Academic Psychiatry

, Volume 42, Issue 2, pp 297–303 | Cite as

Opinions Regarding Benzodiazepine Teaching and Prescribing Among Trainees in Psychiatry

  • Amir Garakani
  • Hussain M. Abdullah
  • Christine M. Chang
  • Nathaniel Mendelsohn
  • Kyle A.B. Lapidus
Empirical Report

Abstract

Objectives

Benzodiazepines are widely prescribed for a variety of symptoms and illnesses. There has been limited investigation on the training psychiatry residents receive regarding benzodiazepine prescribing. This study surveyed US psychiatric trainees about their didactic and clinical experience with benzodiazepines, investigating how experience with benzodiazepines may shape trainees’ opinions and likelihood to prescribe.

Methods

The 14-question online survey was distributed to residents and fellows at US training programs through an invitation from their training directors.

Results

Of 466 programs contacted, with an estimated 1345 trainees, a total of 97 programs (20.8%) and 424 trainees (31.5%) responded. The analyses focused only on the 342 general psychiatry trainees who responded. Most trainees reported having formal didactics on benzodiazepines, and earlier training was correlated with higher trainee quality of instruction assessments (p < 0.01). Most trainees rated their instructors as Above or Well Above Average. Trainees cited the observation and opinion of supervisors as the two most important factors affecting likelihood of future benzodiazepine prescribing. Trainees commonly reported pressure from patients to prescribe benzodiazepines but were split on perceived pressure from supervisors about prescribing and whether a bias exists against prescribing at their program or in general.

Conclusion

The survey indicated that psychiatry trainees generally feel adequately trained through didactic and clinical experience with benzodiazepines. Trainees perceived pressure by patients to prescribe benzodiazepines, but generally felt comfortable in managing benzodiazepine usage. Psychiatry attendings’ opinions on benzodiazepines most impacted trainees. Influences on trainees’ prescribing patterns are important variables that can impact future benzodiazepine prescribing.

Keywords

Benzodiazepines Psychopharmacology Teaching Sedative-hypnotic-anxiolytic 

Notes

Acknowledgments

We would like to acknowledge and thank Nancy Delanoche from the American Psychiatric Association for her help with distribution of the survey. We would also like to thank Lucy Swank for her editorial assistance. And, we would also like to thank all the training directors and trainees for their participation in our survey.

Compliance with Ethical Standards

The study was reviewed by the Mount Sinai School of Medicine Institutional Review Board and qualified for exemption under 45 CFR 46.101(b)(2) part 46 requirements (US Department of Health and Human Services Policy for Protection of Human Research Subjects).

Disclosure

Dr. Lapidus reports non-financial support and other from Halo Neuroscience, non-financial support from Medtronic, non-financial support from Neuronetics, non-financial support and other from Brainsway, non-financial support from Roche, personal fees from FCB Health, personal fees and non-financial support from SmartAnalyst, personal fees and non-financial support from Cipla, personal fees from LCN Consulting, other from New York Neuromodulation, outside the submitted work. In addition, Dr. Lapidus has a patent System and Method for Controlled Medical Therapy pending. Dr. Garakani, Dr. Abdullah, Dr. Chang, and Dr. Mendelsohn all have nothing to disclose.

Funding Sources

None.

References

  1. 1.
    Hohmann AA, Larson DB, Thompson JW, Beardsley RS. Psychotropic medication prescription in U.S. ambulatory medical care. DICP. 1991;25:85–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Ladewig D. Abuse of benzodiazepine tranquilizers. Results of a Switzerland survey of practicing physicians. Med Welt. 1982;33:1306–9.PubMedGoogle Scholar
  3. 3.
    Stahl SM. Don’t ask, don’t tell, but benzodiazepines are still the leading treatments for anxiety disorder. J Clin Psychiatry. 2002;63:756–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Roy-Byrne PP. The GABA-benzodiazepine receptor complex: structure, function, and role in anxiety. J Clin Psychiatry. 2005;66(Suppl 2):14–20.PubMedGoogle Scholar
  5. 5.
    Barbone F, McMahon AD, Davey PG, Morris AD, Reid IC, McDevitt DG, et al. Association of road-traffic accidents with benzodiazepine use. Lancet. 1998;352:1331–6.CrossRefPubMedGoogle Scholar
  6. 6.
    Rummans TA, Davis LJ Jr, Morse RM, Ivnik RJ. Learning and memory impairment in older, detoxified, benzodiazepine-dependent patients. Mayo Clin Proc. 1993;68:731–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Benzodiazepine dependence, toxicity, and abuse: a task force report of the American Psychiatric Association. Washington, DC: American Psychiatric Association; 1990.Google Scholar
  8. 8.
    Salzman C. The APA Task Force report on benzodiazepine dependence, toxicity, and abuse. Am J Psychiatry. 1991;148:151–2.CrossRefPubMedGoogle Scholar
  9. 9.
    Kaufmann CN, Spira AP, Alexander GC, Rutkow L, Mojtabai R. Trends in prescribing of sedative-hypnotic medications in the USA: 1993-2010. Pharmacoepidemiol Drug Saf. 2016;25:637–45.CrossRefPubMedGoogle Scholar
  10. 10.
    Cook JM, Marshall R, Masci C, Coyne JC. Physicians’ perspectives on prescribing benzodiazepines for older adults: a qualitative study. J Gen Intern Med. 2007;22:303–7.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Tinsley JA, Shadid GE, Li H, Offord KP, Agerter DC. A survey of family physicians and psychiatrists. Psychotropic prescribing practices and educational needs. Gen Hosp Psychiatry. 1998;20:360–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Rakofsky JJ, Garlow SJ, Haroon E, Hermida AP, Young JQ, Dunlop BW. Assessing residents’ confidence in the context of pharmacotherapy competence. Acad Psychiatry. 2017;41:391–5.CrossRefPubMedGoogle Scholar

Copyright information

© Academic Psychiatry 2017

Authors and Affiliations

  • Amir Garakani
    • 1
  • Hussain M. Abdullah
    • 2
  • Christine M. Chang
    • 3
  • Nathaniel Mendelsohn
    • 4
  • Kyle A.B. Lapidus
    • 5
  1. 1.Icahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.Westchester Medical CenterValhallaUSA
  3. 3.City of HopeDuarteUSA
  4. 4.New York University School of MedicineNew YorkUSA
  5. 5.Northwell Health, Lenox Hill HospitalNew YorkUSA

Personalised recommendations