Q. I read your article recently about a person who had been on clonazepam for 26 years and was struggling to get off it. Today my doctor prescribed this same drug for my anxiety. I am 81 years old, and also take an antidepressant. I hope I won't have to be on these pills for the rest of my life, as I try and work myself into positive thinking. What are your thoughts?

A.

Keep in mind there is no such thing as good and evil when it comes to medications. Paracetamol is a perfect example of a drug that is unbelievably safe and effective - except when it causes liver failure and death in large overdoses.

Every drug has its costs, and I don't mean just dollars and cents. Rather than good or evil, I prefer to think of medications as tools, like a screwdriver or a spanner. A "screwdriver" that helps you with crippling panic attacks, allowing you to take better care of your kids. A "spanner" that treats your depression, and by doing so, relieves you from a whole host of medical symptoms you didn't even realise were depression-related.

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I'm not talking about miracle cures, I'm just talking about being able to do your daily activities, and have some degree of satisfaction with the quality of your life. Antidepressants and anti-anxiety medications can be the right tools in the right settings, and raise the quality of your life tremendously. I have seen profoundly psychotic patients return to their careers and families thanks to effective psychiatric medications. And I've seen people live wretched lives and die tragic deaths strung out on prescription painkillers. I would urge you to base your health decisions on real-life results rather than on a drug-company sales pitch, media scaremongering, or the medical advice of wishful thinkers.

Discuss it with your family, who know you best, and bring it up with your doctor. Every single treatment, traditional, alternative, or otherwise, has its good and bad effects. The real question is has your medication reduced your anxiety and depression allowing you to lead a more functional and productive life? If so, then rushing to stop them may not be the best bet.

Gary Payinda MD is an emergency medicine consultant in Whangarei.
Have a science, health topic or question you'd like addressed? Email: drpayinda@gmail.com
(This column provides general information and is not a substitute for the medical advice of your personal doctor.)