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Diagnosis and Treatment |

The Clinical Choice of Sedative-Hypnotics

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Supported in part by grants FRO-5555 and MH-12279, U.S. Public Health Service, Washington, D.C., and by a grant from The Medical Foundation, Inc., Boston, Mass.

▸Requests for reprints should be addressed to Richard I. Shader, M.D., 74 Fenwood Rd., Boston, Mass. 02115.

Boston, Massachusetts

Ann Intern Med. 1972;77(1):91-100. doi:10.7326/0003-4819-77-1-91
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The clinician is faced with a bewildering array of available sedatives, hypnotics, and tranquilizers, as well as continuous pressure from patients, the popular media, and the pharmaceutical industry, encouraging and demanding the use of these drugs. Under these influences the rational use of sedatives and hypnotics is not easily achieved. Current evidence favors the benzodiazepine derivatives, although they are far from ideal. Flurazepam allows "physiologic" sleep and has a low potential for abuse. Chlordiazepoxide, diazepam, and oxazepam are effective antianxiety agents. Suicide is virtually impossible with the benzodiazepines, and these agents probably do not interact with oral anticoagulants. Obviously, sedatives and hypnotics are best reserved for situations in which the possible benefit for the patient outweighs the risk associated with the use of the drug.





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