forgot to mention..Valium

[vapour]

hey there, as you know from previous posts I am working up to an effective dose of lamictal currently to get partial seizues under control.

Due to also have PTSD I see a psychiatrist who is now in good contact with my neurologist for the best treatment for me.

I am having to come off seroquel which has been a great med for me with the PTSD as far as intrusive flashbacks and sleepless nights.

So my psychiatrist has prescribed valium for sleep, and he said its good for seizures too.. He said he will also discuss this with the neurologist as valium is also a good emergency medication should I feel a breakthrough seizure coming on.

I was wondering if anyone had any experience with this drug ? The problem is im thinking.. is that I only have a few seconds warning before I have a partial seizure, and this is probably not enough time to get the med and take it.

I will discus this with my neurologist myself, but I think for now I will just take it for sleep.. I still actually need to pick the prescription up.

[RobinN]

It is highly addictive.

[vapour]

I guess that would be a problem if I had an addictive personality.

[RobinN]

I don't have an addictive personality either, but a drug can can create an addiction where there wasn't one prior.

[Dutch mom]

Hello Vapour,

My son has used valium and other benzodiazepines (clobazam, clonazepam) as emergency med and as add on medication on top off several anti-epileptic drugs in combination therapy. It was prescribed because he didn't sleep well and had an increase of seizures in the evening/night, usually whem waking up out of sleep.

The effect was miracolous in the first period, it seemed like a wonder drug. But after a few weeks his brain got used to it and the effectiveness disappeared, untill increasing the dose again and again. We ended up with an addicted child to a med that did'nt work anymore, while weaning of only increased his seizures and made his sleeping problems worse.

Benzos aren't addictive because of a persons personality but as a result how they work. The benzos act as a 'top up' to the GABA in the brain, a neurologist inhibitory chemical, meaning everything is 'subdued' when the GABA level is increased, including seizure activity. But the tolerance aspect comes about when a compensatory mechanism starts occurring, that is - due to the regular artifical top up, the body starts producing less natural GABA, meaning the overall level drops down, requiring another med increase to keep the status quo, the natural GABA production drops down again, another med increase is required, and so on...

Apart from the tolerance problem if using them as regular anti-epileptic drugs, the benzodiazepine meds can become less effective in an emergency situation, as the brain is already 'used' to this class of med, and so a lot more is required to have the same effect.

As once a person is addicted to them, it can be a long hard process withdrawing them off again. We've been there with our son, it took us a whole year to get rid of 10 mg clobazam.
Yes, the weans can be awful - which is also obviously tied into the GABA levels. As you reduce the dose, the GABA levels drop down below what they were previously, and so the brain is in a neurologist excitory state, and so the seizure threshold is lowered until the natural GABA production kicks back in once the brain realises it has a shortfall. That is when they (hopefully!) stabilise, and then you do the next reduction, go through it all again, and so on.

We had 3 yrs of the see-saw adding/reducing/weaning benzo process with our son and the comment from one of the Fleetwood Mac members "benzodiazepines are harder to withdraw off than heroin" used tor ring in my ears throughout the process.

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 (Fig. 1).
The way in which GABA sends its inhibitory message is by a clever electronic device. Its reaction with special sites (GABA-receptors) on the outside of the receiving neuron opens a channel, allowing negatively charged particles (chloride ions) to pass to the inside of the neuron. These negative ions "supercharge" the neuron making it less responsive to other neurotransmitters which would normally excite it. Benzodiazepines also react at their own special sites (benzodiazepine receptors), situated actually on the GABA-receptor. Combination of a benzodiazepine at this site acts as a booster to the actions of GABA, allowing more chloride ions to enter the neuron, making it even more resistant to excitation. Various subtypes of benzodiazepine receptors have slightly different actions. One subtype (alpha 1) is responsible for sedative effects, another (alpha 2) for anti-anxiety effects, and both alpha 1 and alpha 2, as well as alpha 5, for anticonvulsant effects. All benzodiazepines combine, to a greater or lesser extent, with all these subtypes and all enhance GABA activity in the brain.
As a consequence of the enhancement of GABA's inhibitory activity caused by benzodiazepines, the brain's output of excitatory neurotransmitters, including norepinephrine (noradrenaline), serotonin, acetyl choline and dopamine, is reduced. Such excitatory neurotransmitters are necessary for normal alertness, memory, muscle tone and co-ordination, emotional responses, endocrine gland secretions, heart rate and blood pressure control and a host of other functions, all of which may be impaired by benzodiazepines. Other benzodiazepine receptors, not linked to GABA, are present in the kidney, colon, blood cells and adrenal cortex and these may also be affected by some benzodiazepines. These direct and indirect actions are responsible for the well-known adverse effects of dosage with benzodiazepines. http://www.benzo.org.uk/manual/bzcha02.htm

[Bens mom]

Hello Vapour,

My son Ben is on 2mg Clonazepam and through bouts of status we have found no other Benzo's work for him, Clobazam, lorazepam, valium, Midazalam.

This means when Ben goes into status now he always has to go into ICU and is intubated and put on Propofol or thiapentone to break the cycle.

It is not the person who gets addicted to these drugs it's the body.

Hopefully with the help of the KD we will be able to wean him off meds.

It may work as a short term fix but hopefully you are here for the long haul and to discuss a plan B with your consultant and phsyciatrist now might save you alot of grief later on.

Hope I haven't spoken out of turn I wish you all the best with what ever you decide.

Keep Happy