Talk:Chlordiazepoxide/Archive 1

Archive 1

Rating

B is a somewhat generous rating, but the article basically only needs a bit of cleanup. Fuzzform 19:53, 31 May 2007 (UTC)

Cluttered

Conversation was started here Clonazepam Talk Page and then continued on here on chlordiazepoxide page.--Stilldoggy (talk) 11:16, 2 April 2008 (UTC)

The article seems to be cluttered with random citations, coming to the wrong conclusions. Example: Chlordiazepoxide is related to quinazolines - by being investigated together with quinazolines in one citation. Chlordiazepoxide is a hapten - by being mentioned together with the word "hapten" in an article about immuno assay tests. These are not peer reviewed facts. These are ncollections from arbitrary resources which have no relation to the pharmacology of the substance. —Preceding unsigned comment added by 70.137.178.160 (talk) 22:06, 1 April 2008 (UTC)

They are from peer reviewed sources. The quinazoline and hapten is an abstract from a peer reviewed journal, specifically Journal of pharmaceutical sciences. See [1] Please stop vandalising wikipedia articles intentionally or unintentionally with good or bad intentions, just stop going around deleting stuff for no good reason. You have already been warned on your talk page by an admin about doing this.--Stilldoggy (talk) 22:13, 1 April 2008 (UTC)

You conclude that it is related to quinazolines, by being "mentioned together" with quinazolines in this investigation. You claim that it is a hapten, by being mentioned as a hapten in an article about immuno assay tests. Of course it is a hapten there, that is how immuno assays work. Every substance is the hapten in an immuno assay for this substance, you develop an antibody that binds for it, to detect it. But this is not pharmacology of the substance, but the mechanism of an immuno assay test, like urine test strips! Please look at least what the citation is about, before including it. Please have quality control look at this. —Preceding unsigned comment added by 70.137.178.160 (talk) 22:28, 1 April 2008 (UTC) To be specific, the "peer reviewed facts" look like the bot-like inclusion of a pubmed search, without closer inspection of what the article is about, creating a lot of spurious associations, which are irrelevant to the pharmacology of the substance. —Preceding unsigned comment added by 70.137.178.160 (talk) 22:36, 1 April 2008 (UTC)

Please stop cluttering the benzodiazepines with a collection of refs to arbitrary pubmed articles. Those are largely reports of some experiments, which have been carried out sometime, somewhere and for some reason on rats, mice and brain slices. For almost every such article you will find a match which comes to contrary conclusions. Please limit the contribution to agreed conclusions, as found in pharmacology books and the FDA profiles, avoid anecdotal reports, speculative results, could have, may be involved, has one time been observed, is suspected, is being investigated, could have a theoretical connection etc. Not everything which has sometimes been suspected, investigated, speculated or observed is relevant to pharmacology and should be included. Avoid bot-like inclusion of search results. pubmed is not a source but an Augias-Stable of unfinished research and a playground for students. Example: You conclude that chlordiazepoxide "is related" to quinazolines, by being investigated together with quinazolines in one citation. You conclude that it is a hapten, by being mentioned in an article about immuno assay tests. These are not relevant articles for pharmacology. Of course it is a hapten in an immuno assay test! That is how antibody based immuno assays work! But this has nothing to do with its pharmacology. Please limit yourself to agreed facts, like the FDA profiles. And the intention was NOT vandalism, but to arrive at something which looks more like the FDA fact sheet. Example: You claim as a peer reviewed fact the HIGH abuse liability, because it is mentioned in a drug abuse article. FDA says low-to-medium abuse liability, placement in Schedule IV. 70.137.178.160 (talk) 23:02, 1 April 2008 (UTC)

You have had your edits reverted by numerous editors and admins as either vandalism or as bad edits, not just me, does that not tell you something? The only edits you have been made is deleting large chunks of data which many editors have spent a lot of time producing from benzodiazepine articles and adding an external link to some article. Animal studies are useful, why do you think scientists and the FDA frequently use them when approving drugs? You can't cut open a living human's head you know and run tests on living brain tissue you know. You know nothing about pubmed obviously. Pubmed contains mostly abstracts of peer reviewed articles because the full articles are available by purchase only. You don't sound like you are familiar with peer reviewed articles. Show me where the idea of wikipedia is to provide a patient information style leaflet like the FDA's fact sheet? Wikipedia if that was the case may as well pack up its bags and just host government bureaucracy public leaflets on its domain. No need for us editors. I don't know why you are so hysterical about all of this, do you not have better things to do with your life instead of going about ripping out huge chunks out of wiki articles. What are your intentions? Do you work for the drug companies?--Stilldoggy (talk) 23:55, 1 April 2008 (UTC)

Stilldoggy wrote re Clonazepam: Just for the record not all substances/compounds are haptens. Not all compounds produce an immune response in normal circumstances. A very small number of people develop an immune response from benzodiazepines, I have had a patient who was allergic to diazepam, a benzodiazepine before.

No, I don't work for the pharm industry. The abstract about haptens was in fact from an immuno assay article. Please note that your inclusions frequently are may be, could be, has been suspected, has been investigated, could explain etc. This is what I call speculative. And maybe your patient was allergic to the tartrazine dye in the pills. Maybe. Maybe not. Anecdotal evidence doesn't belong in wiki either. I believe facts should be included, after having gained some agreed relevance, exceeding the criteria for inclusion in a peer reviewed journal. An encyclopedia is imo not a loose leaf collection of excerpts from arbitrary articles and abstracts. Besides, in developing an immuno assay, you frequently generate an antibody by artificially making a substance a hapten, by attaching a different molecule. But this is the art of creating antibodies, not the pharmacology of the substance in question. Insofar this citation was out of context, as it had nothing to do with allergy, but with the development of urine tests. And quinazolines look a little similar to benzodiazepines, by having two nitrogens in a ring, attached to a benzene ring. This is a six-membered ring however. And you can make derivatives, similar to benzodiazepines from that system. Thats their relation. However, that is not relevant to the pharmacology of benzodiazepines. It is relevant to structure/activity relationships of compounds, having a nitrogen containing ring attached to a benzene ring. So to say, the activity of Qualuude is not relevant to the pharmacology of Librium and doesn't belong there. This is what I call a spurious association. I just didn't like how the wiki article was bloating with may-bes, ending so much different from a pharmacology text book. 70.137.178.160 (talk) 01:14, 2 April 2008 (UTC)

Qualuude, namely Methaqualone is kind of a quinazoline analog of benzodiazepines. Look at the structure formulas and compare. In your reference quinazolines were compared to benzos in mouse experiments. You concluded that they are "related". They are, but only in the framework of SAR of compounds with a 2-nitrogen ring attached to a benzene ring - not in the framework of the pharmacology of Librium. So this didn't belong here. Also look at the claim of "neurotoxicity", look closely what they meant. FDA wouldn't have approved the drug if it were neurotoxic in normal use. Neurotoxicity after dipping brain slices into a conc. solution of the agent is not surprising or relevant. Inhibition of acetylcholine release as an effect of the modulation of the GABA system is not a big surprise, as the GABA system is inhibitory after all. It is maybe a likely (!) explanation of anti-seizure, calming, hypnotic, amnestic effects, which overlap a little with those of Scopolamine, the classic sedative, and an explanation for paradoxical side effects on senile old people. But is it relevant? Your reference about hapten really had to do with the construction of antibodies against it, by attachment of other molecules to make it a hapten - the art of antibody construction, irrelevant to Librium pharmacology, but relevant to the manufacture of piss test strips. That was what your reference was about. Allergy seems not to be an important reported side effect. Makes me think of FD&C yellow, as I said. The anecdotal single patient evidence you mentioned reminds me of an old article of the "Journal of Irreproducible Results", where the "scientists" carried out all their experiments on a single old mare "Liesl", until she got extremely upset, then resilient, and deceased. Consequently the "investigation" had to be ended. The "high abuse liability" - there you jumped to conclusions from a reference about the separation of benzos in urine tests. This has nothing to do with abuse liability, except that it proves that it IS being abused. However, FDA/DEA places it in Schedule IV, "low-moderate" abuse liability, and this is an agreed conclusion, after many pros and cons in peer reviewed journals. Finally, I am not a vandal. I should maybe get a life. I do know what peer reviewed materials are, and where to place them. But my well meant intention was to shave your bloated article a little with Occam's razor, and to encourage you reading the context of your reference, before inclusion. Your inclusions were too much blindly, bot-like, "by association". This is kind of vandalism too, and particularly treacherous, as it looks genuinely scientific to the lay reader. Besides, there is a bot, which writes automatically contributions like yours, simply by keyword extraction, but it absolutely makes no sense. Did you use that for a linguistic experiment? 70.137.178.160 (talk) 04:20, 2 April 2008 (UTC)

