Talk:Effects of long-term benzodiazepine use/Archive 1

Undue weight on a single study

Professor C Heather Ashton (1987). "Benzodiazepine Withdrawal: Outcome in 50 Patients". British Journal of Addiction. 82: 655–671.

I'm concerned that the section on mental and physical health relies too heavily on the above study. It is a biased sample of only 50 patients, which didn't control for predispositions to any medical conditions, or find conclusive links to these diagnoses. Good epidemiological studies for the long-term effects of dependence have thousands of subjects spread around a lot of places, not just one clinic. The section based on this article ought to be severely reduced or removed completely because it's not a very good source. Letsgoridebikes (talk) 19:33, 8 February 2009 (UTC)

They did not have the symptoms before the benzos, they developed them during use of the drugs, the pattern was the symptoms disappeared after discontinuation of the drugs. The paper was peer reviewed in a respected British academic journal. It did control for pre-exicting disorders because it stated that these symptoms did not exist previously and disapated upon discontinuation of benzos. You could say that about alcohol withdrawal as well or tobacco, maybe alcohol doesn't cause cognitive and mental health problems, maybe it is a coincidence brain function improves after a period of abstinence, maybe it was underlying blah blah. You could say the same about lung function improving in smokers who discontinue smoking. What you need to do is to find a paper which follows people up for a year and shows no improvement or a deterioration in health. You want to discredit the paper with your own opinion and that simply is not how wikipedia works.--Literaturegeek | T@1k? 17:10, 9 February 2009 (UTC)

I don't think you understand my point. I'm not disputing that benzos have negative long term effects. I'm not disputing the findings of this paper, but I am saying the article relies too much on this single paper.Letsgoridebikes (talk) 18:34, 9 February 2009 (UTC)

I can name numerous papers that were published in a "respected academic journal" and where the experiment results seemed equally clear cut but still turned out to be completely wrong when other researchers attempted to duplicate the original results. The "Polywater" controversy in the 60s and 70s is a perfect illustration of this—and in this case, there initially were other research teams that claimed to have reproduced the original results. In the end, Polywater was determined to be nothing more than slightly contaminated water, despite the fact that the original papers described how they went through great lengths to avoid contamination.--Subversive Sound (talk) 04:16, 18 October 2011 (UTC)

There was a study in the BMJ in the 1970's that showed that nitrazepam continued to improve sleep and act as a hypnotic even after six months of nightly use, this doesnt seem to tally with the dire predictions in the article..... I would say that at a minimum, some patients continue to gain benefit from benzodiazepines even with long term use. It seems that tolorance develops to the sedation, but not the anxiolytic or hypnotic effects in a good portion of users.—Preceding unsigned comment added by (121.209.52.159 • talk) 06:43, 12 February 2010 (UTC)

A single study from the 1970's is not a very strong evidence base. Who funded the study? What size was it and what methods were used to assess tolerance or lack thereof? Can you provide a link to the study?--Literaturegeek | T@1k? 23:16, 12 February 2010 (UTC)

Carcinogenicity

Kripke, Daniel F (2008). "Evidence That New Hypnotics Cause Cancer" (PDF). Department of Psychiatry, UCSD. University of California.

This source is of dubious quality. It is published in a repository that may or may not have been peer-reviewed (any peer-review that may have occurred was under the control of Kripke himself) and not in a reputable peer-reviewed academic journal. I read through the entire article, and found his references to be poor; they didn't support his conclusion. The article is not much more than fear-mongering - if there are links between benzodiazepines and cancer, then there would be support from other studies, and not just this single paper.

