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Sedatives and Hypnotics

Evolve Psychiatry is committed to safe outcomes for our patients and minimizes prescribing drugs that can be easily misused or abused.  We strictly offer benzodiazepines and sleep aids as part of a treatment plan that includes tapering them when clinically indicated.  We monitor patient usage of these medications closely and aim to minimize risks of dependency and withdrawal. Rest assured, we are committed to working closely with our patients to develop treatment plans that best meet their unique needs while promoting overall well-being. 

Adverse Effects of Chronic Use of Sedatives

At our practice, we prioritize the well-being and long-term health of our patients. As part of our commitment to evidence-based medicine and patient safety, we do not recommend or prescribe chronic use of controlled substances such as benzodiazepines or sedatives/hypnotics.


Sedatives such as benzodiazepines (Restoril, Xanax, Ativan, Klonopin) and hypnotics (Ambien, Lunesta) are a class of medications primarily prescribed for the short-term management of anxiety, panic disorders, and certain sleep-related conditions. While they can provide effective symptomatic relief in the short term, there are several reasons why their chronic use is generally discouraged:


Risk of dependence and addiction

Sedatives/hypnotics have the potential to cause physical and psychological dependence when used regularly for an extended period. Prolonged use increases the risk of developing tolerance, meaning higher doses may be needed to achieve the same effect. This can lead to a cycle of escalating doses and a higher likelihood of addiction.


Cognitive and psychomotor impairment

Sedatives/hypnotics can cause sedation and impair cognitive function, including memory, attention, and concentration. This can interfere with daily activities, work performance, and overall quality of life. Older adults, in particular, are more susceptible to these cognitive side effects, which can increase the risk of falls, accidents, and other safety concerns.


Interactions with other medications

Sedatives/hypnotics can interact with other medications, including certain painkillers, non-controlled sedatives, and alcohol. These interactions can lead to increased sedation, respiratory depression, and other adverse effects. It is crucial to consider potential drug interactions when prescribing medications, especially for patients who may be taking multiple medications concurrently.


Tapering and withdrawal challenges

Discontinuing sedatives/hypnotics after prolonged use can be challenging due to withdrawal symptoms that may occur. These symptoms can range from rebound anxiety, insomnia, and irritability to more severe manifestations such as seizures in certain cases. Gradual tapering under medical supervision is typically recommended to minimize withdrawal symptoms and ensure a safe discontinuation process.


Availability of alternative treatments

Various non-pharmacological interventions, such as cognitive-behavioral therapy (CBT), relaxation techniques, and lifestyle modifications, have been shown to be effective in managing anxiety and related conditions. These approaches address the underlying causes of anxiety and provide long-term coping strategies, reducing the reliance on sedatives/hypnotics for symptom management.


While there may be exceptional circumstances where such medications are deemed necessary for long-term use, our practice follows a cautious and conservative approach, prioritizing alternative treatments and non-pharmacological interventions whenever possible. Our goal is to provide comprehensive and individualized care that focuses on long-term health, functional improvement, and minimizing the potential risks associated with chronic sedatives/hypnotic use.

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