I have removed the data stating neurotoxicity. I accept your point on hapten's and have deleted hapten from the wiki article. I am going to remove some of the edits that I made as you do have some valid points. I reject strongly your assertion that benzodiazepines are not commonly abused. Here is a quote from a better reference in bold. These drugs have their own addictive potential and are often taken in combination with opiates. Up to 90 per cent of attenders at drug misuse treatment centres reported use of benzodiazepines in a one-year period, 15 and 49 per cent had injected them. That quote comes from a Department Of Health uk government website. If benzodiazepines have a low abuse potential then you have to add in cocaine, heroin and cannabis as having a low to moderate abuse potential on the illicit drug scene. Here is the link to the DOH document on their own website. [2] You need to understand that drugs are not classified solely based on how frequently they are abused, for example cannabis and alcohol are very very commonly abused, cannabis is not a schedule 1 drug and alcohol is legal. Other factors also determine the classification of drugs of abuse include harm to the misuser's health and harm to society, crime, risk and degree of physical or psychological dependency, drug related deaths and so on. In the case of high potency opiates they are much more dangerous in overdose than benzodiazepines which is the main reason and driving force to classify opiates higher than other drugs of addiction. The other main factor was their addictiveness. If you go back in history and study the background of the various drugs of addiction being classified and look up the criteria for classifying drugs you will see that I am correct. So I think in this case it is you who is jumping to conclusions of whether benzos form a big part of the illicit drug scene or not based solely on what schedule they are in. We have both managed to show one another that our edits are not perfect. Maybe we can compromise. Hopefully your next response to me will be more pleasant.--Stilldoggy (talk) 05:43, 2 April 2008 (UTC)

Compared to the huge volume of legitimate use, the abuse is low. Millions of people use them under medical supervision. A few people misuse them, this are the reports from drug centers, mostly mixed abuse with opiates, to increase the narcotic effect. Benzos are able to form an addiction, but their effects are usually not regarded as desirable or euphoric for themselves. Not much better than an old paint thinner cloth, but less stinky. I would stick with the C IV placement, not the stories from the drug centers and their selected clients. These guys would also huff petrol. 70.137.178.160 (talk) 05:59, 2 April 2008 (UTC)

To convince you, look at what William S Burroughs has to say about barbiturates "Nembies" = Nembutal in the old days. It is the lowest stage of addiction, the addicts fall off bar stools, let food fall out of the mouth, are confused, belligerent and stupid. etc. (He talks about junkies who ran out of stuff and use nembies as a substitute because the old monkey is looking over their shoulder) This has seemingly carried over to some benzos, since barbs and qualuudes are not available any more, probably mostly temazepam, clonazepam, (in europe) flunitrazepam (Schedule I in US). The other benzos are not hypnotic enough to be used like that. So your benzo junkies are mostly hungry opiate users, who abuse sleeping pills, like Burroughs described. I would not overgeneralize this to all benzos. 70.137.178.160 (talk) 06:28, 2 April 2008 (UTC)

You can say that about opiates as well. There is a huge amount of legitamate use of opiates as well with millions using opiates legitamately. A similar amount of people abuse opiates as benzodiazepines. I am failing to understand your argument? Here is another reference [3] from another UK government website. It found that benzodiazepines were the second most commonly detected drug among arrested individuals. Only cannabis was more commonly detected. Benzodiazepines were more commonly detected than heroin. I am sorry but I am trying to be diplomatic with you on this talk page and the talk page of clonazepam and have tried to mend fences with you in a way. I have accepted many of your edits and agreed that several of my edits were not well chosen but you come across as having an editing agenda and are making edits which suit your opinion and you are not citing any sources, just delete, delete and ignoring the talk page and my attempt at diplomacy. The department of health and scottish government findings are certainly credible citations, involve humans and are government official reports. You really can't get much more credible sources than that.--Stilldoggy (talk) 06:49, 2 April 2008 (UTC)

I am becoming more and more convinced that you have an agenda. First of all you attack pubmed as being not reliable and screaming to high heaven that only extensive review articles and FDA bureaucracies can be added to wikipedia. Now you are making reference to a single man William S. Burroughs who isn't even a scientist but is a novelist and "social critic". Apparently this is superior to government reports. Benzos are very hypnotic, they are used all the time in hospitals to knock patients out for things like an endoscopy and used along with general anestheics. What are you talking about? I am not a benzo junkie and I have never been an opiate abuser but thanks for the personal attack though.--Stilldoggy (talk) 06:49, 2 April 2008 (UTC)

Should read "your benzo junkies". Not YOU! Not all benzos are very hypnotic. Noctamide, Rivotril, Temazepam, Rohypnol are very hypnotic. The other ones like Librium, Frisium, Ativan are not. They are designed to run around with them during the day. "day-tranquilizers". In deed the abuse problem is limited to "sleeping pills" in "multiple substance" i.e. opiate abusers. If you are so much in favor of the scottish buerocracy, why don't you accept the DEA findings? 70.137.178.160 (talk) 07:04, 2 April 2008 (UTC)

Ativan is sedating and is widely used for sedation in hospitals, it was just marketed as an anxiolytic because the market dictated that there were already enough hypnotics on the market. Librium is long acting and therefore unsuitable as a hypnotic. Frisium is not a 1,4 benzo and anyway it has been marketed as an antiepileptic. Diazepam is currently the most commonly abused benzodiazepine in the uk, it is not a sleeping pill. Xanax is the most commonly abused benzo in the USA and it is not a sleeping pill or marketed as one. The pharmacological properties of day time benzos and night time benzos are the same, they are all benzodiazepine receptor agonists. What DEA findings? You only stated that the DEA classed benzos as schedule IV. I never disputed that. I know that. When did I reject that?--Stilldoggy (talk) 07:13, 2 April 2008 (UTC)

Of course benzos are found more often then heroin in arrests! They are handed out with "no questions asked" by doctors, and my grannie is munching them as candies! Where is your logic? It proves nothing. The agenda of the drug agencies is to put everything under tighter control, including grandmas life savers. But we can't turn everything upside down for a few idiot kids. And obviously you have not compared Rohypnol against Librium yourself. Of course they all act on the benzodiazepine receptor, but with a different profile. Frisium has been marketed as a day tranquilizer in the old days, it really had almost no hypnotic properties. There are subtypes of benzo receptors, as pointed out in Frisium article. They are not the same, it is not just marketing hype. Daytime and nighttime benzos are not the same. DEA findings = C IV, for good reason. 70.137.178.160 (talk) 07:28, 2 April 2008 (UTC)

