Comments on: Batman #677: A Medical Review http://www.politedissent.com/archives/2048 a blog of medicine, comics, television, science and other fun stuff Fri, 10 Feb 2012 05:09:03 -0600 http://wordpress.org/?v=2.8.4 hourly 1 By: Your Obedient Serpent http://www.politedissent.com/archives/2048/comment-page-1#comment-406317 Your Obedient Serpent Thu, 07 Aug 2008 18:58:39 +0000 http://politedissent.com/?p=2048#comment-406317 I vote for the <i>Equilibrium</i> reference, myself. I vote for the Equilibrium reference, myself.

]]> By: Scott http://www.politedissent.com/archives/2048/comment-page-1#comment-405252 Scott Wed, 06 Aug 2008 15:48:43 +0000 http://politedissent.com/?p=2048#comment-405252 <font color="green">In the past five years, I think I've prescribed Librium twice. Once was for alcohol withdrawal, just like you mention. It does work well for it, but you have to be careful not to substitute one addiction for another. The second was for a patient who has been on it for 20+ years for anxiety. She only takes one pill every few weeks and it seems to work well for her, so I decided that changing medications was probably not in her best interest (following the old adage "if it ain't broke, don't fix it").</font> In the past five years, I think I’ve prescribed Librium twice. Once was for alcohol withdrawal, just like you mention. It does work well for it, but you have to be careful not to substitute one addiction for another. The second was for a patient who has been on it for 20+ years for anxiety. She only takes one pill every few weeks and it seems to work well for her, so I decided that changing medications was probably not in her best interest (following the old adage “if it ain’t broke, don’t fix it”).

]]> By: BPK http://www.politedissent.com/archives/2048/comment-page-1#comment-405167 BPK Wed, 06 Aug 2008 13:54:51 +0000 http://politedissent.com/?p=2048#comment-405167 In psychiatry and addiction medicine, Librium is also sometimes used for alcohol or benzodiazepine detoxification as a more or less "self-tapering" benzo to use in withdrawal, again, because of its long half life. You still generally taper it to detox the patient but it has a long tail before the drug is gone from the system completely. Because it is metabolized by the liver, it is not as good a choice as, say, oxazepam or lorazepam if there is any liver impairment, as there frequently is in chronic alcoholics. I doubt anyone would start a patient Librium these days as an anxiolytic. None of this explains why it would be useful in this comic - I agree it's an odd choice; either they want the long half life or the writer just picked a med that is modestly plausible in its mechanism of action but isn't as famous among the lay public as Xanax is, either as an anxiolytic or as a drug of abuse, since that's not how they're using it here and so confusion is avoided. A short-acting substitute that could have been chosen would be Lexotan (bromazepam), which isn't available in the US so isn't well known among the public. Of course, since it isn't sold in the US it would be harder for Dr. Hurt to get a hold of in Gotham. In psychiatry and addiction medicine, Librium is also sometimes used for alcohol or benzodiazepine detoxification as a more or less “self-tapering” benzo to use in withdrawal, again, because of its long half life. You still generally taper it to detox the patient but it has a long tail before the drug is gone from the system completely. Because it is metabolized by the liver, it is not as good a choice as, say, oxazepam or lorazepam if there is any liver impairment, as there frequently is in chronic alcoholics.

I doubt anyone would start a patient Librium these days as an anxiolytic.

None of this explains why it would be useful in this comic – I agree it’s an odd choice; either they want the long half life or the writer just picked a med that is modestly plausible in its mechanism of action but isn’t as famous among the lay public as Xanax is, either as an anxiolytic or as a drug of abuse, since that’s not how they’re using it here and so confusion is avoided. A short-acting substitute that could have been chosen would be Lexotan (bromazepam), which isn’t available in the US so isn’t well known among the public. Of course, since it isn’t sold in the US it would be harder for Dr. Hurt to get a hold of in Gotham.

]]> By: Sean Duggan http://www.politedissent.com/archives/2048/comment-page-1#comment-405091 Sean Duggan Wed, 06 Aug 2008 11:53:16 +0000 http://politedissent.com/?p=2048#comment-405091 I'll admit that I'm mainly familiar with Librium because originally that was what they were going to name the emotion-removing drug in Equilibrium (upon finding that the word Librium was trademarked, they chose the more recognizable but non-infringing name of Prozium for the drug). Until now, I hadn't actually realized that Prozac and Librium were the same kind of drugs. It adds an additional layer to the name switch. I’ll admit that I’m mainly familiar with Librium because originally that was what they were going to name the emotion-removing drug in Equilibrium (upon finding that the word Librium was trademarked, they chose the more recognizable but non-infringing name of Prozium for the drug). Until now, I hadn’t actually realized that Prozac and Librium were the same kind of drugs. It adds an additional layer to the name switch.

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