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Shafiq N, Arshad U, Zarren G, Parveen S, Javed I, Ashraf A. A Comprehensive Review: Bio-Potential of Barbituric Acid and its Analogues. CURR ORG CHEM 2020. [DOI: 10.2174/1385272824666200110094457] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In our present work, we emphasized on the potential of barbituric acid (1) derivatives
as drugs like anti-bacterial, hypnotic, sedative, anti-microbial and antifungal
agents. As naturally occurring, barbituric acid (1) is inactive but in the derivative form, it
has a large number of medicinal uses and nowadays, it has a great demand in the pharmaceutical
industry. Barbituric acid has a wide range of applications in the synthesis of a diverse
class of compounds like heterocyclic, carbocyclic, synthetic alkaloids, and due to its
broad-spectrum applications, barbituric acid acquired the position of building blocks in
synthetic chemistry. Through the history of humanity, a number of bioactive agents have
been applied to cure the disease related to hypnotics and sedatives, while the exact efficacy
of these agents was found to be limited. Till now, review articles on barbituric acid
only express their specific aspect but in present review article, all aspects are discussed in detail to provide a
platform to readers and researchers so that they could obtain all information and background knowledge from a
single point.
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Affiliation(s)
- Nusrat Shafiq
- Department of Chemistry, Government College Women University, Faisalabad-38000, Pakistan
| | - Uzma Arshad
- Department of Chemistry, Government College Women University, Faisalabad-38000, Pakistan
| | - Gul Zarren
- Department of Chemistry, Government College Women University, Faisalabad-38000, Pakistan
| | - Shagufta Parveen
- Department of Chemistry, Government College Women University, Faisalabad-38000, Pakistan
| | - Irum Javed
- Department of Biochemistry, Sardar Bahadur Khan Women’s University, Quetta, Pakistan
| | - Aisha Ashraf
- Department of Chemistry, Government College Women University, Faisalabad-38000, Pakistan
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Dixon LJ, Lee AA, Gratz KL, Tull MT. Anxiety sensitivity and sleep disturbance: Investigating associations among patients with co-occurring anxiety and substance use disorders. J Anxiety Disord 2018; 53:9-15. [PMID: 29127882 DOI: 10.1016/j.janxdis.2017.10.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/26/2017] [Accepted: 10/31/2017] [Indexed: 01/04/2023]
Abstract
Sleep disturbance is a common problem among individuals with anxiety and substance use disorders (SUD). Anxiety sensitivity (AS) is elevated in patients with anxiety disorders and SUD and has been linked to sleep-related problems, including insomnia and somnolence (i.e., daytime sleepiness). We examined the unique roles of AS cognitive, physical, and social concerns in sleep disturbance among a sample of 99 residential SUD patients with anxiety disorders. Clinical levels of insomnia or somnolence were evidenced by 53.5% of the sample. Consistent with predictions, AS physical concerns was significantly associated with insomnia, and AS cognitive concerns was significantly related to insomnia and somnolence. Hierarchical linear regression models were conducted to test the association of AS cognitive and physical concerns with insomnia and somnolence symptoms while controlling for relevant factors. AS cognitive concerns accounted for unique variance, above and beyond withdrawal symptoms, anxiety, and depressive symptoms, in the model examining insomnia symptoms (B=0.30, SE=0.13, p=0.023). Results suggest that AS cognitive concerns may represent an important transdiagnostic mechanism underlying sleep disturbance among individuals with dual diagnosis.
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Affiliation(s)
- Laura J Dixon
- Department of Psychology, University of Mississippi, P.O. Box 1848, University, MS 38677, United States.