The classification of benzos as schedule IV drugs is listed here. [4] I vaguely remember doing the edit myself but could be wrong. It is already listed in the article. So I don't reject the DEA's schedule status. Actually benzo prescribing is frowned upon by doctors in the UK and they generally try to avoid prescribing them. UK guidelines state benzos are to be prescribed for 2-4 weeks only. Check the British National Formulary. They ain't handed out like candy here. A quote from your latest post "They are handed out with 'no questions asked' by doctors, and my grannie is munching them as candies! Where is your logic? It proves nothing. The agenda of the drug agencies is to put everything under tighter control, including grandmas life savers. But we can't turn everything upside down for a few idiot kids." As far as I am concerned your post has demonstrated to me that you are of mindset of the prodrug group. This is reflected in your above post and in your editing, such as deleting the entire tolerance section of this article and numerous other edits, arguing every way possible to show the drug in a positive light. You contribute no citations. Your sole intention is to delete, delete and delete selectively content which you don't like. I accept some of my edits were worthy of deletion and I accepted a lot of the amendments that you made but it is becoming increasingly clear that you are obsessive with getting your own way no matter what and no amount of reasoning with you is going to work because you have an agenda. You are not open to diplomacy regarding edits. I am ceasing conversation with you. An admin can settle this. I came to wikipedia to try to help expand articles, I may not have been perfect in my edits but I did not come here to engage in an edit war or an argument with a fanatical prodrug individual. I have been up all night with no sleep trying to sort out and "perfect" these articles for you and wikipedia and now I realise instead of you having genuine concerns about the articles I find that my initial suspicions were confirmed, that you are not here to improve wikipedia but to further your own personal prodrug legalisation beliefs. I am going to bed. I will be having no more contact with you.=--Stilldoggy (talk) 07:41, 2 April 2008 (UTC)

I believe the agenda is just a cultural difference between brits an yankees. We don't want to make the whole society child- and idiot safe. We don't take away grannies life savers. If one of the idiots injects the shit and then breaks open a car, we lock him up, or shoot him in the head, no questions asked. It has nothing to do with pro-drug. It has to do with a childsafe nanny society full of cameras, as you are approaching in UK, ah yes, and with gun control. We have a more liberal picture of society. The state is not our mother. If we fuck up, we are responsible ourselves. 70.137.178.160 (talk) 07:53, 2 April 2008 (UTC)

Can't resist replying to this one. I support gun rights and am opposed to the nanny state. I support UKIP and if I was an american I would vote for the constitution party. Your assumption of my political beliefs is wrong. Have a good life, bye! ;=)--Stilldoggy (talk) 08:32, 2 April 2008 (UTC)

Stilldoggy, Kid, I don't want to be accused of being member of a PRO-DRUG group, just because I insisted on the low to medium abuse liability of Librium, as reflected by C IV. I am not member of a PRO-DRUG group, but of a different group. We have no parents, girl friends, aunts, uncles, few living friends, many already dead, also the state is not our mother or father. We are OLD. And we don't want to have a nanny society kindergarten, just because your generation doesn't want to grow up. It is not only a cultural problem between brits and yankees, it is a generation problem too. Consequently I don't want you to bunch up Librium to the level of Heroin. 70.137.178.160 (talk) 08:49, 2 April 2008 (UTC)

Good grief, UKIP and constitution party, that explains your hysteria. Get a life. 70.137.178.160 (talk) 08:58, 2 April 2008 (UTC)

As someone that hasn't been involved in this debate, it seems to me like you're arguing over the abuse potential of this drug. I would recommend taking a look at WP:MEDMOS, which might help you to better reorganize the article. I don't think you want to be focusing on the abuse potential in the article so much as some other, more important things. You can include some brief information about the potential for abuse of this drug in other areas, such as 'adverse effects' or 'legal status', even 'history'. But a section entitled 'abuse potential' is not normally found in wikipedia articles about drugs.

Don't get bogged down talking about minor topic areas. Concentrate on the pharmacology, and the science, and these little questions will be ultimately answered through the course of your research.

The overall structure of this article should be reexamined as well; it's generally better to minimize the use of section and subsection headers to only the ones which are absolutely necessary. Overuse of such headers, such that there are many section & subsection headers with very little text in them, decreases overall readability, and ultimately leads to a poorly organized article. If I was reviewing this article against the Good Article or Featured article criteria, it wouldn't even come close to passing. It's probably just barely a B-class article as it is. Dr. Cash (talk) 19:04, 2 April 2008 (UTC)

Dr Cash, the problems with this anonymous user is not just a lil debate about abuse (I wish it was). He is running about making bold deletions of very very large amounts of data to suit his POV despite it being against wiki bold guidelines which recommend only established contributers make bold edits, see bold policy [5]. Please see this edit of his [6]. He has made numerous edits. I am trying to avoid this anon user. They are now harassing me all over wikipedia accusing me of edits that I did not do.--Literaturegeek (talk) 06:14, 4 April 2008 (UTC)

I dont know much about this drug, but those vast amounts of deleted data here are not clinical data but laboratory data - always trumped in the clinic. Also, I think the Anon is also right about the wp:undue on the abuse issue, why do the findings of that UK committee take up half the page? If the risk was that huge, it would not be available on either continent, especially as there are other sedative choices.io_editor (talk) 16:21, 5 April 2008 (UTC)

Also, I had to blink to find the Indications section, which is all of 2 sentences, unsupported. Should an encylopedia not focus on the Medical Science (need, intent, benefit) i.e. the "Use" profile, and make the Abuse paradigm secondary?io_editor (talk) 16:46, 5 April 2008 (UTC)

Hi, Ok first of all I have not been involved much in the editing of this article, ok I was just trying to stop this trolling anon user from harming article after articles with no citations and doing major deletions. They were on a major deleting spree of multiple articles. They were reverting admins reverts and has gotten several articles locked as a result. I tried talking to the anon user sensibly and they reply with psychotic ramblings about how he and his fellow residents in the nursing home (which is where he is editing from) whorship some God which has 5,000 eyes and 10,000 ears and some wild boar with iron feet and an iron tail or some nonsense. The person is out of their mind. The real issue is not talking about an imperfect article. It is about psychotic anon user who claims to be a resident in a nursing home for the elderly doing enormous deletions and filling up talk page after talk page with gibberish with no understanding of what they are talking about. I dunno maybe this elderly gentleman was a former nurse who lost their marbles and went into an elderly nursing home with access to a computer who likes medical things, I dunno. I know the article is not perfect but that is why it is not rated Class A or featured article. The anon user deleted 3 quarters of a non perfect article so there are bound to be deletions that you agree with because it is an imperfect article. I wouldn't mind if the anon article was a wiki contributer who was trying to replace the text and using citations. Also if you read wiki bold deleting guidelines, only established editors are meant to do them, not some anon user going from page to page to page doing major bold deletions who claims to worship some God with 5,000 heads and 10,000 ears, ya see my point? Now I have tried to stop this troll and as a result I have an army of editors telling me about the imperfections of various articles, many articles of which I had only a limited input into. I am getting tired of it. I have done nothing to deserve this. I was only trying to defend articles from major deletions by this trolling anon user using no citations and instead I get an even bigger headache. I should get praise for doing the job of administrators. I know that clinical results are superior to laboratory findings and take the tolerance section for example, if someone wants to replace the section on tolerance with citations of clinical data which are superior to explain tolerance, be my guest. Improve the article. I don't want to get into a discussion too deeply about this article's imperfections. I could cite sources to dispute some of the things that you have said but like I say this is not an article I have been involved in and it really is not the point and we would be going around in circles and it would encourage the anon user again. The problem is some old man from a nursing home who claims he and worships some God with 5,000 heads going on mass deletion sprees and filling up talk page after talk page with silly arguments, flagging article after article as neutrally disputed, reverting admins reverts of his edits and then getting articles locked against vandalism. Once you resolve one "dispute" they fill up the talk page with another dispute, it is never ending. Maybe now you understand the real problem. Here is a link to one of his edits about him and all of his fellow residents at the nursing home worshiping a 5,000 headed god with 10,000 ears.[7] when I was trying to have a sane conversation with him. and another edit.[8] and [9] and another [10]--Literaturegeek (talk) 18:39, 5 April 2008 (UTC)

He copied this - BS, which wasn't very polite, but you fell for it as if it were fact. But the Anon is not from Mars, etc. I am not in a position to judge all or even half of his edits, but right now he is actually making a little bit more sense than you. You don't believe me? Well just look up, how do you expect anyone to read all that? I commented on Talk:Temazepam too, please take my advice. I have absolutely no axe in this matter, and have no Admin clout or persuasion of any kind, and also I consider these drugs important but relatively unimportant, certainly not enough to merit this sort of attention....io_editor (talk) 22:20, 5 April 2008 (UTC)

To my anon stalker (70.137.178.160)

(read my above post first) I see that within 20 or so minutes of me posting my reply to io editor, you were on his talk page. This happens everytime I make a post anywhere. I see that your last edit was at 13:18. Why do you sit on here all day refreshing my edit history? Your last edits below.

