Video, Dr. Josef Witt-Doerring, May/23: Can Med Reinstatement Improve Symptoms?

[[Co...]]

On 03/05/2024 at 04:20, [[T...] said:

Thank you for your feedback. It is very insightful. 

I am glad that you found my comments useful. Of course, I am only supplying my own perspective and take on how the contents of the video might or might not apply to our members.

[[Co...]]

On 03/05/2024 at 12:37, [[M...] said:

Hi i recently reinstated klonopin after experiencing Acute withdrawal symptoms psychiatrist again gives me klonopin again while I was on the step of healing one month I was experienced worst symptoms it's a traumatic experience in my life while I was on the way to healing but I also had MDD diagnosis and had suicidal ideation after reinstating klonopin that suicidal ideation went away and I was experienced severe urinary retention due to withdrawal and akathisia these both are settled with reinstating but I was little derealized or dissociated while going through withdrawal that didn't go away still i am having that minimally I got better from reinstating but that was a mistake a huge mistake and it's not my mistake psychiatrist who forced to reinstate now iam again tapering dry cut this BB format gives me new ideas previously I was not aware of P/WD and all my doubts are cleared in here I feel confident to move with taper after i explored BB and I have done a chat with Dr Josef i was asked switching to valium he replies do klonopin itself and 5 percentage cut per month for 1 mg klonopin recommended more than a year taper he is contributing to us he is good ethical psychiatrist doing things in a holistic approach 

But for some people meds are essential so completely closed door against medicine does not make sense 

Hello @[Ma...]. I generally suggest to members that unless they have already experienced problems with their taper, interdose withdrawal effects, etc., then tapering off directly from their existing benzodiazepine probably makes most sense. I do this from a principle of make as few changes as possible, as unnecessary changes carry their own risks. But if we encounter significant problems, then reassess and consider other options. So, in your situation, tapering off directly from Klonopin makes sense to me.

As for you last sentence: yes, there is far too much use of blanket statements about medications, including psychoactive medications and benzodiazepines. Like any other medication, they have their risks and their uses too. Are the potential downsides often understated? Yes, they are. But the response to this should not be to state they should be banned, or label all use of psychoactive medications as 'bad', etc. These debates are - or should be - more nuanced than this.

[[Co...]]

12 hours ago, [[C...] said:

As Ashton describes it is exactly my experience.

Ashton seemed to aim for the KISS (Keep It Simple Stupid) approach to tapers. I think that's right. Or, at least, the correct approach for most people who seek to quit benzodiazepines. I liked her and her matter of fact approach.

This does not mean that there is nothing more to learn of course. And research is important. But the core of her Manual is as relevant today as it was 20-odd years ago.

[[st...]]

3 hours ago, [[L...] said:

A primary goal of JWD’s YouTube channel is to raise awareness about side effects/adverse reactions associated with psychiatric medications.

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That’s all fine and dandy, but here is what he thinks about benzobuddies and “adverse reactions”. This is in another video, isn’t he skewing benzobuddies big time?

“…when you go on the kind of the survivor websites places like benzobuddies.com it's a skewed sample. So you may be reading a lot of reports on there about people who haven't had any Improvement in several years, 10 years, things like that. What you need to understand about those websites is you're seeing those reports because that's kind of where the worst cases are going to go, that's where they're getting their support and their community from…”

I don’t agree with his generalization of BB at all. There are thousands of shorter than “several years” outcomes on benzobuddies that have great results, many from 6 to 12 months post taper. BB contains volumes of info about each individual’s “what, when, how, and why”, these are experienced, wonderful people wanting to help others with their examples.

Interestingly, in the linked article below, he acknowledges that an enormous amount of people come to BB for help:
https://www.psychiatrictimes.com/view/online-communities-drug-withdrawal-what-can-we-learn

"The traffic moving through these sites is mostly from within the US and is substantial: www.benzobuddies.org receives on average 250,000 hits a month and www.survivingantidepressants.org receives approximately 150,000 hits each month. It is interesting to note that the patient narratives from these websites are generating early clinical data that researchers are using to learn more about unexpectedly difficult withdrawal symptoms and syndromes."

How can you have it both ways, that one day BBs are just skewed extremes and another day that BB has huge traffic? You can, but only if you acknowledge that either extreme cases are only a small part of BB traffic; or that the benzo problem is much bigger than we are led to believe.   