| | - Aaron A Lee
- VA Center for Clinical Management Research, Ann Arbor, MI, United States
| | - Kim L Gratz
- Department of Psychology, University of Toledo, 2801 W. Bancroft, Toledo, OH 43606, United States
| | - Matthew T Tull
- Department of Psychology, University of Toledo, 2801 W. Bancroft, Toledo, OH 43606, United States
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Brower KJ, Krentzman A, Robinson EAR. Persistent insomnia, abstinence, and moderate drinking in alcohol-dependent individuals. Am J Addict 2011; 20:435-40. [PMID: 21838842 DOI: 10.1111/j.1521-0391.2011.00152.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Insomnia is common, persistent, and increases the risk for relapse in alcohol-dependent (AD) patients. Abstinence has long been considered the best strategy for allowing sleep to normalize, although how many and which patients respond to abstinence is unknown. The aims of this study were to investigate the prevalence and correlates of both baseline and persistent insomnia in AD patients. The course of sleep problems in response to abstinence, moderate drinking, or relapse following treatment was also examined. A naturalistic longitudinal outcomes study interviewed 267 patients (69% male; mean age of 44 years) with DSM-IV alcohol dependence at baseline and 6 months later (84% follow-up rate) . The Sleep Problems Questionnaire, Time-Line Follow-Back Interview, and Brief Symptom Inventory measured insomnia, drinking, and psychiatric symptoms, respectively. Simple correlations, logistic regression, and repeated measures analysis of variance were used to analyze the data. At baseline, 47% of patients were classified with insomnia, which was independently predicted by female gender and psychiatric severity. Both abstinence and moderate drinking outcomes significantly predicted a reduction of insomnia symptoms after controlling for gender and psychiatric severity. Among patients with baseline insomnia, however, insomnia persisted in over 60% of cases, which was predicted by baseline insomnia severity. Moreover, insomnia persisted in one-quarter of patients despite abstinence. Treatment aimed at preventing relapse to heavy drinking provides good first-line therapy for insomnia in AD patients, but some may require insomnia-specific evaluation and treatment in addition to substance-focused treatment and psychiatric care.
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Affiliation(s)
- Kirk J Brower
- Department of Psychiatry and Addiction Research Center, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109–2700, USA.
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Puhl MD, Fang J, Grigson PS. Acute sleep deprivation increases the rate and efficiency of cocaine self-administration, but not the perceived value of cocaine reward in rats. Pharmacol Biochem Behav 2009; 94:262-70. [PMID: 19751755 PMCID: PMC2778345 DOI: 10.1016/j.pbb.2009.09.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Revised: 08/25/2009] [Accepted: 09/01/2009] [Indexed: 11/22/2022]
Abstract
Relapse to drug seeking and drug taking is elicited by exposure to stress, drug-associated cues, or drugs of abuse themselves. According to the clinical literature, relapse also can be elicited in humans by sleep deprivation. Even so, the effect of sleep deprivation on drug-seeking and drug-taking behaviors has received relatively little attention in the laboratory (i.e., currently, no animal model exists) and the underlying circuitry remains unexplored. In the present study, 42 naïve male Sprague-Dawley rats were trained to self-administer cocaine and were then divided, on the basis of their behavior, into low (n=20) and high (n=22) drug-taking groups. Self-administration behavior was extinguished, and the effect of acute sleep deprivation (0, 4, or 8h) on drug-induced reinstatement and on progressive ratio responding (i.e., on the motivation to work for drug) was investigated. The results showed that, relative to low drug-takers, high drug-takers took more drug in acquisition, made more infusion attempts during drug-induced reinstatement, worked harder for drug, and exhibited greater goal-directed behavior. Acute sleep deprivation had little impact on high drug-takers beyond increasing the rate of infusions self-administered during progressive ratio (PR) testing. Conversely, in low drug-takers, acute sleep deprivation completely abolished cocaine-induced reinstatement during extinction testing. During PR testing, however, sleep deprivation increased the speed with which low drug-taking rats initiated responding for drug, increased the rate of infusions, and increased goal-directed behavior. It did not, however, increase the perceived value of the cocaine reward (i.e., neither sleep-deprived low drug-takers nor high drug-takers exhibited a higher break point for cocaine than their non-deprived counterparts). These data are the first to demonstrate a direct link between sleep deprivation and responding for cocaine, particularly in subjects that would otherwise respond little for drug.
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Affiliation(s)
- Matthew D Puhl
- Department of Neural and Behavioral Sciences, Pennsylvania State University College of Medicine, USA.