1. 19:18, 5 April 2008 (hist) (diff) User talk:Io io editor‎ (pointing to benzodiazepine discussion)
2. 13:48, 5 April 2008 (hist) (diff) Talk:Temazepam‎ (reply to goodson, literaturegeek.) (top)

So basically you have sat on the computer since after 1 pm UTC until 7 PM UTC refreshing my edits waiting for a reply/edit by me on wiki. WEIRD!!!!!! What is your problem? When are you going to stop trolling? It is really annoying. I have happily edited on wikipedia for over a year in peace and quiet without a problem. You have kicked off drama for me on this talk page on an article that I did very little editing to. You have dragged TheGoodSon into it as well now on another talk page Talk:Temazepam. Do you not have other things in your residential home to occupy yourself with? Maybe talk to your fellow residents? Maybe worry about "clutter" in the residential home. Why are you spending all day long following me about complaining about clutter. You must spend all of your waking hours on wiki obsessed with clutter. I am sick of this stalking behaviour because I am telling you it is really really really bizarre behaviour!!! As I have said before I used to enjoy wikipedia and now I am rapidly going off it. I am writing this publicly because private messaging admins is not working.--Literaturegeek (talk) 20:04, 5 April 2008 (UTC)

Lets try and work this out

Tell ya what anon user, lets try and compromise. Tell me what parts of the chlordiazepoxide article that you have a problem with and I will try to work this out and come to an agreement. This has gone on long enough. Lets all calm down. I know that we can come to some sort of an agreement on this.--Literaturegeek (talk) 01:42, 6 April 2008 (UTC)

go over my edits with somebody else, and try to figure out what I meant. 70.137.178.160 (talk) 05:20, 6 April 2008 (UTC)

As part of dispute resolution, I agreed with the comments on this talk page about the committee on safety of medicines report taking up too much of the page and affecting the neutrality of this short wiki article so I have removed it from this article.--Literaturegeek (talk) 11:48, 6 April 2008 (UTC)

Rapid tolerance development to anxiolytic effect [10}, in what species was this done, what dosage, does it carry over to humans? Do you have an english translation ? its in polish. 70.137.178.160 (talk) 14:25, 6 April 2008 (UTC)

I accept your arguments on that reference and as part of resolving this conflict I have removed the citation completely and text associated with it and replaced it with an extensive review article of tolerance to benzodiazepines including chlordiazepoxide in humans.--Literaturegeek (talk) 15:26, 6 April 2008 (UTC)

LG, my hat is off, I just looked now, and I could not believe it was the same page. I dont know much about content on this one, but at least the semblance of purpose is now there.io_editor (talk) 15:35, 6 April 2008 (UTC)

Toxicity: The citation about mouse sperm toxicity - does it carry over to humans? The dosage was corresponding to 2.5g/day, scaled to 75kg body weight. I know, mice are different from human in metabolism. But does it carry over? Otherwise remove as irrelevant. Interaction with Cannabidiol: Has been observed in rats, 1977. Is it clinically relevant? Else remove. Tolerance: Does the mouse experiment "tolerance against anti-seizure, pentetrazole model" carry over to humans, and if yes, on what scale? Is it relevant? Abuse potential: The ref is about separation of benzos by chromatography. Does it suggest the HIGH abuse potential of CHLORDIAZEPOXIDE, or is this your conclusion? Interaction: Is talking about "low dose contraceptives" wrt. bleeding. this got lost. SUGGESTION: Maybe merge Abuse, legal status, tolerance, withdrawal etc. in one concise chapter. 70.137.178.160 (talk) 16:12, 6 April 2008 (UTC)

First a personal comment, very much off the topic. Your SUGGESTION makes me want to accuse you of being a sock-pupput of another editor - and that would be ME. I have had problems with a drug far more important than this (a DMD) but when I complained, the sensationalists (who know far less on my topic than LG does on this) got the Admin rubber stamp to preserve the staus quo entirely! So - while I generally agree with your SUGGESTION, if the others and Admins do not, then I do not count and I must be gone.io_editor (talk) 16:46, 6 April 2008 (UTC)

But I completely agree with this mouse and rat study stuff, because unless the drug is being trialled for a totally new and unrelated indication, that lab stuff should never be on the page, as the human studies make it obsolete. Well you are able to write, and LG is listening (and unless disagree, so why not try it.io_editor (talk)

Alrighty,,, Canabinol effect on seizures has been removed from interactions list.

Tolerance to the anticonvulsant effects does occur with benzodiazepines in humans but your specific question about the pentetrazole model, I am not sure but chlordiazepoxide is rarely prescribed for seizures (except short term alcohol withdrawal) so to be honest it ain't isn't that important so I will just delete it as well.

Concerning abuse, benzodiazepines as a class of drugs are used "illicitly" as commonly as opiates and I posted links up the page about that, however, because the degree of "addictiveness" both physically and psychological does vary from benzo to benzo, I have removed the wording "high misuse potential" as a compromise.

Sorry, can you elaborate on what your complaint is with the oral contraceptives interaction citation?

I have merged tolerance and dependence into one section and legal status and abuse potential section into one section as you requested.

My view on the sperm toxicity in mice of chlordiazepoxide, is that it makes it clear that it is a result in animals, not humans so it is not deceptive to the reader. It is just a fact reported in the encyclopedia entry of the drug. It is an encylopedia entry for the drug and facts about the drug. It is not a patient information leaflet but an encyclopedia article would be my view.--Literaturegeek (talk) 18:11, 6 April 2008 (UTC)

Well LG great work, you are putting in all the time as well. I had to check your User page to see if you were an Admin or maybe even Mother Teresa, you have done everything reasonably possible for the Anon. Actually i see your specialty is Addictions, which explains your interest in those aspects of these drugs. See you (I only wish you knew something about MS).io_editor (talk) 18:28, 6 April 2008 (UTC)

OK - Anon why dont you just Edit the rest, I think the war is over here. And no ancient poetry please.io_editor (talk) 18:28, 6 April 2008 (UTC)

Thanks io_editor the impossible has happened, me and anon are resolving issues haha! Well, I know that chronic usage of benzodiazepine use can cause multiple sclerosis like symptoms which are often misdiagnosed as a preliminary diagnosis but ruled out at further investigation. I have spoken to one person who this has happened to and it has also been reported in the medical literature. Read this fulltext reference.Benzodiazepine Withdrawal: Outcome in 50 Patients. Might interest you. Take care.--Literaturegeek (talk) 18:41, 6 April 2008 (UTC)

It might even be worth citing that in Multiple_sclerosis wiki entry, might solve a few riddles for physicians who treat MS who come across such patients with "unexplained" MS like symptoms.--Literaturegeek (talk) 18:45, 6 April 2008 (UTC)

Yes, I would not have thought it possible that this would be cleaned up. Or that I would find this MS analogy! While I would say that the MS page itself is already overly long - I actually called for brevity in the DMD section on the talk page - it is interesting. However would you believe that a week or so back I was describing MS mis-diagnosis in a certain wiki context - I assure you that you would end up being sorry to have anything to do with it (based upon your page, I assume you have no background in serious/progressive DMD drugs)...gotta run.io_editor (talk) 19:00, 6 April 2008 (UTC)

It has certainly been an interesting few days. The world is full of coincidences. I actually had to look up dmd, didn't click at first disease modifying drugs haha, so there is my knowledge. Laters!--Literaturegeek (talk) 19:11, 6 April 2008 (UTC)

PPS Thanks for your help in helping to resolve this conflict.--Literaturegeek (talk) 18:57, 6 April 2008 (UTC)

Not needed - you actually resolved it yourself really. See you.io_editor (talk) 19:01, 6 April 2008 (UTC)

Interactions: The increased bleeding is for (modern) "low-dose" contraceptives. The increased Chlordiazepoxide levels would occur with the (old) high dose contraceptives, it appears, not with the modern ones.