The only valid, recent research I could find after making a quick search was this study and it did not find an association between regular use of benzos and ovarian cancer. This entire section needs to be re-written with quality sources. Letsgoridebikes (talk) 19:45, 8 February 2009 (UTC)

Errrr, there is a citation from a stufy of 1.1 million people by the american cancer society funded by the national institute of health in the article. Funny that is not reliable or "valid" but a small study assessing a single type of cancer is reliable to discredit the 1.1 million persons study. Are you sure you checked his references? How come you missed this study in his citations showing benzos causing ovarian cancer? Why did you forget to mention that one? By the way Kripke has acknowledged I think that there are from memory 3 studies which showed no association with increased mortality and 15 which did show increased mortality (mainly increased cancer deaths). You seem to have picked out one of the 3 studies which did not. Do I detect a little bit of an agenda here LOL? Anyway doesn't really matter because what you need to do is to find a survey of 1.1 million people finding no link. The onus is on you to disprove and a single small (which is disputed anyway by another study) study of one type of cancer is not a good start.--Literaturegeek | T@1k? 17:10, 9 February 2009 (UTC)

Can someone please tell me which of these references is the study by the American Cancer Society? It doesn't seem to be at the end of the sentence where the study is mentioned. I can't find the reference.Rose bartram (talk) 12:26, 1 April 2009 (UTC)

It is there. Here it is.--Literaturegeek | T@1k? 20:28, 1 April 2009 (UTC)

Have you noticed that I didn't touch the reference from the American cancer society? I didn't, by the way. Just think about the Kripke paper for a moment. He's stating that all BZs potentially cause all types of cancer in everybody. This is a ridiculous thesis. Cancer isn't one homogenous thing. There are many, many forms, and causation is rarely spoken about. Risk factors, sure, but definitive causes? Very rare. Have you looked at the studies he's cited? I have, and they don't support the statement "benzos cause cancer" which is how the section currently reads.

BTW, the onus is on an editor to add material into an article, not to take it out. I don't care one way or another if BZs cause cancer; what I do care about is supporting statements with reliable sources, which Kripke's paper is not. The study I cited is an example of a quality source of information, in which the authors investigated a certain type of cancer in a specific population with specific criteria on usage. I didn't bring it up to counter the notion that BZ do or don't cause cancer - that isn't the point.Letsgoridebikes (talk) 18:41, 9 February 2009 (UTC)

Whatever. You said "then there would be support from other studies, and not just this single paper." So you were ignoring that paper by the American Cancer Society of 1.1 million interviewees and trying to state that there is no evidence to back him up LOL, trying to say he is fringe. The article doesn't say cause, it states the facts which is increased incidence/risk.--Literaturegeek | T@1k? 21:37, 9 February 2009 (UTC)

Have you looked at Kripke's website The Dark Side of Sleeping Pills? There's a website that just reeks of professionalism and scientific rigor. The grim reaper in particular shows just how unbiased Kripke must be. Letsgoridebikes (talk) 22:27, 9 February 2009 (UTC)

That is a personal website of his and not meant to be a professional website.--Literaturegeek | T@1k? 02:12, 3 April 2009 (UTC)

Outside post here, as a pharm sci student. Kripke's paper is unpublished, it's just a bit he's thrown up on the UCSD website. It doesn't strike me as reliable at all, good number of the citations in it are questionable at best, and it seems like he's out to promote a specific viewpoint where the bulk of the literature points in the opposite direction, or is ambivalent at best. Moreover, listing your incredibly nonprofessional website in competing interests, while stating that there are no competing interests strikes me as a little sketchy. Kripke's research seems to be more aimed in the direction of sleep than in either cancer or the raw pharmacology, at least what he's published. While it's all well and good to advocate behavioral interventions for managing sleep issues, and they're fairly well established, he seems to want to advocate them to the exclusion of all else. 68.5.230.53 (talk) 08:35, 18 February 2009 (UTC)

A "nonprofessional" website with amteurish graphics on the site is not a conflict of interest. What does he stand to gain personally from publishing his research? If anything he potentially stands to lose a lot by annoying powerful corporations. I am not sure you know what a COI is defined as. It is not the same as a point of view which he declared anyway at the bottom of the publication via acknowledging he has a website criticising hypnotic drugs. There have been some recent edits which appear to have resolved neutrality issues anyway which I am happy with. An editor added some research papers disputing carcinogenicity potential. This I would hope resolve neutrality issues. The American Cancer paper is published and surveryed 1.1 million people so I would hardly say there is little or no evidence. The literature certainly isn't 100% definitive I admit but your suggestions that the bulk of the scientific literature points the other way I don't agree with. Although I am happy to be proved wrong.--Literaturegeek | T@1k? 02:12, 3 April 2009 (UTC)

