1. they DO work well for anxiety and for insomnia
2. they ARE habit forming
3. the DO have a potentially severe withdrawal syndrome if discontinued suddenly after long use
4. they DO have a host of bad interactions with other medicine and particularly with alcohol
5. patients often become dependent on these medicines and engage in risk taking behavior in order to not run out of them
6. 'tachyphylaxis' occurs with these medicines... that means that over time patients will tend to escalate doses in order to get the same effect or feeling after taking them
different considerations in a clinical setting
1. if you have a good relationship with your patient and these medicines are prescribed for short term anxiety or insomnia they are sometimes a good choice
1. these medicines can have either no effect or a paradoxical effect in the elderly... in other words, they often do not work in the elderly like they do in younger, healthier populations
2. or they do not work at all OR they can cause agitation rather than relaxation/ sleepinesss
3. also, the elderly tend to be on more medications so the potential interactions are generally much greater in the geriatric population
1. older physicians established their knowledge base when the benzodiazepines were commonly prescribed and not generally known as poor choices for long term treatment of anxiety or insomnia
2. they DO work, so many physicians, pressed for time, will default to these medicines rather than prescribing, say, an ssri like celexa (not habit forming but takes a few weeks of therapy to work) in order to move through their patient load for the day and provide a satisfied customer/patient interaction
3. however, if a physician chooses to prescribe these, they must be diligent in setting a stop date, and stop dates are not generally appreciated or liked by patients taking these medicines as they DO work and they DO NOT want to take the harder route of non addictive medication and psychotherapy in order to overcome their anxiety/insomnia problems that the benzodiazepines do treat well for the short term.
I hope this has been a good answer. I do not see in you in chat so will switch to Q and A.
if this has been a good answer please leave positive feedback, if you have further questions please ask them below.
positive feedback and tips are greatly appreciated.
When are you back on?
IM on now and you can post another question to me... simply send it to 'medical' and start your question with 'for 911doc only'.... will be happy to assist.
Okay but I have been having problems with the sight. When I do medical it transfers me over to homework. They are working on the problem. I will let you know.
I sent you a question and its under short 2page essay. the first line is 911 doc....Thanks