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Friedmann PD, Rose JS, Swift R, Stout RL, Millman RP, Stein MD. Trazodone for sleep disturbance after alcohol detoxification: a double-blind, placebo-controlled trial. Alcohol Clin Exp Res 2008; 32:1652-60. [PMID: 18616688 DOI: 10.1111/j.1530-0277.2008.00742.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Trazodone is a commonly prescribed off-label for sleep disturbance in alcohol-dependent patients, but its safety and efficacy for this indication is unknown. METHODS We conducted a randomized, double-blind, placebo-control trial of low-dose trazodone (50 to 150 mg at bedtime) for 12 weeks among 173 alcohol detoxification patients who reported current sleep disturbance on a validated measure of sleep quality or during prior periods of abstinence. Primary outcomes were the proportion of days abstinent and drinks per drinking day over 6-months; sleep quality was also assessed. RESULTS Urn randomization balanced baseline features among the 88 subjects who received trazodone and 85 who received placebo. The trazodone group experienced less improvement in the proportion of days abstinent during administration of study medication (mean change between baseline and 3 months: -0.12; 95% CI: -0.15 to -0.09), and an increase in the number of drinks per drinking day on cessation of the study medication (mean change between baseline and 6 months, 4.6; 95% CI: 2.1 to 7.1). Trazodone was associated with improved sleep quality during its administration (mean change on the Pittsburgh Sleep Quality Index between baseline and 3 months: -3.02; 95% CI: -3.38 to -2.67), but after it was stopped sleep quality equalized with placebo. CONCLUSIONS Trazodone, despite a short-term benefit on sleep quality, might impede improvements in alcohol consumption in the postdetoxification period and lead to increased drinking when stopped. Until further studies have established benefits and safety, routine initiation of trazodone for sleep disturbance cannot be recommended with confidence during the period after detoxification from alcoholism.
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Affiliation(s)
- Peter D Friedmann
- Program to Integrate Psychosocial and Health Services, Research Service, Providence Veterans Affairs Medical Center, Providence, Rhode Island, USA.
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Abstract
Sleep disturbances are extremely common in the early stages of recovery from alcohol dependence and may persist for several months despite continued abstinence. Studies indicate that sleep disturbances independently increase the risk for relapse to alcohol, suggesting that targeting these problems during recovery may support continued abstinence. However, there is limited information in the addiction literature about available and effective treatments for sleep disturbances in recovering alcoholic patients. The primary goals of this article are to describe the phenomenology of sleep disturbances during recovery from alcohol dependence, to outline the evidence linking sleep problems with alcohol relapse, and to describe available pharmacological and nonpharmacological treatment options, including the evidence regarding their efficacy in recovering alcoholic patients. Recommendations for future research are provided along with special considerations for treating insomnia in this population, including avoiding cross-dependent sedatives, such as benzodiazepines and benzodiazepine receptor agonists (BzRAs).
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Abstract
STUDY OBJECTIVES To review evidence of an association between disturbed sleep and alcohol use. DESIGN We searched MEDLINE, PSYCHINFO, ETOH, BIBLIOSLEEP and the Rutgers Alcohol Studies databases between January 1966 and August 2002. Search terms included alcohol-related disorders or alcoholism in combination with sleep, sleep initiation and maintenance disorders, or sleep apnea syndromes. The search produced over 440 citations. We reviewed 107 relevant articles, of which 60 included quantitative measures of both alcohol use and sleep. MEASUREMENTS AND RESULTS Behavioral studies suggest that up to 2 to 3 standard drinks before bedtime initially promotes sleep, but these effects diminish in as few as 3 days of continued use. Clinical investigations support a relationship between sleep disturbance and alcohol use, but variability in the definition and measurement of these domains and a preponderance of cross-sectional studies make uncertain the strength and direction of the association. CONCLUSIONS The association of insomnia with alcohol use disorders suggests that the clinical evaluation of patients with sleep problems should include a careful assessment of alcohol use. Future studies of this relationship should employ prospective designs with standardized, validated measures of both sleep and alcohol use. Rigorous treatment studies for chronic insomnia in alcohol dependent patients are also needed.
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Affiliation(s)
- Michael D Stein
- Brown Medical School, Division of General Internal Medicine, Rhode Island Hospital, Providence, RI 02903, USA
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Abstract
Alcohol-dependent outpatients with persisting insomnia were treated with either gabapentin or trazodone. Patients were assessed at baseline and after 4-6 weeks on medication using the Sleep Problems Questionnaire (SPQ). Of 55 cases initially treated, 9% dropped out due to morning drowsiness. Of the remaining 50 cases, 34 were treated with gabapentin (mean dose +/- SD = 888 +/- 418 mg) at bedtime and 16 were treated with trazodone (105 +/- 57 mg) at bedtime. Both groups improved significantly on the SPQ but the gabapentin group improved significantly more than the trazodone group. Controlled studies are warranted to replicate these findings.
