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Use of hypnotics for the management of insomnia in psychiatric patients: A clinical audit and review on Z‑drugs
Ohri, Lakshmi Mahil, Jasmin Merlici, Sorina
Ohri, Lakshmi
Mahil, Jasmin
Merlici, Sorina
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2023-11-09
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Abstract
BACKGROUND: Insomnia is a common condition in patients with mental illness, for which hypnotic medications are regularly prescribed. AIM: It was intended to study the clinical practice of using hypnotic medications including Z-drugs for insomnia and compare it with treatment guidelines. METHODS: In this clinical audit, data were collected from the clinical records of patients who attended outpatient department in adult and old age psychiatric units in a mental health service. RESULTS: Out of the consecutive 203 patients screened, 50 (24.6%) were prescribed hypnotic/sedative drugs. It was observed that around half (54%) received nonpharmacological interventions for insomnia, 42% had psychoeducation, and 24% sleep hygiene. Zopiclone (56%) and promethazine (26%) were more commonly prescribed; however, lorazepam (14%) and diazepam (16%) were also used. In the majority of cases, these were prescribed on a “if required” basis. Duration of hypnotic prescription was specified in only 36%, whereas many patients continued these medications for months (26%) and years (26%). CONCLUSION: There is a scope to increase the use of nonpharmacological treatments for insomnia. Reviewing the period of use of hypnotic medications is essential as many patients continue them for longer durations than recommended. Treatment of insomnia needs focused attention in psychiatric clinics.
Citation
Kar N, Ohri LR, Mahil J, Merlici S (2023) Use of hypnotics for the management of insomnia in psychiatric patients: A clinical audit and review on Z‑drugs. Odisha Journal of Psychiatry, 19(1), pp. 8-13.
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Journal article
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en
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© 2023 Odisha Journal of Psychiatry. Published by Wolters Kluwer - Medknow. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://journals.lww.com/odjp/fulltext/2023/01000/use_of_hypnotics_for_the_management_of_insomnia_in.3.aspx
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0975-122X