"Symptom Reduction In Persons
Withdrawing from
Benzodiazepines"
By: TERRY NEHER, DDS, CCDC, NCAC
Vice President, Research and Development
NeuroGenesis, Inc. League City,
Texas
ABSTRACT
An amino acid, vitamin and mineral formulation was designed to restore
GABAergic, opioidergic, and serotonergic deficits observed in persons
suffering acute and protracted withdrawal symptoms associated with reduced use
of benzodiazepines. In addition amino acids, vitamins and minerals were added
which have been shown to further reduce anxiety provoked responses of striated
and cardiac musculature.
Seventeen adult male and eighteen adult female subjects who had been
prescribed benzodiazepines for periods of time ranging from one to fifteen
years, and who were all experiencing withdrawal symptoms as a result of
attempting to reduce and stop the drugs, volunteered for the study.
Twenty seven of the participants were following the tapering regimen
suggested by Professor Heather Ashton of England and described in her manual
"Benzodiazepines, How they Work and How to Withdraw". This guide is
strongly supported by the author of this study. Each respondent understood
they would not know whether they were receiving placebo or experimental
product.
Each was given a 30 day supply of either placebo or experimental. At the
end of 30 days the products were switched and those having received placebo
received experimental and visa versa. Symptoms were described and noted for
each participant prior to beginning the study and during the study. Symptoms
varied from extreme to moderate withdrawal depending on the benzodiazepine
being used. Those persons attempting to taper Klonopin, Xanax or Ativan had a
more difficult time due to rapid cycling of highs and lows of Norepinepherine
activity. Those persons on long acting benzodiazepines such as Valium were
more successful in the tapering process and experienced lower levels of
anxiety and associated symptoms.
Regardless of the drug being used, however, all respondents but two
expressed that they were better able to function and were more clear headed
when using the supplement as part of their tapering. The time period for this
study was relatively short and further results will be documented over the
coming months. At this time the product is scheduled to be tested in Europe as
well as the United States.
INTRODUCTION
Since 1964 the use of benzodiazepines in this country has exploded to
epidemic proportions. Librium, the first discovered, became known as
"mothers little helper" and prescriptions for these
"tranquilizers" were soon in the millions per year. People began to
expect a pill to solve their problems of worry and anxiety and we soon stopped
"solving" our problems and took drugs to change the way we felt. No
one knew or expected that the use of these pharmaceuticals would one day
create a monster of a problem linked to their use.
As patients took these drugs for longer periods of time and then attempted
to stop they were confronted with terrible psychological and physiological
withdrawal symptoms which incapacitated them. People in withdrawal have lost
jobs, families, their very lives as the extreme anxiety, sleeplessness,
confusion, heart problems and other extreme withdrawal factors prevented them
from interacting in society in any meaningful manner.
Even patients who attempted to very slowly taper their dosages and
gradually withdraw from this dependency experienced some degree of discomfort
and the difficulty remained for months and years after use. While these people
were no longer "dependent" on the benzodiazepine they continued to
suffer protracted withdrawal and a significant degree of disability.
Over the years even more potent benzodiazepines have been developed with
the result that even more debilitating withdrawal is now evident. Recently,
persons who were familiar with NeuroGenesis products and successes with
nutritional supplements ask that we look at the "benzo" problem and
determine if we could help those suffering with this dependency with a
nutritional supplement.
Upon reading the "Ashton Manual" on withdrawing from
benzodiazepines and talking with numbers of people in this predicament it soon
became clear that each person's experience of withdrawal is unique. Although
there are many features in common, every individual has his/her own personal
pattern of withdrawal symptoms. These differ in type, quality, severity,
time-course, duration, and many other features. Such variety is not surprising
since the course of withdrawal depends on many factors: the dose, type,
potency, duration of action and length of use of a particular benzodiazepine,
the reason it was prescribed, the personality and individual vulnerability of
the patient, his or her lifestyle, personal stressors and past experiences,
the rate of withdrawal, and the degree of support available during and after
withdrawal, to name but a few.
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SUBJECTS AND METHOD
Eighteen adult female and seventeen adult male subjects from all areas of
the United States made it known they would be willing to participate in a
study related to benzodiazepine withdrawal. All but three of the subjects were
currently taking benzodiazepines and the others had been off the drugs for
periods of time up to 12 months. Of those on the drugs all but two were
following some kind of a tapering regimen for gradual withdrawal. Ten of the
subjects were taking Klonopin, eight were taking Xanax, two were taking Ativan
and twelve were taking Valium.