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Affiliation(s)
- Maher Karam-Hage
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI
| | - Kirk J. Brower
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI
- Corresponding author: University of Michigan Addiction Research Center, 400 E. Eisenhower Parkway, Suite 2A, Ann Arbor MI, 48108. Tel: 734-930-0201 ext. 227. Fax: 734-930-0727.
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Currie SR, Clark S, Rimac S, Malhotra S. Comprehensive assessment of insomnia in recovering alcoholics using daily sleep diaries and ambulatory monitoring. Alcohol Clin Exp Res 2003; 27:1262-9. [PMID: 12966320 DOI: 10.1097/01.alc.0000081622.03973.57] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Many alcoholics continue to experience disrupted sleep after quitting drinking. Previous studies with recovering alcoholics have relied on retrospective questionnaires and a single night of polysomnography to document sleep problems. In the present study, sleep was assessed at home over the course of a week using both subjective and objective sleep measures. METHODS A mixed gender group of alcoholics in recovery (n = 63) experiencing insomnia underwent a multimodal sleep assessment including a structured interview, daily sleep diaries, questionnaires, and ambulatory sleep monitoring. Alcoholics with short-term (<12 months) and long-term (>12 months) abstinence had their sleep monitored prospectively and were compared. RESULTS Over half of the participants reported sleep problems that predated the onset of alcohol dependence. Alcoholics with short- and long-term abstinence had similarly disturbed sleep. Overall, problems with getting to sleep were worse than sleep maintenance difficulties. Severity of insomnia was unrelated to drinking history and modestly correlated with the current level of depressive symptoms. Poor sleep hygiene was evident in the sample. CONCLUSIONS Alcoholics can experience sleep problems for many months after quitting drinking. Implications for sleep interventions with this population are discussed.
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Abstract
Insomnia and alcoholism are significantly associated in community surveys and patient samples. Insomnia occurs in 36-72% of alcoholic patients and may last for weeks to months after initiating abstinence from alcohol. Some correlates of insomnia in alcoholic patients are identical to those observed in non-alcoholic insomniacs, including anxiety and depression, tobacco smoking, and the use of alcohol to aid sleep. Other studies suggest that as the severity of alcoholism increases, so does the likelihood of insomnia in alcoholic patients. In the sleep laboratory, alcoholic patients who complain of insomnia have disrupted sleep continuity when compared to alcoholic patients without insomnia complaints. Recently sober alcoholics are also more likely than non-alcoholics to have sleep-disordered breathing and increased periodic leg movements, which might contribute to insomnia in some alcoholic patients. The co-occurrence of insomnia and alcoholism is clinically significant because alcoholism can exacerbate the adverse consequences of insomnia (e.g. mood changes and performance decrements) and because insomnia among patients entering treatment for alcoholism has been significantly associated with subsequent alcoholic relapse. Baseline polysomnographic correlates of subsequent relapse include prolonged sleep latency, decreased sleep efficiency and total sleep time, increased rapid eye movement sleep pressure, and decreased slow wave sleep. Whether treatment of insomnia in alcoholic patients reduces relapse rates is unknown, but preliminary treatment guidelines that accommodate the special characteristics of alcoholic patients are provided, with a goal to reduce daytime impairment and psychological distress.
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Affiliation(s)
- Kirk J Brower
- University of Michigan Addiction Research Center, Ann Arbor, MI 48108, USA.
