Areas › Worry and anxiety › Panic and the body
The strengthened warning on this class covers misuse, addiction, physical dependence and withdrawal. The part most people miss is that dependence builds with ordinary correct use over weeks, with nobody doing anything wrong.
That distinction needs handling gently, because patients hear dependence and hear addict. Physical dependence is the body settling around something that has been there every day, and it shows itself as a hard time coming off rather than as a hunger for more. It is also why stopping suddenly is dangerous, seizures among the risks, and why the taper is worth planning at the start rather than improvising at the end.
Qur’an and Sunnah
God wishes to lighten your burden; man was created weak (Quran 4:28). A body that adapts to what it is given is not a failure of character, and it deserves to be brought off gently.
يُرِيدُ ٱللَّهُ أَن يُخَفِّفَ عَنكُمۡۚ وَخُلِقَ ٱلۡإِنسَٰنُ ضَعِيفࣰ ا
God wishes to lighten your burden; man was created weak
Qur’an 4:28read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
Across 124 studies, cognitive and behavioural treatment for panic disorder with and without agoraphobia did better than no treatment and better than placebo controls. That is the case for having a route that does not depend on daily dosing to hold, which counts for more once dependence is in the picture. Those trials tested psychological treatment and say nothing about withdrawal, which is a regulatory warning rather than anything they measured.
Mitte K. (2005). A meta-analysis of the efficacy of psycho- and pharmacotherapy in panic disorder with and without agoraphobia.. Journal of affective disorders doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
A body that has adjusted to a daily drug needs it taken away slowly enough to adjust back.
When not to
Nobody should stop a benzodiazepine abruptly on their own, and the taper is arranged with the prescriber.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
Drug names ending in pam or lam are almost always benzodiazepines. It is a quick way to pick the class out of somebody's medication list.
Within this class the choice is mostly about how long the drug lasts rather than how well it works. They all pull on the same receptor, so the real question is what pattern of cover the person in front of you needs.
Benzodiazepines turn the volume down. They do not change the setting the volume keeps returning to, and it is worth saying that plainly before someone starts one.