Toxicity: If we give this an extra chapter, then this mouse sperm experiment is a little lonely with its clinical irrelevance. Thats from the early toxicity investigations and didn't make it into clinical relevance. I really would reconsider if it should be removed. It is not deceptive, because it states its an animal experiment. But it should somehow be marked as likely irrelevant to human pharmacology, as otherwise misconceptions may come up.

LG: Good job, now have it reviewed and rated.

I don't do edits, because I don't want to be reverted and lynched.

humor:what about ref (Librium causing auto-amputation and immolation in undead. J.Transsylv.Psych vanHelsing et al.) 70.137.178.160 (talk) 19:34, 6 April 2008 (UTC)

Thank you. Ok so what would you like to happen with the interactions with oral contraceptives? Would you like it edited? If so to what? Or would do you feel that the oral contraceptives interactions should be deleted? What about including all of the interactions from this website? side effects They do mention oral contraceptives though. It would improve the interactions section for the reader if it was expanded. Auto aputation sounds good lol.--Literaturegeek (talk) 20:40, 6 April 2008 (UTC)

Gave wrong link, I meant this one. librium interactions--Literaturegeek (talk) 20:46, 6 April 2008 (UTC)

Come on Anon, who's going to lynch you now? Not an enemy in sight.io_editor (talk) 20:31, 6 April 2008 (UTC)

Side effect and interaction sheet in full beauty seems too bulky and ranging from important to obscure. Maybe summarize: Alcohol and Medications which cause drowsiness themselves e.g. bloodpressure medications, sedatives, antidepressants, antihistamines, sleep aids ,narcotic pain medications may increase the side effects and lead to dangerous interactions. See patient leaflet... or the like. That should caution against mixing with pain killers and sleeping pills. Read the WP pharmacology guidelines, they advise against inclusion of such lists in full beauty. Maybe leave the toxicity out instead. Keep it concise. Maybe a list like in diazepam? 70.137.178.160 (talk) 22:02, 6 April 2008 (UTC)

Hey there I know I've haven't been been a great participant in this debate but I thought I'd help with the interaction section. I'll give a list which someone may choose to use/not use/edit. It's up for consensus. I've cut it down from the full one which was over 10 times as long. I'm listing the major interactions in for benzodiazapines and what actually happens in these interactions. (I think the latter moves it more towards and encyclopedia) The interactions apply to all benzodiazapines unless I specified otherwise. (Source British National Formulary (BNF) 53, published March 2007. I know this is not necessarily specific to this article per say but here it is anyway.

• Antibacterials: metabolism of midazolam inhibited by clarithromycin, erythromycin, quinupristin/dalfopristin and telithromycin (increased plasma concentration with increased sedation).
• Antifungals: plasma concentration of midazolam increased by fluconazole, itraconazole and ketaconazole (risk of prolonged sedation); plasma concentration of midazolam increased by posaconazole
• Antipsychotics: increased risk of hypotension, bradicardia and respiratory depression when parenteral benzodiazapines given with intramuscular olanzapine; diazepam increaases plasma concentration of zotepine
• Antivirals: increased risk of prolonged sedation and respiratory depression when alprazolam, clonazepam, diazepam, flurazepam or midazolam given with amprenavir; increased risk of prolonged sedation when midazolam given with efavirenz, indinavir or nelfinavir - avoid concomitant use; increased risk of prolonged sedation when alprazolam given with indinavir - avoid concomitant use; plasma concentration of alprozolam, diazepam, flurazepam, midazolam and zolpidem possibly increased by ritonavir (risk of extreme sedation and respitatory depression - avoid concomitant use); plasma concentration of anxiolytics and hypnotics possibly increased by ritonavir; plasma concentration of midazolam increased by saquinavir (risk prolonged sedation)
• Sodium Oxybate: benzodiazapines enhance effects of sodium oxybate (avoid concomitant use)

I've omitted alcohol because it's not classed as a major interaction. It does interact with benzodiazapines but the mechanism by which they are both metabolised is different so they don't potentiate each other. The best way of describing it would be if a dose of benzodiazapines caused x and alcohol caused y then their combination would cause x + y. It's also important to mention notable interactions other than just increased sedative effects. I've given then important ones. If you wish any other interactions to be listed I am more than happy to do it but these are considered to be the most important ones to watch out for. Another point to take. While some of the classes I've listed only describe one drug e.g. midazolam plasma concentration increased by fluconazole, itraconazol and ketaconazole there is a very high chance than this will apply for other benzodiazapines. The reason for the uncertainty is that there are not trials examining the interactions of other specific drugs. It also is from clinical experience.

You'll need to be more specific if you mention medications to add. e.g. try to avoid saying things like blood pressure medication as it's not specific enough. Instead offer things like diuretics, beta blockers, ACE inhibitors etc.

In response to the medications you did mention I've also given the general type of interactions. I can get more specific if you wish

• Alcohol: increased sedative effect in combination with benzodiazapines.

• Anti-hypertensives (blood pressure medications): The interaction is not major but it mainly increases the hypotensive effect of the antihypertensives. Increased sedative effect has not been found in class of antihypertensive.

• Anxiolytics and Hypnotics (sedatives and sleeping aids): Not really an interaction as such because all benzodiazapines in theory could be used as these and it's the exact class they fall under

• Antidepressants: This is quite a tricky one as some antidepressants sedate whereas other have the opposite effect. SSRI's generally increase plasma concentration but due to their slight stimulant effects don't seem to potentiate drowsiness. MAOI's and Tricyclic antidepressants increase drowsiness but don't increase plasma concentration of benzodiazapines.

• Antihistamines: Increased sedative effect depending on whether the antihistamine is sedative in the first place. e.g. loratadine is unlikely do cause this effect

• Opiate/opioid (narcotic pain*)medications: increased sedative effect

Try to avoid using the word narcotic. It's not incorrect but does carry certain connotations. Use opioid instead. Medos ^{(talk • contribs)} 11:18, 7 April 2008 (UTC)

Blood pressure medications: mainly thinking of alpha2 agonists e.g. clonidine. Antihistamines: the old sedating ones, doxylamine, diphenhydramine. In US as OTC sleep aids. Antidepressants: The sedating tricyclics. Remember Limbatril = Amitryptiline+Chlordiazepoxide, this vas VERY sedating, much more than the sum of the components. Opiates/Opioids 70.137.163.38 (talk) 11:40, 7 April 2008 (UTC)

Alcohol: Mentioned because of one main danger: Somebody who is already very drunk and takes benzos on it may then pass out and/or choke on vomit. Same probably with opioids. I think a good deal of the coroners patients are such cases. 70.137.163.38 (talk) 11:48, 7 April 2008 (UTC)

• Alpha-blockers there is a minor increased hypotensive and sedative effect when given with benzodiazapines. Strange one to hone in on as in antihypertensive therapy they are about 4th or 5th line drugs depending on guidelines.
• Can you give me a drug used as an OTC sleep aid in the US? In the UK the general one used is diphenhydramine and this increases the sedative effect.
• With sedating antihistamines (some of the new ones sedate also) the sedative effect is increased with benzodiazapines.
• I can't find any evidence to agree with your claims of increased potentiated effect between tricylics and benzodiazepines. Amitryptiline is acted on by CYP2D6 and some of the CYP2C compounds. None of these are linked with benzodiazepine metabolism. As a result it is highly unlikely that the potentiate each other further than the sum of their effects. (Drowsiness is a classic side effect of tricyclic antidepressants) If you find me any evidence that they do this I'll have a look at it. To add to this it would also seem unlikely that a combination product would be marketed with an inbuilt interaction. If you're asking about interactions to the combination product Limbatril then I can't see how it would apply to this article. Although Limbatril is a product only available in Germany as far as I know. I don't see how it applies to the English version of Wikipedia. Has it existed in the US? I know it hasn't existed in the UK.

The danger is correct with alcohol but passing out is very likely with a large quantity of alcohol consumption alone. I think from a social point it has some importance but in terms of interactions it is not very significant. the opiate example is much more important with alcohol due to the respiratory depression associated with opiates. To complicate matters further chlordiazepoxide is actually licensed as an adjunct in alcohol withdrawal.