Neonatal Toxicity

I'm not so sure that this section belongs in this article; it would probably be better off in the main benzodiazepine article.The rest of this article is focused on the effects that long-term BZ therapy can produce, and it seems weird that this section is in at the end. The references indicate that neonatal damage can occur from therapeutic doses, although they don't specify that these were long-term prescriptions. Also, the statements made in the section are somewhat distorted from what is contained in the references. As I've stated before, it's difficult to make conclusive statements based on case studies, yet this section takes what was observed in a few babies and makes sweeping statements that make it seem like these things will occur in all neonates whose mother's have been exposed to BZs. Letsgoridebikes (talk) 03:53, 9 February 2009 (UTC)

Errr, why is it not relevant if long lasting effects occur in the neonate? Furthermore it is accepted by the FDA and all health bureaucracies that benzos are harmful to babies, eg all benzos are regulated as either Category D or Category X.--Literaturegeek | T@1k? 17:10, 9 February 2009 (UTC)

Again, you've misunderstood what I've said. I'm not disputing the FDA's categorization, but I am saying that this information doesn't fit with the rest of the article. It is relevant, and it is good information, but I believe it would be better off being the main BZ article. Letsgoridebikes (talk) 18:46, 9 February 2009 (UTC)

Author: What is your agenda?

I question the neutrality of this so-called information. One suspects the author is in charge of cost-cutting for the NHS, perhaps?

24.4.28.149 (talk) 03:43, 29 June 2010 (UTC)

The agenda is to write an article on the long-term effects of benzodiazepines for the benefit of users of the world wide web/humanity; wikipedia is meant to represent the sum of all human knowledge. The article is a work in process and I intend to improve on it. I am not instructed by the NHS nor any other organisation or individuals to edit wikipedia. My editing of wikipedia is entirely of my choice and free will; I derive no personal benefit from my editing of wikipedia. Could you explain what you think is not neutral in this article? I feel that the content of this article is generally well referenced but I intend to do some refining with secondary sources in the near future. From my own perspective I feel that what government bureaucracies and regulatory agencies say and what the peer reviewed literature says conflict on benzodiazepines and to a lesser extent on alcohol. My agenda is to write good quality evidence based articles which accurately reflect the benefits/risks of benzodiazepines and alcohol.--Literaturegeek | T@1k? 15:48, 29 June 2010 (UTC)

Please also see WP:CIVIL and WP:NPA; making public accusations of bad faith particularly without any evidence is considered poor form on wikipedia; not to worry though we all make mistakes, especially when new to wikipedia.--Literaturegeek | T@1k? 15:52, 29 June 2010 (UTC)

I do not think any of the main authors are from the UK so I doubt they are working for the NHS. :-) Doc James (talk · contribs · email) 16:26, 29 June 2010 (UTC)

There are three articles being referenced through the site http://www.benzo.org.uk, this site also features a 'BAN' petition that is indicative of a very strong agenda on their side. Can these articles not be reference directly instead of through this site? 195.240.86.253 (talk) 14:27, 24 June 2011 (UTC)

This entire article is a hack job by someone with a questionable motive, author claims benzo use increases violence,

see the reference article, it says:

"It would therefore be predicted that chronic BZD use may induce aggressive and impulsive behaviour." http://www.bcnc.org.uk/violent.html Reference #50

"be predicted" and "may induce" are a far cry from what the author extracted.

I'm not data mining,  this is the only reference I checked,

enough to conclude a lack of objectivity.

— Preceding unsigned comment added by 209.78.20.61 (talk) 22:54, 14 August 2012 (UTC)