In sci.med Nomen Nescio <Use-Author-Supplied-Address-Header@[127.1]> wrote:

<snip details>

And your qualifications are?

I sincerely hope he doesn't ever drink _and_ take any
benzodiazepine.  

In sci.med Nomen Nescio <Use-Author-Supplied-Address-Header@[127.1]> wrote:

^^^^^^^^^^^

Which can mean this person is a SEVERE alcoholic. His body has adjusted to
LARGE amounts of ETOH.

He can appear umimpaired at doses that would leave other light drinkers
_comatose_.   

    re:SSRIs & active ETOH use

You do not prescribe SSRIs to treat a depression in an active substance
abuser.

Alcohol INCREASES depression.

You will only wind up with an active alcoholic who is receiving a Tx that
is even less likely to work.

It's about as hopeful as treating COPD or Lung CA in a current smoker.
Good Luck!

The only Tx for depression is -=sobriety=- BEFORE starting a drug Tx for
depression.
(eg. why is there no mention of AA, etc?!)

PS. Does this person admit an ETOH problem? If not, there is very little
hope for this person to see any improvement. Beating the denial is 1/2 the
battle.

TTFN,

Emma

In sci.med Nomen Nescio <Use-Author-Supplied-Address-Header@[127.1]> wrote:

Injected benzos, while hospitalized, to stop any seizures or psychosis
from the DTs, yes.

I have seen injected Librium and Ativan given -- and if they don't work
and the guy is wild (not uncommon for a severe alcoholic to go psychotic
when quitting) -- you can do what my hubby does on his forensic ward. Six
mg of Ativan and 10 of Haldol -- then to seclusion.

Take-downs aren't fun, but sometimes necessary.

A written Rx to take home? Ofcourse not. Ativan is just gin in a pill, my
dear.

That makes a Doctor just a legal drug dealer.

They both work on GABA... so Ativan is a way of tickling his
brain's alcohol receptors.

Plus, Ativan hits quickly and wears off quickly. The two actions that
are a Prescription for creating an additional Ativan addiction. Really
-- in terms of pharmokinetics, why not just give him Crack?

If he must be sedated, he could be put on Clonazepam. It has no
recreational value, it starts slow and stays long.

Someone else should hold the pills and give them. Record the doses.

HTH,

Emma

Hi, I agree with Nomen Nescio about this person with the alcoholproblem that
he should receive benzo's instead of an SSRI or a tri cyclic anti
depressant, but if he is still doing loads of alcohol then nothing should be
given to him as alcohol in combination with benzo's can be fatal i am not
sure about alcohol and SSRI's, but i cannot be healthy. If this person would
stop drinking then librium in an sufficient amount should do the job like to
begin with 200 mg's a day for the first day then the second day 150 mg's the
third day 100 mg's and then the worst is over regarding alcohol WD and then
to prevent this person to go back to alcohol i would recommend a daily dose
of say 25 to 100 mg's of librium or else 10 to 40 mg's diazepam. I once had
an alcoholproblem and its quite a bitch to get rid of it however i would
trade any day an alcoholproblem for my methadone addiction, because once in
a clinic off the alcohol they gave me 800 mg tegretol together with 50 mg
librium for the first three days this was not enough, because i could
bearily sleep at night, but four days later i had no problem with nothing
anymore and this while i was used to atleast 1/4 gallon of whiskey a day.
Alcohol is easy to get rid of the only thing what is absolutely needed is
that you WANT to come off the alcohol and then some amount of benzo can do
the rest, but if you dont want to get rid of the alcohol then you can forget
about it how hard you may try as an outsider.
For the rest never stop alcohol at once if you drank heavily for years the
same goes for benzo's as everybody knows, but not everybody knows that this
goes for alcohol also, because if you stop at once you can get insults and a
delirium and you can become very crazy and if the situation is real bad you
can even die from alcohol WD so always stop with the help of benzo's and for
benzo's it can go the other way around so take some alcohol if you have
difficulties stopping them, but then you have a chance to become an
alcoholic so therefor better taper benzo's if you want to stop them.
Kind regards, Freek Bok, the Netherlands.

As an alcoholic, I say that benzodiazepines are a very bad idea for
coming off of booze.  Sure they help (immensely), but the problem is
that they feel very much like booze does and before you know it you
wake up one day with a nasty pill habit going on.  Been there before,
blah blah blah.

I just got out of rehab, and I was in detox for five days.  During
those five days I was given 50 mgs of valium a day, along with 8 mgs of
haldol (sp?).  Then they cut me off and put me on Gabitril, which does
help me sleep at night, but I'm not too crazy about the side effects.
After I got home I stopped taking them and so far so good.  I think
that time is the only thing that really helps in the long run.