Can I get help coming off my medication?

[Alastair]

Yes you can and especially if you find that the difficulty is with Benzodiazepams -- -- -- the Valium family. Below is a link to a site which will give you lots of help.
http://www.benzoisland.org/benzoforum/index.php

These are some Benzodiazepams

Table 1. BENZODIAZEPINES AND SIMILAR DRUGS5

Benzodiazepines5 Half-life (hrs)1
[active metabolite] Market Aim2 Approximately Equivalent
Oral dosages (mg)3
Alprazolam (Xanax) 6-12 a 0.5
Bromazepam (Lexotan, Lexomil) 10-20 a 5-6
Chlordiazepoxide (Librium) 5-30 [36-200] a 25
Clobazam (Frisium) 12-60 a,e 20
Clonazepam (Klonopin, Rivotril) 18-50 a,e 0.5
Clorazepate (Tranxene) [36-200] a 15
Diazepam (Valium) 20-100 [36-200] a 10
Estazolam (ProSom) 10-24 h 1-2
Flunitrazepam (Rohypnol) 18-26 [36-200] h 1
Flurazepam (Dalmane) [40-250] h 15-30
Halazepam (Paxipam) [30-100] a 20
Ketazolam (Anxon) 2 a 15-30
Loprazolam (Dormonoct) 6-12 h 1-2
Lorazepam (Ativan) 10-20 a 1
Lormetazepam (Noctamid) 10-12 h 1-2
Medazepam (Nobrium) 36-200 a 10
Nitrazepam (Mogadon) 15-38 h 10
Nordazepam (Nordaz, Calmday) 36-200 a 10
Oxazepam (Serax, Serenid, Serepax) 4-15 a 20
Prazepam (Centrax) [36-200] a 10-20
Quazepam (Doral) 25-100 h 20
Temazepam (Restoril, Normison, Euhypnos) 8-22 h 20
Triazolam (Halcion) 2 h 0.5
Non-benzodiazepines with similar effects4,5
Zaleplon (Sonata) 2 h 20
Zolpidem (Ambien, Stilnoct) 2 h 20
Zopiclone (Zimovane, Imovane) 5-6 h 15

Half-life: time taken for blood concentration to fall to half its peak value after a single dose. Half-life of active metabolite shown in square brackets. This time may vary considerably between individuals.

Market aim: although all benzodiazepines have similar actions, they are usually marketed as anxiolytics (a), hypnotics (h) or anticonvulsants (e).

These equivalents do not agree with those used by some authors. They are firmly based on clinical experience but may vary between individuals.

These drugs are chemically different from benzodiazepines but have the same effects on the body and act by the same mechanisms.

All these drugs are recommended for short-term use only (2-4 weeks maximum).

Duration of effects. The speed of elimination of a benzodiazepine is obviously important in determining the duration of its effects. However, the duration of apparent action is usually considerably less than the half-life. With most benzodiazepines, noticeable effects usually wear off within a few hours. Nevertheless the drugs, as long as they are present, continue to exert subtle effects within the body. These effects may become apparent during continued use or may appear as withdrawal symptoms when dosage is reduced or the drug is stopped.

Therapeutic actions of benzodiazepines. Regardless of their potency, speed of elimination or duration of effects, the actions in the body are virtually the same for all benzodiazepines. This is true whether they are marketed as anxiolytics, hypnotics or anti-convulsants (Table 1). All benzodiazepines exert five major effects which are used therapeutically: anxiolytic, hypnotic, muscle relaxant, anticonvulsant and amnesic (impairment of memory) (Table 2).

Table 2. THERAPEUTIC ACTIONS OF BENZODIAZEPINES (IN SHORT-TERM USE)

Action Clinical Use
Anxiolytic - relief of anxiety - Anxiety and panic disorders, phobias
Hypnotic - promotion of sleep - Insomnia
Myorelaxant - muscle relaxation - Muscle spasms, spastic disorders
Anticonvulsant - stop fits, convulsions - Fits due to drug poisoning, some forms of epilepsy
Amnesia - impair short-term memory - Premedication for operations, sedation for
minor surgical procedures

Other clinical uses, utilising combined effects:


Alcohol detoxification

Acute psychosis with hyperexcitability and aggressiveness

These actions, exerted by different benzodiazepines in slightly varying degrees, confer on the drugs some useful medicinal properties. Few drugs can compete with them in efficacy, rapid onset of action and low acute toxicity. In short-term use, benzodiazepines can be valuable, sometimes even life-saving, across a wide range of clinical conditions as shown in Table 2. Nearly all the disadvantages of benzodiazepines result from long-term use (regular use for more than a few weeks). The UK Committee on Safety of Medicines in 1988 recommended that benzodiazepines should in general be reserved for short-term use (2-4 weeks only).

Mechanisms of action. Anyone struggling to get off their benzodiazepines will be aware that the drugs have profound effects on the mind and body apart from the therapeutic actions. Directly or indirectly, benzodiazepines in fact influence almost every aspect of brain function. For those interested to know how and why, a short explanation follows of the mechanisms through which benzodiazepines are able to exert such widespread effects.

All benzodiazepines act by enhancing the actions of a natural brain chemical, GABA (gamma-aminobutyric acid). GABA is a neurotransmitter, an agent which transmits messages from one brain cell (neuron) to another. The message that GABA transmits is an inhibitory one: it tells the neurons that it contacts to slow down or stop firing. Since about 40% of the millions of neurons all over the brain respond to GABA, this means that GABA has a general quietening influence on the brain: it is in some ways the body's natural hypnotic and tranquilliser. This natural action of GABA is augmented by benzodiazepines which thus exert an extra (often excessive) inhibitory influence on neurons