I think that if you're going to list the most important interactions then that should be the case. The ones you're requested mostly not important. (Exception being alcohol) I think for the sake of avoiding lists and trying to keep it brief surely the most significant interactions would make sense. Medos ^{(talk • contribs)} 12:51, 7 April 2008 (UTC)

1. OTC sleep aids in US = diphenhydramine, doxylamine 2. Interaction with e.g. Amitryptilin is certainly not by metabolism, but by two different mechanisms of sedation. I was not thinking of interactions with Limbatril. I mentioned it as "anecdotal evidence" for very increased sedation by combining Librium w. Amitryptiline. It was indeed much more sedating than the components, which for themselves were barely noticeable in that dosage. I think Roche intended that. Maybe it would be interesting to look HOW e.g. Amitryptiline sedates. 3. Alcohol: I was thinking practical, harm reduction. If you drink more and more you pass out, but you have a chance to stop before it happens. But if you take some benzos on it, it comes as a surprise, without warning. 70.137.163.38 (talk) 13:22, 7 April 2008 (UTC)

1. This has been addressed 2. If you can find evidence more than "I think Roche intended that" I'd be happy to look over it. I mean links to things, or referenced material which can be looked over. Otherwise it can't really be accepted as it will fall under WP:OR. I can't find anything myself but feel free to help. 3. I think alcohol needs it's own section for debating. It's a very tricky subject. If you can find evidence on it please show it. Don't worry I think it's rude to just say that and not do anything so I've found some things as a starting board. [11], [12],[13] Medos ^{(talk • contribs)} 14:05, 7 April 2008 (UTC)

Ok, I did the interactions list. Lemme know if there are any problems. Thanks for the help.--Literaturegeek (talk) 16:06, 7 April 2008 (UTC)

Medos, good job with your edits on the article, thank you.--Literaturegeek (talk) 18:47, 7 April 2008 (UTC)

Pharma wiki undercover op joke and humour

Right as far as I am concerned this benzo article is finished. I accepted a few of your deletions anon, so you have something positive to report back to Roche pharmaceuticals when you get asked of your achievements. There goes me with my humour again, or am I being serious? Or am I being both? You like riddles anon, what do ya think? ;=)--Literaturegeek (talk) 17:32, 7 April 2008 (UTC)

I'm not sure of you intentions with comments like that but they slightly inflammatory and are going to lead to another dispute. Medos ^{(talk • contribs)} 19:47, 7 April 2008 (UTC)

I also undid some of your deletions on chlordiazepoxide because as far as I am concerned they were not justified. Now which benzo article is next? Clobazam? Lets do clobazam next.--Literaturegeek (talk) 18:43, 7 April 2008 (UTC)

Nah they won't lead to a dispute because I am getting to like anon now and am winding her up, sort of, just joking around n trying to get her to open up and tell me who she is. Don't like be friends with nobody's. I know it is a her with a degree in chemistry. I renamed this section.--Literaturegeek (talk) 20:22, 7 April 2008 (UTC)

Also,,,, anon likes playing jokes n games because she originally told me she was an old man,,,, and had me thinking it was some crazy old man in a residential home with some knowledge of chemistry. I can see the funny side of it now... and anon has humour side. She be cool lol. To be safe though I will keep jokes to a minimum.--Literaturegeek (talk) 20:28, 7 April 2008 (UTC)

No! Keep the jokes coming! Is the Anon really a female? Maybe she lied to invoke your chivalry, so that you do all the edits.....lol.....she is cerainly a changeling isnt she, nursing-home, ancient viking mystic, summary executor of addicts.io_editor (talk) 22:39, 7 April 2008 (UTC)

But I loved the Roche Pharma one, wp:COI for a generic!! My first ever edit was on a branded drug (actually not on the drug page, but a disease page), and got slapped with a wp:COI, accuser wont give up.io_editor (talk) 22:39, 7 April 2008 (UTC)

I am really a retired old man. I have not claimed to be a "she". Don't know how to arrive at that. 70.137.163.38 (talk) 23:11, 7 April 2008 (UTC)

So you werent kidding about the nursing home? (maybe Im kidding, no need to give serious answer) It sounds like you worked closely with this class at some point - clinical or treating? No I dont think you are the CEO of Roche.io_editor (talk) 23:21, 7 April 2008 (UTC)

Proof reading

1. You have edited at such speed that you typed in the same sentence twice in a row, in Toxicity. 2. The newborn withdrawal belongs with withdrawal, not toxicity. Move it there. 3. The quinazolines, made it back, but now as a remark about the structure and activity. Should be quinazolinones, to be precise, as the benzos are also -ones. The similarity makes more sense then. It really doesn't belong into the pharmacology of the substance, but more into speculations about SAR. But as phrased it is acceptable. belongs into Benzodiazepines article, not here, is not important for the particular substance and its pharmacology. Consequently shouldn't be replicated all over. Your source said, that no conclusive SARs have been found. 4. The melanoma cell stuff is basic research and doesn't belong, unless it has clinical relevance. Get another opinion. 70.137.163.38 (talk) 19:13, 7 April 2008 (UTC)

Generally try to write more concise, w.o. bloating. Young academics get trained for scenic routing through the topic, because their writing is rated by number of pages and citations. Nobody reads that. The professor puts the report on a scale and directly reads the rating. 70.137.163.38 (talk) 19:26, 7 April 2008 (UTC)

Well withdrawal is part of toxicity, the body responds to a toxic substance by making adapations to try to overcome it (tolerance). The body does the same with poisons such as arsenic. Some super rats become immune/tolerant to rat poisons that way... depends how you define toxicity though. but hey I am just being argumentative. I moved it. You describe the molecule and then you describe the pharmacological properties of that molecule, so I think that it is fine to introduce the molecule in the introductory first sentence. SAR and a knowledge of molecular chemistry. You sound like you have a degree in chemistry. I will move the quinazolones sentence n ref over to the main benzodiazepines article. Compromise. Right onward to the next benzo article, clobazam ;-).--Literaturegeek (talk) 20:12, 7 April 2008 (UTC)

Same sentence twice: Chlordiazepoxide in animal studies has been shown to increase reward seeking behaviours which may suggest an increased risk of addictive behavioural patterns.[21] Chlordiazepoxide in animal studies has been shown to increase reward seeking behaviours which may suggest an increased risk of addictive behavioural patterns.[22]

Read loudly and quickly: How many wood would a woodpeck peck, if a woodpeck would peck wood.

Get some opinion on the melanoma cell research. 70.137.163.38 (talk) 20:32, 7 April 2008 (UTC)

I can say that one just about lol. Oh lol, I got mixed up what was deleted and what wasn't. I removed double sentence.--Literaturegeek (talk) 20:50, 7 April 2008 (UTC)

I have to admit that there are some very valid points the anon user is making.

• I agree with the toxicity point as there is no toxicity being shown but merely withdrawal as a result of exposure according to the text.
• Ok opinion on the melanoma. I have to agree with questioning the fact about melanoma given in the pharmacology section. It's not sticking to the main facts. It may have a place in the article but not there. I don't personally agree the comment about length of the article. I think if it needs to be long then it should be.

Since I entered this debate I admit I have generally been looking at the talk page but on actually looking through this article I've turned out to have more concerns about it than the anon user.

• The history section is ridiculous. All is says is to see the "main article" benzodiazapines for the history of Librium. Surely it should be chlordiazepoxide not Librium and the use of the phrase main article is a bit clumsy. Also it should be the other way around. It should be the more detailed information in this article, not nothing in this article.
• The pharmacology section has avery poor structure to it. It seems to have random facts inserted into it which bear no importance to the main aspect of the pharmacology. There's no general direction to it.

I'll give an example as to how it could be written with some structure.

