Benzodiazepines, Prescribing and De-Prescribing: A Panel Discussion-View Presentation

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Video Summary

The video presents a detailed discussion on the use of benzodiazepines in clinical practice, moderated by Dr. Ron Winchell and Dr. Kathy Crone. The speakers, including Dr. Ilse Wieckers and Dr. Ed Silberman, revisit the controversial topic of benzodiazepine use, emphasizing both the risks and benefits associated with these drugs. The risks highlighted include cognitive impairment, dependency, and dangers for the elderly or those with substance abuse issues. Despite these risks, the therapeutic potential of benzodiazepines in treating conditions like panic disorder and catatonia is acknowledged.<br /><br />The panel also addresses the psychological aspect of benzodiazepine withdrawal, suggesting that anxiety about stopping the medication might complicate the process. The discussion extends to long-term benzodiazepine use, where the panel emphasizes the importance of safe tapering and harm reduction, underscoring the need for individualized treatment plans.<br /><br />A recurring theme is the distinction between different groups of benzodiazepine users, specifically those with well-diagnosed anxiety disorders treated by psychiatrists, those with polysubstance use issues, and a larger, less-studied group prescribed by primary care physicians for varied reasons.<br /><br />Questions from the audience touch on various concerns such as prescribing practices, the comparative use of alternative medications like gabapentin, and the impact of benzodiazepines on special populations, including those with PTSD. Throughout, the panel agrees on the necessity of psychiatrists leading the discussion on safe benzodiazepine use and deprescribing, while being aware of their own biases and anxieties associated with these medications. They also stress the importance of addressing disparities in prescribing patterns and considering the broader social and historical context of drug use.

Keywords

benzodiazepines

clinical practice

Dr. Ron Winchell

Dr. Kathy Crone

cognitive impairment

dependency

panic disorder

catatonia

withdrawal

tapering

anxiety disorders

polysubstance use

prescribing practices