And the part about BB being used for clinical data research is particularly interesting.

This is another funny line from the article, does this sound like advancing a potential job opportunity while kissing up to potential future employers?:

"An important ethical issue to consider is who should conduct research into drug-related problems that emerge following licensing? Burdening pharmaceutical companies to conduct such research before granting them license to sell would certainly slow down the development of many new and helpful medications. "

Yes I think the pharmaceutical companies should never be burdened with first putting out ethical, pre-tested and proven safe products, but just allowed to run wild, mighty bold, care free and reckless too, concocting and dealing what many came to experience as mind altering poisons. Seriously, don't you think that those who designed this crap knew exactly how it would work?! Personally, I choose not to underestimate their "brilliance."

For me, BenzoBuddies is were I learned that I will get better, how to do it, and what to expect. I am here today to pay it forward,  I recovered because of BenzoBuddies, my faith and stubbornness. Thank you BenzoBuddies! I owe you.

 

[[Ca...]]

As Ashton describes it is exactly my experience.

[[Ca...]]

I'd be interested in people's opinions on whether The Maudsley Deprescribing Guidelines have added anything to Ashton's seminal work. I have the book but for some reason have been afraid to read it. 

I do think the BB site is skewed towards those having a tough time. People that are getting off with little difficulty might not find it helpful to participate here. And so, the posts can be scary and that's why it is wisely recommended not to enter the Long Hauler's group unless you quantitatively qualify. I was on this site from 2016-18 following my cold turkey and many of the people that were on then have disappeared -- or maybe they are now in the Long Hauler's group! But I know several people who recovered after microtapers and they don't come on anymore. And when I reinstated and was fully functioning, I did not come on here.

I don't think Dr. Josef's observations are inconsistent. And he certainly is not dissing BB. 

[[jo...]]

18 hours ago, [[C...] said:

I'd be interested in people's opinions on whether The Maudsley Deprescribing Guidelines have added anything to Ashton's seminal work. I have the book but for some reason have been afraid to read it. 

I do think the BB site is skewed towards those having a tough time. People that are getting off with little difficulty might not find it helpful to participate here. And so, the posts can be scary and that's why it is wisely recommended not to enter the Long Hauler's group unless you quantitatively qualify. I was on this site from 2016-18 following my cold turkey and many of the people that were on then have disappeared -- or maybe they are now in the Long Hauler's group! But I know several people who recovered after microtapers and they don't come on anymore. And when I reinstated and was fully functioning, I did not come on here.

I don't think Dr. Josef's observations are inconsistent. And he certainly is not dissing BB. 

Yeah some of the long haulers post in here sometimes which the absolutely should if they want to reach the largest amount of people either to seek or give advice and comfort. Some of their stories are scary to newbies though. But hey, you just have to learn and train yourself to navigate things that trigger you both in life and in forums.

[[Co...]]

On 04/05/2024 at 20:01, [[s...] said:

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That’s all fine and dandy, but here is what he thinks about benzobuddies and “adverse reactions”. This is in another video, isn’t he skewing benzobuddies big time?

If you point me to the video, I'll take a look.

The are some apparent errors and mischaracterisations from in the following. And a few things with which I simply do not agree. I'll run through them.

On 04/05/2024 at 20:01, [[s...] said:

“…when you go on the kind of the survivor websites places like benzobuddies.com it's a skewed sample. So you may be reading a lot of reports on there about people who haven't had any Improvement in several years, 10 years, things like that. What you need to understand about those websites is you're seeing those reports because that's kind of where the worst cases are going to go, that's where they're getting their support and their community from…”

Of course JWD (Josef Witt-doerring) is correct when he describes BB as a 'skewed sample'. Just like any other forum other there, ours is a self-selecting membership; it is not a randomised study with a control group. BB typically caters to those who experience problems with benzodiazepine use and/or withdrawal. I've written about this many times over the years, but it is pretty obvious stuff, really.

But the skewing also occurs within our membership. Members who suffer for longer are more likely to remain active for longer at BB. This means that members who suffer protracted withdrawal symptoms are overrepresented within our active membership. However, on the flipside to this, members experience protracted withdrawal symptoms often instead post to the Long Haulers' group operated by @[Na...]. This means they are less represented on our main forums than they otherwise would be.