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Friedmann PD, Herman DS, Freedman S, Lemon SC, Ramsey S, Stein MD. Treatment of sleep disturbance in alcohol recovery: a national survey of addiction medicine physicians. J Addict Dis 2003; 22:91-103. [PMID: 12703672 PMCID: PMC2761628 DOI: 10.1300/j069v22n02_08] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Sleep disturbance is common among patients in recovery from alcoholism and can precipitate relapse. Though sleep complaints are commonly managed with medication, little is known about their management among recovering alcoholic patients. We performed a postal survey of a self-weighted, random systematic sample of 503 members of the American Society of Addiction Medicine (ASAM) to examine addiction medicine physicians' medical management of sleep disturbance among patients in early recovery from alcoholism. After 3 mailings, 311 (62%) responded. Of responents, 64% have offered pharmacological treatment to an insomniac, alcoholic patient in the first 3 months after detoxification, but only 22% offered medication to more than half of such patients. Trazodone was the preferred therapy, chosen first by 38% of respondents, followed by other sedating antidepressants (12%), and antihistamines (12%). The mean duration of therapy for trazodone and other sedating antidepressants exceeded one month. Experts in addiction medicine appear reluctant to prescribe medication to sleep-disturbed patients in early recovery from alcoholism. When they do prescribe, trazodone, other sedating antidepressants and antihistamines are favored, despite limited evidence for or against this indication. Although the treatment of disordered sleep among alcoholic patients in early recovery may have merit to prevent relapse, controlled studies of these sleep agents are needed.
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Affiliation(s)
- Peter D Friedmann
- Division of General Internal Medicine, Department of Medicine, Brown University School of Medicine and Rhode Island Hospital, Providence, RI 02903, USA.
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Kirkwood CK. Management of insomnia. JOURNAL OF THE AMERICAN PHARMACEUTICAL ASSOCIATION (WASHINGTON, D.C. : 1996) 1999; 39:688-96; quiz 713-4. [PMID: 10533351 DOI: 10.1016/s1086-5802(15)30354-5] [Citation(s) in RCA: 170] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To review current issues in the pharmacologic and nonpharmacologic management of insomnia. DATA SOURCES Controlled trials and case studies identified via MEDLINE for 1990 through April 1999 under the search terms insomnia, hypnotics, flurazepam, quazepam, estazolam, temazepam, triazolam, zolpidem, zaleplon, L-846, CL-284,846, melatonin, and valerian. DATA SYNTHESIS Insomnia is a common, undertreated disorder. Nonpharmacologic management strategies (e.g., stimulus control, relaxation therapy, sleep hygiene) are therapeutic options that, compared with medication use, provide more sustained effects. The benzodiazepines and zolpidem are the most commonly prescribed hypnotic agents, but their use is associated with tolerance and central nervous system adverse effects. A new nonbenzodiazepine hypnotic agent, zaleplon, was very recently approved in the United States. Because of its short half-life, zaleplon will be useful in patients experiencing difficulty in falling asleep and in those who wake up at night and have trouble falling back to sleep. Antidepressants, antihistamines, and alternative medications are other treatment options. To avoid complications of therapy, hypnotic agents should be used at their lowest possible doses and for limited treatment durations. CONCLUSION Pharmacotherapy is currently the most common treatment modality for insomnia, but long-term use of hypnotic agents can become complicated by drug tolerance, dependence, or rebound insomnia. Nonpharmacologic options--including combinations of behavioral interventions, sleep-restriction therapy, and patient education--provide longer-lasting benefits.
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Affiliation(s)
- C K Kirkwood
- School of Pharmacy, Virginia Commonwealth University, Richmond 23298-0533, USA.
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Sowers W, Golden S. Psychotropic medication management in persons with co-occurring psychiatric and substance use disorders. J Psychoactive Drugs 1999; 31:59-70. [PMID: 10332640 DOI: 10.1080/02791072.1999.10471727] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Persons presenting with concurrent psychiatric and substance problems present unique challenges for diagnosis and for effective and rational treatment planning. This is especially true for psychiatrists attempting to prescribe pharmacologic interventions which will promote recovery from both disorders and improve function. In order to be effective in this endeavor it is important to have a clear understanding of the dynamics of addiction as well as the particular issues and struggles related to mental illness which will affect an individual's attitude toward and use of medication. This article discusses some of the common problems related to diagnostic decision making and initiation of medication in persons with co-occurring disorders. An algorithm for guiding these decisions is presented. Common misconceptions held by these individuals regarding medication, as distinguished from "drugs," are considered. Unique psychodynamic issues that may lead these persons to actively seek medication as a solution to their problems, or which may, conversely, lead them to an outright rejection of medication as a part of their recovery, are discussed. Countertransferential issues influencing the physician's approach to prescribing for this population are also considered. The article concludes with recommendations for pharmacologic approaches to address specific psychiatric syndromes which may present in this population.
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Affiliation(s)
- W Sowers
- Center for Addiction Services, St. Francis Medical Center, Pittsburgh, Pennsylvania 15201, USA
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