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Re: RLS/Valium

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Lee

Valium (diazepam) was the No.1 prescription drug in late '70s. In 1995,

it was No.57. Other benzodiazepines like Xanax, Ativan and Klonopin have

replaced it in popularity. Valium acts as an anti-anxiety agent more

than as a hypnotic (sleeping pill). It is also one of the better muscle

relaxants. Its fall from grace has been due to several factors. It is

long acting and thus has the side effect of drowsiness. It has

unpredictable effects in the elderly, sometimes causing excitation and

sometimes mimicking a stroke. Also, the fact that the patent has run out

makes Valium less attractive for the manufacturer to promote. The

" social stigma " of Valium has had something to do with its loss of

popularity, but not much. In 1995, Xanax ranked No. 10 among all Rx

drugs. Xanax has a worse social reputation than Valium, but is still

prescribed frequently. Because Valium is more a sedative than a

hypnotic, it has not been used that much in RLS. It usually has little

effect on RLS symptoms.

Valium is associated with less withdrawal reactions than the shorter

acting benzodiazepines because of its longer half life. If you stop

taking it, it takes longer to clear the body of the drug, so you have a

built-in tapering off effect that makes withdrawal milder. It also

exhibits less tolerance development. It is associated with just as much

psychological dependence as the other benzodiazepines, but not more so.

As with any of this class of drugs, it has the ability to make you feel

like a zombie, but overdosage, in the absence of alcohol, almost never

leads to death.

Valium is still a good short term agent for treating acute anxiety and

muscle spasm. There are many people who have taken Valium for years with

no significant side effects. The fact that you are concerned about the

potential side effects and the long term consequences of your various

drugs makes it less likely that you will run into serious trouble from

them.

Wishing you a Happy New Year.

Dr. Levin

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