David Baxter PhD
Late Founder
Thanks for the clarification. I do find that a lot of people frighten themselves away from using prescribed medications because of internet information which is at best uninformed and at worst outright alarmist.
Any information you find about any medication that does not include a control group, usually a placebo group, where you can determine how many people with the same disorder or condition had the same symptoms in the absence of that medication is fundamentally flawed.
Additionally, when you read a phrase like "can cause X", it needs to be accompanied by the percentage of people who experienced that side effect (in comparison with those not taking the drug who also experienced that side-effect). You also need to know what dose of the medication was being taken.
So for example, with clonazepam, you may see something like this:
What does that actually mean? Very little, as written. For one thing, those lists are generally based on side effects reported by 1% or more of patients. For another, the dose is unstated.
Looking further into the statistics for clonazepam, we find this:
Most Common Adverse Events ( ≥ 1%) Associated with Discontinuation of Treatment
Side Effect | Clonazepam (N=574) | Placebo (N=294)
Somnolence | 7% | 1%
Depression | 4% | 1%
Dizziness | 1% | < 1%
Nervousness | 1% | 0%
Clearly, other than sleepiness which is to be expected, none of this are high probability side effects. But even this doesn't tell us the whole story. Digging a little deeper, we see that these data are based on "doses ranging from 0.5 to 4 mg/day". So which patients were taking 0.5 mg and which were taking 4.0 mg? How many reported any of these side-effects at 0.5 mg vs. 4.0 mg?
Treatment-Emergent Adverse Event Incidence in 6- to 9- Week Placebo-Controlled Clinical Trials
Side Effect | < 1 mg | 1- < 2 mg | 2- < 3 mg | % ≥ 3 mg | All Doses | Placebo
Somnolence | 26 | 35 | 50 | 36 | 37 | 10
Fatigue | 9 | 6 | 7 | 7 | 7 | 4
Dizziness | 5 | 5 | 12 | 8 | 8 | 4
Depression | 7 | 6 | 8 | 8 | 7 | 1
Nervousness | 1 | 4 | 3 | 4 | 3 | 2
Appetite Decreased | 1 | 1 | 0 | 3 | 1 | 1
Blurred Vision | 1 | 2 | 3 | 0 | 1 | 1
So what should this tell you?
Any information you find about any medication that does not include a control group, usually a placebo group, where you can determine how many people with the same disorder or condition had the same symptoms in the absence of that medication is fundamentally flawed.
Additionally, when you read a phrase like "can cause X", it needs to be accompanied by the percentage of people who experienced that side effect (in comparison with those not taking the drug who also experienced that side-effect). You also need to know what dose of the medication was being taken.
So for example, with clonazepam, you may see something like this:
What does that actually mean? Very little, as written. For one thing, those lists are generally based on side effects reported by 1% or more of patients. For another, the dose is unstated.
Looking further into the statistics for clonazepam, we find this:
Most Common Adverse Events ( ≥ 1%) Associated with Discontinuation of Treatment
Somnolence | 7% | 1%
Depression | 4% | 1%
Dizziness | 1% | < 1%
Nervousness | 1% | 0%
Treatment-Emergent Adverse Event Incidence in 6- to 9- Week Placebo-Controlled Clinical Trials
Somnolence | 26 | 35 | 50 | 36 | 37 | 10
Fatigue | 9 | 6 | 7 | 7 | 7 | 4
Dizziness | 5 | 5 | 12 | 8 | 8 | 4
Depression | 7 | 6 | 8 | 8 | 7 | 1
Nervousness | 1 | 4 | 3 | 4 | 3 | 2
Appetite Decreased | 1 | 1 | 0 | 3 | 1 | 1
Blurred Vision | 1 | 2 | 3 | 0 | 1 | 1
- Only a minority of people taking this medication experienced any of these side-effects.
- The most likely side-effect is sleepiness, part of which is also a symptom of anxiety itself (see Placebo = 10%).
- For most side-effects, whether or not or how frequently they occur is dose-related.
- Many of the reported side-effects occur as frequently with the placebo patients as with the clonazepam patients.