Benzodiazepine receptors are associated with the GABA chloride channel complex (GABAA receptor). GABA agonists cause opening of the Cl channel. Benzodiazepine receptor is a modulating unit, modifying the response to GABA. Benzodiazepine agonists (benzodiazepines) enhance submaximal responses to GABA (They cannot enhance maximal responses). They have no direct action on the Cl channel. GABA increases benzodiazepines binding. There are 2 types of receptor: Stimulation of benzodiazepine 1 receptor causes hypnotic effects while benzodiazepine 2 receptors mediate anticonvulsant effects. It is likely there is also a peripheral benzodiazepine receptors. Benzodiazepine receptors found in cerebral cortex, limbic system, cerebellar cortex and spinal cord With increasing doses of benzodiazepines there is an increase in receptor occupancy, producing a progressive spectrum of effect from anxiolysis and anticonvulsant effects to amnesia, sedation and eventually hypnosis and anaesthesia. Flumazenil when given in increasing doses progressively reverses these effects without any change in the pharmacokinetics of the agonist drug. Thiopentone and neurosteroids also act on GABA-Cl channel complex. The anxiolytic effect is probably mediated by 5-HT receptors in limbic system. An endogenous ligand probably exists but has yet to be identified (some patients in hepatic coma can be wakened by flumazenil)

This could easily be added to and expanded if necessary. The language would also need to be simplified where possible to make it fit an encyclopedia.

• The pharmacokinetics are not ideal and possibly not even necessary as the drug box covers in most cases.
• The tolerance and dependence section is not too bad. It is a bit lacking in science i.e. physiological mechanisms but has some clinical facts.
• The indications section is way too short. It should also clarify the difference between licensed and unlicensed uses of the medication.
• The dosage section does not list ANY doses for any treatments. It merely has the strengths of formulations.
• I'm aware that I have offered a list to try to help the situation but they are rarely found in good pharmacology articles. I don't think this needs to become a patient information leaflet. If there were no lists in this it would be ideal. (and that is possible)
• No pharmacodynamics section. They tend to go with pharmacokinetics sections. Neither have to be there. You can easily work them both into text.
• There probably should be a metabolism section, which gives the mechanism of reaction of chlordiazepoxide
• The abuse section should be either merged with of put next to the tolerance and dependence section.
• Personally I'd axe the trade name sections.

Hopefully that wasn't too brutal. I think those issues need to be addressed before anything beyond that is put in place. Medos ^{(talk • contribs)} 20:52, 7 April 2008 (UTC)

Side effects: The B16/C3 melanoma cells are imo an immortalized strain of cancer cells, used for cell research. They are not mainly found in the skin, they are found only in the laboratory. This is not a side effect, unless you are a walking tumor. The patient who had them is dead. Deleted. Explain significance before reinserting. 70.137.163.38 (talk) 22:35, 7 April 2008 (UTC)

Strictky speaking cancer cells are immortalized anyway as they don't undergo apoptosis like a normal cell.Medos ^{(talk • contribs)} 10:34, 8 April 2008 (UTC)

Yes, and express telomerase. I know, but thought to explain. 70.137.190.187 (talk) 15:13, 8 April 2008 (UTC)

The latent learning impairment by dysfunction of the cholinergic system is about mice in a maze. Does it carry over to humans in a maze? I added "in mice" the next sentence should also have this added. The article is Japanese. Somebody speaks Japanese here? Is this a side effect?

I speak a little Japanese. Arigato.io_editor (talk) 00:09, 8 April 2008 (UTC)

The rashes are already in the list of side effects. Deleted duplicate mentioning adjacent to "melanoma". 70.137.163.38 (talk) 00:00, 8 April 2008 (UTC)

70.137.163.38 (talk) 00:00, 8 April 2008 (UTC) Maybe we can arrive at some conclusion, how to keep basic research separate from established facts. 70.137.163.38 (talk) 00:28, 8 April 2008 (UTC)

I think they can both be quite happily done. If the established material is first presented and then followed by the research then it has some merit. I think the main issue would be to mention things like. "A trial involving 536 people in Sweden has demonstrated..." or something to that tone. There is an obvious danger that individuals with no scientific training will take this as fact but I think there's only so much damage control you can actually do.Medos ^{(talk • contribs)} 10:34, 8 April 2008 (UTC)

Arigato, can you take a look if the Japanese ref is about a mouse model for anterograde amnesia? Speculation about the mechanism, GABA action reducing cholinergic transmission? How relevant in this section? 70.137.163.38 (talk) 01:11, 8 April 2008 (UTC)

Alrighty y'all,

Medos, no problem on the criticism because I have never really tried to develop this page before. Never even had any intention to develop it either. I just added a few refs when I stumbled across them, hoping that someone else would shape the page up better than I as I didn't have the time nor intention. I am happy for infant withdrawal to be under dependence as I said above. I just wrote the history section. I think anon and you will be impressed. I just wrote the history section up and cited a source. Good write up for the medos pharmacological section, but would need a citation or citations. I would rather come back to the that section next time i stumble across a good citation on mechanism of action etc. I am getting librium fatigue and it is not drug induced fatigue lol. I actually disagree on the pharmacokinetics because most people don't read or don't think to read the drug box and also the half life which is very useful for readers to know is not contained on the drug box.

Indications and doses section sorted out.

Trade section has been axed.

On the melanoma thing, benzo receptor agonists increase the cancer risk anon including benzos, the so called "non"benzodiazepines, and alcohol and they also cause significant changes in immune function, a ref i have have not yet shown you but hey I ain't gonna cite it in this article so don't worry. I can compromise and let the melanosis thing drop and leave it deleted from this article. Librium only prescribed really now a days for 7 - 10 days for alcohol w/d so it is probably clinically irrelevant and insignificant, just to using med jargon for the sake of it lol!

I always think that there should be idea of the overall structure of the article. It definitely has benefits. All I'd really say is not to pick articles randomly. I've done it myself but it's not needed until there is a more complete basics section.Medos ^{(talk • contribs)} 10:34, 8 April 2008 (UTC)

Medos or io editor, a question about wikipedia, why does no one use "LOL" when talking on wikipedia? Everywhere else uses it, just wondering why it doesn't seem to be used by the wiki community.

For me I never use it, although I can only speculate. Maybe it's an age thing? Maybe it's perceived as dumbing down the language? The average wikipedia user, as far as I can recollect, is a white, English-speaking male who holds a third level degree (The last one I could be corrected on). As a result I think with Wikipedia it has an intellectual slant to it, for bad or for good, and as a result people probably want to appear that way. Medos ^{(talk • contribs)} 11:13, 8 April 2008 (UTC)

That sounds like a good theory of why. :=)--Literaturegeek (talk) 22:24, 9 April 2008 (UTC)

Anon, yes benzos impair memory and learning and a variety of cognitive functions. I cited a ref to a human study and replaced the animal study with the human study.

Well anon, on the basic research versus established facts, now that we are almost done with the chlordiazepoxide page, there is on the clonazepam article an article promoting clonazepam to be used to reduce side effects of SSRI medication. It is basic research and speculative and not really established. Also furthermore there is a strong potential that the results are biased because the manufacturers of clonazepam funded the drug trial. I am sceptical of a lot of these trials because most of them are funded by the drug companies. There are many of them on wikipedia. What it boils down to though is what wikipedia says is an authoritative source. I would like to debate whether trials funded and controlled by the manufacturer really should be allowed on wikipedia, nevermind independent research to be honest. If you would like to delete the roche trial from the clonazepam article you are free to do so anon. I would back you up. I didn't delete it myself because I try to stay a neutral editor on wiki.--Literaturegeek (talk) 02:41, 8 April 2008 (UTC)

It's somewhat of a mixed area. I definitely am more careful with taking the opinion of a manufacturers trials. I think recently there was a case with Glaxo (I may have the company wrong) which has resulted in all trial data must be shown when submitting a drug for approval. This could have large benefits. I wouldn't say that they should be disregarded altogether, as they are quite valuable, but independent trials can be used to test the cracks in their evidence. Don't worry about being neutral. Remember to be bold with editing. If the edit isn't liked by other editors, then talk it through with them. Medos ^{(talk • contribs)} 10:34, 8 April 2008 (UTC)

