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The Carlat Psychiatry Report

Benzodiazepines and Hypnotics in Psychiatry (September) | 2005

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A Constitutional Right to Benzos?

September 1, 2005

My standard practice in treating patients with very frequent panic attacks had always been to start both a benzo and an antidepressant, with the expectation of eventually tapering the benzo. But I noticed, both with my patients and those I inherited from other psychopharmacologists, that hardly anyone ever seemed to get off benzos despite my preparing the patient for this plan. Read More

John M. Talmadge, M.D., on Using Benzodiazepines in Substance Abusers

September 1, 2005

John M. Talmadge, M.D.

Dr. Talmadge, in your practice, do you ever prescribe benzodiazepines to people with substance abuse histories? Read More

Should we Prescribe Benzos to Alcohol Abusers?

September 1, 2005

Daniel Carlat, MD

Whether one should prescribe BZs to patients with a history of alcoholism is a controversial question, and one that tends to polarize psychiatrists into the “purists” versus the “realists.” Most alcoholics take BZs at some point in the course of their disorder, sometimes illegitimately, but often as part of a bona fide treatment program. Read More

Getting Patients off Benzos: Tips from Old Masters

September 1, 2005

Daniel Carlat, MD

Tapering patients off benzos (BZs) is certainly more art than science, but TCR has unearthed a surprising number of studies that help bring more science into the process. These studies are, by modern standards, ancient, because research follows the money, and there’s no longer much money to be made in benzodiazepines. So file these studies under “oldies but goodies”! Read More

Lunesta, Rozerem, and More: Showtime for the New Hypnotics

September 1, 2005

Daniel Carlat, MD

Suddenly, putting patients to sleep is all the rage in psychiatry. Over the last year, two new hypnotics have been approved by the FDA – Lunesta (eszopiclone) in December 2004 and Rozerem (ramelteon) in July 2005. Indiplon (the generic name) is on the launching pad for approval in early 2006. Read More