Never abused them and only took when necessary but I started using them nightly due to insomnia as prescribed by my Dr. Coming off of benzos was the most hellish withdrawal process I've ever had, and I've been through countless wicked opiates detoxes. Actually on the tail end of one as I'm typing this. The benzo withdrawal took me about 9 months to get back to mostly baseline. That w/d was the most pure definition of true terror and mental terrorism I've ever experienced. I rate it 0/10 and most definitely would not do again 8(

I limit my .25mg alprazolam dosing to 2/week at most and I don't seem to build any tolerance issues or dependence when I don't take it nor rebound anxiety.

Hope that helps!

-SK

 

[CuriosityMonster]

I limit my .25mg alprazolam dosing to 2/week at most and I don't seem to build any tolerance issues or dependence when I don't take it nor rebound anxiety.

Hope that helps!

-SK

0.25mg of alprazolam twice a week controls your symptoms? Really? Do you take any supplements or anything like that? Considering the half-life of alprazolam is 11-12 hours I would've thought that such a way of taking the drug would be ineffective.

 

[keeping]

0.25mg of alprazolam twice a week controls your symptoms? Really? Do you take any supplements or anything like that? Considering the half-life of alprazolam is 11-12 hours I would've thought that such a way of taking the drug would be ineffective.

i assume stillkickin is using his xans sparingly, like only when he can feel a panic attack or something coming as opposed to taking it pre-preemptively everyday.
imo this is the best way to use xanax, i'm pretty against taking benzos daily but if you had to something longer lasting like clonaz or diaz would be much more appropriate.
༼ ༎ຶ ෴ ༎ຶ༽

 

[stillkickin]

i assume stillkickin is using his xans sparingly, like only when he can feel a panic attack or something coming as opposed to taking it pre-preemptively everyday.
imo this is the best way to use xanax, i'm pretty against taking benzos daily but if you had to something longer lasting like clonaz or diaz would be much more appropriate.
༼ ༎ຶ ෴ ༎ຶ༽

You're spot on keeping. After having a legit benzo dependence in the past and successfully detoxing from it, I only reserve dosing for periods where I'm having a very very hard time. As far as controlling anxiety on a daily basis now, I've learned to cope with it better and remain more aware of triggers and and my personal diffusion methods. Regular exercise seems to help combat anxiety significantly for me as well.

We are in agreement that I would rarely if ever promote the idea that daily benzo intake is a wise method of dealing with chronic anxiety due to the dependence issues primarily. There are other cognitive drawbacks associated with use as well that aren't appealing if at all can be avoided.

 

[keeping]

I only reserve dosing for periods where I'm having a very very hard time. As far as controlling anxiety on a daily basis now, I've learned to cope with it better and remain more aware of triggers and and my personal diffusion methods. Regular exercise seems to help combat anxiety significantly for me as well.

that's totally awesome man - borderline inspirational, i fuck with that ༼ ༎ຶ ෴ ༎ຶ༽

 

[dood42069]

Do you mean to say all the different effects are proportionate in regards to how effected they are by tolerance? If I take a benzo for a few days it'll stop making me drowsy, but in terms of the anxiolytic effects, they persist. Wouldn't this suggest that there are different levels of tolerance for different aspects of the drug?

Thank you for your reply.

Yeah, I suppose that could or you just get used to the drowiness

No problem man! I love helping people out.

i assume stillkickin is using his xans sparingly, like only when he can feel a panic attack or something coming as opposed to taking it pre-preemptively everyday.
imo this is the best way to use xanax, i'm pretty against taking benzos daily but if you had to something longer lasting like clonaz or diaz would be much more appropriate.
༼ ༎ຶ ෴ ༎ຶ༽

Agreed.

 

[stillkickin]

that's totally awesome man - borderline inspirational, i fuck with that ༼ ༎ຶ ෴ ༎ຶ༽

Thanks mang! It was a bitch getting here, but I know what the cost is of having another legit detox and I just can't be livin that again.