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Clinical Update

Inpatient Use of Benzodiazepines for Patients With Substance Use Disorders

January 31, 2024

Audrey Abelleira, PharmD, BCPP. Clinical pharmacist practitioner, VA Connecticut Healthcare System; clinical instructor, Yale School of Medicine, New Haven, CT.

Dr. Abelleira has no financial relationships with companies related to this material.

Benzodiazepines are highly beneficial for managing anxiety and agitation in psychiatric inpatient settings, but we must be cautious about prescribing them to patients with substance use disorders (SUDs). Here we review strategies to reduce the risk of benzodiazepine misuse and discuss alternative medication options, including second-generation antipsychotics, antidepressants, gabapentin, and pregabalin.

An Off-Label Guide to Gabapentin

January 31, 2022

Rajesh R. Tampi, MD, MS, DFAPA. and Chris Aiken, MD.

Rajesh R. Tampi, MD, MS, DFAPA. Professor of Medicine, Case Western Reserve University. Chairman, Department of Psychiatry & Behavioral Sciences, Cleveland Clinic Akron General, and Chief of Geriatric Psychiatry, Cleveland Clinic. Chris Aiken, MD. Editor-in-Chief of TCPR. Practicing psychiatrist, Winston-Salem, NC. The authors have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Off-label gabapentin (Neurontin) got a bad rep when it missed the mark in bipolar disorder, but there may be something worth salvaging in this drug. Here, we weigh its pros and cons for anxiety, substance use disorders, sleep, pain, and hot flashes, and compare it to its underutilized cousin, pregabalin (Lyrica).

Pharmacology for GAD: Complex Choices

November 15, 2019

Randall Moore, MD.

Randall Moore, MD. Dr. Moore has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

A meta-analysis of 25 medications in over 25,000 patients with generalized anxiety disorder. The usual FDA-approved options are there, along with some surprises. Not all are equal, but the most effective of the bunch carries so many side effects that we can only recommend it as a last resort.