Yea I think that it was glaxosmithkline with their drug paroxetine (Paxil, seroxat), where they covered up clinical trials which showed that their antidepressant increased suicidal and violent behaviour more than placebo in children and then declared it remarkably safe and effective for children. You can watch the panorama video clip of it on the BBC website.[14] I do think it is mixed, some of the advancements of the drug companies have had immense benefits for medicine and humanity and some have had terrible effects, bromides, thalidomide and others.--Literaturegeek (talk) 22:24, 9 April 2008 (UTC)

Hey guys, for a drug which is prescribed for only 7-10 days for alcohol withdrawal and rarely for any other condition I think that we can think about wrapping it up here or does anyone else think anything major major needs to be done? I really think that to try and make this a superdooper article isn't worth it because the drug is not all that important outside of alcohol withdrawal. I reckon we pack up here. I can always come back to it at a later date next time I am reading something about the mechanism of action of benzos and expand the article to read something similar to what medos wrote for the pharmacology section.--Literaturegeek (talk) 02:49, 8 April 2008 (UTC)

I think getting it past B-class has a long way to go. I don't think it can be done over-night. It doesn't need to be abandoned. I think with time and effort it could be worked on to get it up to good article status. If when editing you play a more active role in wikiprojects pharmacology and medicine it will help a lot for getting other editors to help with the editting process. Medos ^{(talk • contribs)} 10:34, 8 April 2008 (UTC)

I am not familiar with wikiprojects. I might be able to help out on certain projects. I will consider working up chlordiazepoxide from the ground up.--Literaturegeek (talk) 22:29, 9 April 2008 (UTC)

Question for io editor and medos, now we know people can have a conflict of interest but what about citing sources which have a conflict of interest? Does this violate wp:COI or is it to be discouraged on wikipedia? I tend to leave such journal articles if people cite them to be a neutral editor even though at times I think or sometimes know they are fraudulent or inaccurate. Research has shown that industry sponsored trials are 3.6 or is it 3.2 times more likely to produce positive results than independent trials or studies of their drugs meaning that many of these trials are extremely biased and one could argue fraudulent and even propaganda to socially engineer doctors into prescribing their product if you want to look at it from an extreme perspective. Should such articles be deleted? What is wikipedia's stance on this? But like I say I don't delete them to leave page neutral, I am just wondering.--Literaturegeek (talk) 03:09, 8 April 2008 (UTC)

To be precise, everybody has SOME agenda, except of course old retired people. Otherwise they would not fund the research and pump money into it. There is no Ministery of Truth, dedicated to the truth. (MINITRUTH), like in Orwells 1984. Your last addition about memory impairment is from NIAAA (Nat.inst.f.alcohol abuse&alcoholism), the sister of the NIDA. Famous history of prohibition era science. http://en.wikipedia.org/wiki/NIAAA read their mission statement, thats the agenda. I agree, that they kind of counterbalance industry agenda. But they are also the source of Anslinger propaganda. Remember studies "Marihuana makes blacks rape white women" all strictly scientific, of course. State research is to be treated with some distrust too! It is not REALLY independent. It frequently has a political side to it. Plutonium all harmless and healthy. Nuclear tests no problem, a little radiation only refreshing. I am cynical. State research has blessed eugenics, apartheid and the characterization of dissidence as a disease. Also in the US. Look through history, and you find the truth. 70.137.190.187 (talk) 04:40, 8 April 2008 (UTC)

So anon, without being too nosey, what did you retire from? What area of academia did you work in? I didn't read anything particularly alarming in their mission statement? What was I meant to be reading? I know state research has promoted propoganda such as eugenics in the past and can have an agenda behind them. Drug companies were involved in the nazi era. I agree that state sponsored research can be very biased. It was Bayer pharmaceuticals who made the cyanide gas for example.--Literaturegeek (talk) 22:16, 9 April 2008 (UTC)

It's a very tricky area to navigate. It could very easily be argued that it could fall under that class, but then there are numerous organisations who will test them such as NICE and the FDA. Looking at history NICE has much more rigorous methods of accepting drugs than the FDA mainly due to cost efficacy. (Note I did not say the cheapest. I said cost effective) As bad as it may sound the best way to find out what effects a drug will exhibit is to see it in a clinical setting with real patients.Medos ^{(talk • contribs)} 10:34, 8 April 2008 (UTC)

It is actually the mhra who approve drugs here, not joking but they get 100% of their funding from the drug companies, the mhra. So basically the drug companies approve their own products here. NICE is good but always under attack from the drug companies releasing press releases and the like so a lot of negative bias against NICE in the media here. NICE's role is to say whether an already approved mhra drug is as you correctly state is "cost effective". If it is not then it is classed as not prescribable on the NHS. Basically they try to bring about a cost effective healthcare system. They do have other roles as well and do issue guidances and the like. I agree, you are right, the best clinical trials are those carried out in patients in real live clinical practice. Just gotta hope the patient doesn't develop exploding head syndrome when new drugs come on the market eh. What about links to the official website of a product like, I dunno klonopin.com or restoril.com etc? Surely that would violate wikipedia's policy of links not allowed which promote "your own product or business"?--Literaturegeek (talk) 22:16, 9 April 2008 (UTC)

Hey guys, very very sick here, can barely type or stand up. Nasty virus, talk in a day or 2 or maybe later if I feel up to it. Will reply to everyone when I am feeling a lil better.--Literaturegeek (talk) 16:32, 8 April 2008 (UTC)

Feel better Literature. Hopefully see you soon. Medos ^{(talk • contribs)} 17:22, 8 April 2008 (UTC)

Cheers Medos. I got a good sleep of about 12 hours, feeling a lil better. I have been sick for about a week and not sleeping due to headaches and then finally collapsed last night. Weird one it really hit me after over a week of having it. Usually a virus hits me hardest within the first few days. At least I had enough energy to defend the benzo articles before shutting down from exhaustion.--Literaturegeek (talk) 22:16, 9 April 2008 (UTC)

Anon user

You made this comment:

Should read "your benzo junkies". Not YOU! Not all benzos are very hypnotic. Noctamide, Rivotril, Temazepam, Rohypnol are very hypnotic.

Define hypnotic and then explain to me in which way is clonazepam (Rivotril) considered to be a "very hypnotic" benzodiazepine? Has it ever even been classified as a hypnotic-sedative? Benzodiazepine hypnotics are typically moderate to very strong agonists of the α₁ receptor subunits of the GABA_A receptor. The alpha1 subunit mediates hypnotic effects, including ataxia, speech disturbance, heavy sedation, amnesia, and motor-impairment. It is this subunit which is also believed involved with benzodiazepine self-administration and reinforcing effects. However, it is quite common knowledge that clonazepam's affinity to this particular subunit is weak, even when compared to diazepam, alprazolam, and lorazepam.

Flunitrazepam, temazepam, nimetazepam, nitrazepam, triazolam, midazolam, flutoprazepam, and loprazolam are the most "hypnotic" benzodiazepines. Lormetazepam and brotizolam may also be considered here. Within this group you will find the most recreationally valued and most tightly controlled benzodiazepines. The abuse of various benzodiazepines, most importantly, temazepam and nimetazepam is a significant point. The level of addiction, abuse, and mortality which temazepam and nimetazepam demonstrated to be capable of, is quite unique amongst all benzo abuse.

In regards to your comments about "legitimate use", well when a drug starts to be manufactured illegally due to prescription controls or being taken off the market, then it starts to turn into a "primary drug of abuse" - as has been seen with temazepam, and to a lesser extant, nimetazepam. Illegal manufacture of temazepam has been going on since the early 2000's (Interpol shut down small operations), but it is only now becoming bigger and more bold. Small to moderate seizures of the drug have been occurring in many ports and airports worldwide. Nimetazepam seizures in Southeast Asia total to over a million tablets annually (more than MDMA for the region). Temazepam and nimetazepam have shown that benzos are capable of becoming primary drugs of abuse. If you are still gong to hold on to your mistaken beliefs, then I'm going to suggest you start reading more in depth about benzos, addiction, and maybe you can meet and talk to some addicts. TheGoodSon 07:36, 21 April 2008 (UTC)