Benzodiazepines and ADHD drugs for depression

I am writing to dispel some of the myths about the benzodiazepine and amphetamine families. They became a popular alternative to barbiturates and conventional amphetamines in the mid 1950s and have more recently been much criticised as addictive drugs likely to increase psychosis in the long run. This has not been my experience. I recently had a very prolonged bout of psychosis and depression due to a real life situation I found neither tolerable or soluble. I was initially treated with strong anti psychotic drugs and sedatives of the old fashioned kind (e.g. trazadone) pre-dating benzodiazepines. After many months I got temazepam back as a treatment for my acute daytime panic attacks but sleep remained disturbed and often led to sleep walks, falls and inappropriate behaviour. Because the UK health service has few psychiatrists the appointments were months apart so trials lasting months were carried out of many anti-psychotics such as amitriptyline, fluoxetine, mirtazepine, sertraline, trazadone and venlafaxine. During these months little was prescribed to ensure a solid period of night time sleep which led to my family having to deal with an individual in a state of anxiety and subject to bizarre behaviour. During my treatment every class of anti-psychotic was tried until a cocktail so strong was prescribed that I had a serious fall breaking my left acetabulum, pubic bone and lower sacrum. This led to not fracture clinic treatment but the prescription of oxycodone as a pain killer along with continued high dose sertraline as an anti-depressant combined with indomethacin. The combination rendered me delirious and so constipated that I had to go back to A&E once every few days to have catheter and enema treatment. It is a very effective formula for chemical castration. One night I missed my tablets and decided to stop the lot when offered the morning doses. Within three days I was walking again and alert during the day. True walking was difficult after the fractures but simple tramadol plus cocodamol helped a lot. I was aware of the need for long term pain killers and hence the need for something benign which I chose myself. As I recovered I found that a single fanatical doctor had brainwashed my entire family to see all benzodiazepines as the spawn of Satan. This led me to do a lot of research during which I found that there were many diazepines suited to different tasks and many patients who should not take them. It is fairly easy to identify someone who should not be given benzodiazepines; prescribe a week of short term acting bezodiazepines like temazepam and then tell the patient to take a break for a week. If they cannot go cold turkey then they are likely to ramp up doses and become addicted if treatment is resumed. Wikipedia has an almost exhaustive list of bezodiazepines listing the half life of each so the doctor needs to match drug to problem. I had insomnia so something with a long half life like diazepam is good as it helps at night and reduces my panic attacks in the day. For severe and acute panic temazepam is better and oral administration may be too slow. In my own case my depression took the form of not wanting to do anything at all and none of the medications helped with that. Once I did finally see psychiatrists both physically and online our conclusion was that the daytime symptoms should be treated like ADHD with drugs like adderrall and ritalin as daytime treatments. Unfortunately, although I still think this is correct, there is only one UK institute that is able to prescribe these drugs (Maudsley) and my place on the waiting list is likely to have a longer life than me. What I am trying to say is that few drugs are all bad. Even older drugs like phenobarbitone and chloral hydrate (prescribed as welldorm or chloral betaine now) have their uses. I understand the reluctance to dole out benzodiazepines like sweets but please do not throw out the baby with the bathwater. In my case careful and minimal use has been a vital part of my recovery. I am much more worried about the ability of a GP to dish out such high doses of oxycontin that I could not even get up for weeks. It would be good to hear from psychiatrists and patients about their experience