On 04/05/2024 at 20:01, [[s...] said:

I don’t agree with his generalization of BB at all. There are thousands of shorter than “several years” outcomes on benzobuddies that have great results, many from 6 to 12 months post taper. BB contains volumes of info about each individual’s “what, when, how, and why”, these are experienced, wonderful people wanting to help others with their examples.

You are, of course, correct. Members have only to view the Success Stories forum to understand this. There are well over 1,500 Success Stories posted there. Further, we did not always operate the Stories forum (other success were and are posted elsewhere within the community). Further, far from all member post their Story.

On 04/05/2024 at 20:01, [[s...] said:

Interestingly, in the linked article below, he acknowledges that an enormous amount of people come to BB for help:
https://www.psychiatrictimes.com/view/online-communities-drug-withdrawal-what-can-we-learn

"The traffic moving through these sites is mostly from within the US and is substantial: www.benzobuddies.org receives on average 250,000 hits a month and www.survivingantidepressants.org receives approximately 150,000 hits each month. It is interesting to note that the patient narratives from these websites are generating early clinical data that researchers are using to learn more about unexpectedly difficult withdrawal symptoms and syndromes."

The figures in the above (relating to BB) are incorrect. I think JWD used one of those sites which attempts to estimate the number of 'hits' BB has per month. Firstly, those estimates are invariably widely incorrect. Without access to the server logs, they cannot possibly hope to be close. Secondly, 'hits' refers to the number of times the server is queried. Typically, a single page view results in very many 'hits' of the server. Although highly unusual, a simple web page of static text, with embedded images and style sheets might result in a single server hit. More typically, though, a single page impression will result in dozens of (or 100 or more) hits. Thusly, I assume that what JWD means to refer to page impressions.

But 250,000 page impressions is wildly incorrect too; there about 4,000,000 page impressions (views) per month at BB.

On 04/05/2024 at 20:01, [[s...] said:

How can you have it both ways, that one day BBs are just skewed extremes and another day that BB has huge traffic? You can, but only if you acknowledge that either extreme cases are only a small part of BB traffic; or that the benzo problem is much bigger than we are led to believe.

Actually, I think both of those things can be true. Although I take issue with the BB membership being characterised as 'skewed' by an outsider (it appears/feels dismissive, doesn't it?), skewing and huge traffic numbers are not mutually exclusive. They can go together, but are independent characteristics.

On 04/05/2024 at 20:01, [[s...] said:

And the part about BB being used for clinical data research is particularly interesting.

There was a study, with cooperation of many of ours members, some years ago by Catherine Pittman. And there is nothing to stop researches from using some raw data from BB. (Though, they should operate within their ethical guidelines). We have a rule against members being used as research subjects, but this only properly applies to researches who join BB. 

On 04/05/2024 at 20:01, [[s...] said:

This is another funny line from the article, does this sound like advancing a potential job opportunity while kissing up to potential future employers?:

"An important ethical issue to consider is who should conduct research into drug-related problems that emerge following licensing? Burdening pharmaceutical companies to conduct such research before granting them license to sell would certainly slow down the development of many new and helpful medications. "

I'd need to see the original for context. But the above sounds like an argument for not having pharmaceutical companies perform the research. Presumably, it instead would be done by an independent body. I would agree with that. But, I'd need to read the original to make sure I understand what's suggested there.

On 04/05/2024 at 20:01, [[s...] said:

Yes I think the pharmaceutical companies should never be burdened with first putting out ethical, pre-tested and proven safe products, but just allowed to run wild, mighty bold, care free and reckless too, concocting and dealing what many came to experience as mind altering poisons. Seriously, don't you think that those who designed this crap knew exactly how it would work?! Personally, I choose not to underestimate their "brilliance."

There is a good argument for independent bodies performing the research. The counter argument would be that it is more expensive and this would feed into the price of medications.

On 04/05/2024 at 20:01, [[s...] said:

For me, BenzoBuddies is were I learned that I will get better, how to do it, and what to expect. I am here today to pay it forward,  I recovered because of BenzoBuddies, my faith and stubbornness. Thank you BenzoBuddies! I owe you.

I happy to hear that BenzoBuddies helped you in your recovery. Peer support and paying it forward is what it is about. Thank you.