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Benzodiazepines Ii: Waking Up On Sedatives: Providing Optimal Care When Inheriting Benzodiazepine Prescriptions In Transfer Patients, Jeffrey Guina, Brian Merrill
Benzodiazepines Ii: Waking Up On Sedatives: Providing Optimal Care When Inheriting Benzodiazepine Prescriptions In Transfer Patients, Jeffrey Guina, Brian Merrill
Psychiatry Faculty Publications
This review discusses risks, benefits, and alternatives in patients already taking benzodiazepines when care transfers to a new clinician. Prescribers have the decision—sometimes mutually agreed-upon and sometimes unilateral—to continue, discontinue, or change treatment. This decision should be made based on evidence-based indications (conditions and timeframes), comorbidities, potential drug-drug interactions, and evidence of adverse effects, misuse, abuse, dependence, or diversion. We discuss management tools involved in continuation (e.g., monitoring symptoms, laboratory testing, prescribing contracts, state prescription databases, stages of change) and discontinuation (e.g., tapering, psychotherapeutic interventions, education, handouts, reassurance, medications to assist with discontinuation, and alternative treatments).
Benzodiazepines I: Upping The Care On Downers: The Evidence Of Risks, Benefits And Alternatives, Jeffrey Guina, Brian Merrill
Benzodiazepines I: Upping The Care On Downers: The Evidence Of Risks, Benefits And Alternatives, Jeffrey Guina, Brian Merrill
Psychiatry Faculty Publications
Benzodiazepines are some of the most commonly prescribed medications in the world. These sedative-hypnotics can provide rapid relief for symptoms like anxiety and insomnia, but are also linked to a variety of adverse effects (whether used long-term, short-term, or as needed). Many patients take benzodiazepines long-term without ever receiving evidence-based first-line treatments (e.g., psychotherapy, relaxation techniques, sleep hygiene education, serotonergic agents). This review discusses the risks and benefits of, and alternatives to benzodiazepines. We discuss evidence-based indications and contraindications, and the theoretical biopsychosocial bases for effectiveness, ineffectiveness and harm. Potential adverse effects and drug-drug interactions are summarized. Finally, both fast-acting/acute …