Each person was interviewed by telephone and asked to describe the dose
they were taking, any other medications, any other supplements and the
symptoms they experienced on a daily basis. As expected the symptoms varied
greatly but all described a torment that prevented the person from interacting
in family and society successfully. (Persons taking antidepressants at the
same time as benzodiazepines were excluded from the study). Each was then sent
either placebo or experimental product sufficient to last 30 days and asked to
take six capsules per day in divided doses. Each person was reinterviewed at
periods between two and four weeks of the study and asked to again describe
symptoms present at that time.
Not surprising, those on placebo expressed little relief from the previous
symptoms. Those on experimental product, however, indicated an awareness that
some of their symptoms had diminished, and this added hope to their process.
Interestingly, when the original experimental group was sent placebo for their
second 30 day period they all stated they could tell the original discomfort
was returning by the third week. They all requested that the previous
"product" be sent to them when reinterviewed at the second and
fourth week of the second month.
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Eighteen of the original participants have remained in contact at the four
month mark and all are still taking "experimental product". They all
report that the symptoms of withdrawal continue to wane as they taper their
use of the tranquilizer. Several have stopped the benzodiazepine and are
continuing on Neu Recover BZ and are expected to do so for an unknown period
of time.
One factor that stood out as each reported their progress/lack thereof was
that those persons taking Valium were much more able to taper their use and
experienced improved functionality sooner than those on the other
benzodiazepines. Klonopin was the most difficult to taper and assist with
symptom reduction via nutritional supplementation. All Klonopin users
described extreme mood swings and difficulty functioning when attempting to
taper the drug. Xanax users reported the same phenomenom and Ativan appeared
to be almost as difficult. As Ashton points out in her manual, it much more
simple to taper the long acting Valium and this was born out in our study.
RATIONALE FOR FORMULA
The Gamma Amino Butyric Acid (GABA) receptor is an extremely complex
receptor system. GABA accounts for almost 40% of all neurotransmitters in the
brain and this fact indicates it's importance in maintaining calm and logical
thinking. Located on the GABA receptor are several other sites that become
occupied by other various neurotransmitter chemicals. Principal among these
auxiliary receptors are those that receive benzodiazepines. When a benzo
occupies a receptor site it assists GABA in opening a channel into the neuron
on which it is located and chloride (from NaCl, salt, for instance) passes
through this channel into the neuron. This then reduces the firing rate of
that neuron and "calms" down activity. While it is obvious that we
were not born with a receptor for benzodiazepines, which were not known until
1964, it is obvious that we have a normal and natural neurotransmitter to act
at these sites. These natural transmitters act very quickly and are so quickly
degraded that they have not been positively identified and named at this time.
The issue that is most important and the issue that causes all the problems
of dependency is this: when the auxiliary receptors are occupied for longer
than normal periods of time by drugs such as benzo's the result is that the
brain begins to reduce the supply of GABA. The brain works to maintain
balance, homeostasis, and will not do what it doesn't need to do. If auxiliary
receptors are busy doing most of the work it does not need to make GABA, and
it does not. The problem comes when the person attempts to stop the use of the
drug which is assisting GABA and now there is not enough GABA to do the job on
its own. Also, since "artificial" neurotransmitters in the form of a
benzo were being introduced the brain makes less of its' own auxiliary
transmitter and the problem is compounded. Dependency now exists for the
benzodiazepine to open channels to allow chloride to calm activity. If the
channels are not opened then adrenalin and noradrenalin run rampant and
continually fuel the fight or flight response. Heart rate increases, sleep
decreases, appetite decreases, all the states that are required for an alert
are constantly present. Normal everyday human activity is not possible when
the brain and body are engaged in the process of fighting or fleeing.
CONCLUSION
The depletion of brain chemistry required to maintain calm can be brought
about by prolonged use of drugs such as benzodiazepines. The symptoms
associated with this depletion become obvious when the drug is discontinued.
The result is that the person is so incapacitated by these overwhelming
negative states that they are virtually unable to function in society. In the
past the medical community has simply told the patient to take the
benzodiazepine all the time. This leads to distinct problems with blunting of
affect and reduced ability to think and act as required for job and
family.
The solution is not more drug use. The solution has to involve rebuilding
the normal brain chemistry needed to think and act calmly and rationally. This
can be accomplished by a combined effort to gradually reduce the drug use and
at the same time provide the building blocks for normal brain function which
can only be gained from nutritional sources. In this case the precursor
loading of the selective building blocks allows brain function to eventually
resume normal function.
**Statements relating to these products have not been evaluated by the Food
and Drug Administration. These products are not intended to diagnose, treat,
cure, or prevent any disease.
