Benjamin James Sadock > Quotes

“Abusive parents have inappropriate expectations of their children, with a reversal of dependence needs. Parents treat an abused child as if the child were older than the parents. A parent often turns to the child for reassurance, nurturing, comfort, and protection and expects a loving response.”
― Benjamin James Sadock

“DENIAL
Defense mechanism in which the existence of unpleasant realities is disavowed; refers to keeping out of conscious awareness any aspects of external reality that, if acknowledged, would produce anxiety.”
― Benjamin Sadock, Sadock's Comprehensive Glossary of Psychiatry and Psychology

“Psychotropic drugs have also been organized according to structure (e.g., tricyclic), mechanism (e.g., monoamine, oxidase inhibitor [MAOI]), history (first generation, traditional), uniqueness (e.g., atypical), or indication (e.g., antidepressant). A further problem is that many drugs used to treat medical and neurological conditions are routinely used to treat psychiatric disorders.”
― Benjamin J. Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“The issues of antidepressant-associated suicide has become front-page news, the result of an analysis suggesting a link between medication use and suicidal ideation among children, adolescents, a link between medication use and suicidal ideation among children, adolescents, and adults up to age 24 in short term (4 to 16 weeks), placebo-controlled trials of nine newer antidepressant drugs. The data from trials involving more than 4.4(K) patients suggested that the average risk of suicidal thinking or behavior (suicidality) during the first few months of treatment in those receiving antidepressants was 4 percent, twice the placebo risk of 2 percent. No suicides occured in these trials. The analysis also showed no increase in suicide risk among the 25 to 65 age group. Antidepressants reduced suicidality among those over age 65. Following public hearings on the subject, in October 2004, the FDA requested the addition of “black box” warnings—the most serious warning placed on the labeling of a prescription medication—to all antidepressant drugs, old and new.”
― Benjamin James Sadock, Kaplan & Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“Medications used to treat psychiatric disorders are commonly referred to as psychotropic drugs. These drugs are commonly described by their major clinical application, for example, antidepressants, antipsychotics, mood stabilizers, anxiolytics, hypnotics, cognitive enhancers, and stimulants. A problem with this approach is that these drugs have multiple indicators. For example, selective serotonin reuptake inhibitors (SSRls) are both antidepressants and anxiolytics, and the serotonin-dopamine antagonists (SDAs) are both anxiolytics and mood stabilizers.”
― Benjamin J. Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“selective serotonin reuptake inhibitor (SSRI) and serotonin–norepinephrine reuptake inhibitors (SNRIs) are now used as primary treatments, with benzodiazepines used as adjuncts. Benzodiazepine abuse is rare, usually found in patients who abuse multiple prescription and recreational drugs.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“The complex interplay of the emotions, however, is far beyond the understanding of functional neuroanatomists. Where, for example, are the representations of the id, ego, and and the superego? Through what pathway are ethical and moral judgments shepherded? What processes allow beauty to be in the eye of the beholder? These philosophical questions represent a true frontier of human discovery.”
― Benjamin Sadock, Kaplan And Sadocks Synopsis Of Psychiatry 11Ed

“dysfunction and weight gain. However, the SSRIs are still often preferred because they target common comorbid conditions, such as depression or obsessive-compulsive disorder (OCD). Benzodiazepines and SSRIs can be initiated together to treat acute panic symptoms; use of the benzodiazepine can be tapered after 3 to 4 weeks after the therapeutic benefits of the SSRI have emerged.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“The manufacturer of nefazodone recommends that the dosage of triazolam be lowered by 75 percent and the dosage of alprazolam be lowered by 50 percent when given concomitantly with nefazodone.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“The benzodiazepines (especially IM lorazepam) are used to manage substance induced and psychotic agitation in the emergency department. Benzodiazepines have been used instead of amobarbital (Amytal) for drug-assisted interviewing.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“The benzodiazepine hypnotics differ principally in their half-lives; flurazepam has the longest half-life, and triazolam has the shortest. Flurazepam may be associated with minor cognitive impairment on the day after its administration, and triazolam may be associated with mild rebound anxiety and anterograde”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“administration of medications more frequently than the elimination half-life leads to drug accumulation, medications such as diazepam and flurazepam accumulate with daily dosing, eventually resulting in increased daytime sedation.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“The fact that all benzodiazepines are lipid soluble to varying degrees means that benzodiazepines and their active metabolites bind to plasma proteins. The extent of this binding is proportional to their lipid solubility. The amount of protein binding varies from 70 to 99 percent. Distribution, onset, and termination of action after a single dose are thus largely determined by benzodiazepine lipid solubility, not elimination”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“additional flumazenil is unlikely to have an effect. Sedation can return in 1 to 3 percent of persons treated with flumazenil. It can be prevented or treated by giving repeated dosages of flumazenil at 20-minute intervals. For repeat treatment, no more than 1 mg (given as 0.5 mg a minute) should be given at any one time, and no more than 3 mg should be given in any 1 hour.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“Clonazepam has been shown to be an effective treatment for social phobia. In addition, several other benzodiazepines (e.g., diazepam) have been used as adjunctive medications for treatment of social phobia.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“Chronic catatonia does not respond as well to benzodiazepines. The definitive treatment for catatonia is electroconvulsive therapy.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“persons with a history of substance abuse, cognitive disorders, renal disease, hepatic disease, porphyria, central nervous system (CNS) depression, or myasthenia gravis.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“A small number of persons with idiopathic Parkinson’s disease respond to long-term use of zolpidem with reduced bradykinesia and rigidity. Zolpidem dosages of 10 mg four times daily may be tolerated without sedation for several years.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“frequently associated with bipolar disorder than with schizophrenia”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“may decrease the plasma concentrations of benzodiazepines, and smoking may increase the metabolism of benzodiazepines.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“The most serious adverse effects of the benzodiazepines occur when other sedative substances, such as alcohol, are taken concurrently. These combinations can result in marked drowsiness, disinhibition, or even respiratory depression. Infrequently, benzodiazepine receptor agonists cause mild cognitive deficits that may impair job performance. Persons taking benzodiazepine receptor agonists should be advised to exercise additional caution when driving or operating dangerous machinery.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“The combination of benzodiazepines and clozapine (Clozaril) has been reported to cause delirium”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“Benzodiazepine withdrawal syndrome consists of anxiety, nervousness, diaphoresis, restlessness, irritability, fatigue, lightheadedness, tremor, insomnia, and weakness (Table 29.9-2). Abrupt discontinuation of benzodiazepines, particularly those with short half-lives, is associated with severe withdrawal symptoms,”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“be tapered slowly (25 percent a week); otherwise, recurrence or rebound of symptoms is likely.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“taper alone.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“High-potency benzodiazepines, especially triazolam, can cause anterograde amnesia. A paradoxical increase in aggression has been reported in persons with preexisting brain damage.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“Triazolam has received significant attention in the media because of an alleged association with serious aggressive behavioral manifestations. Therefore, the manufacturer recommends that the drug be used for no more than 10 days for treatment of insomnia and that physicians carefully evaluate the emergence of any abnormal thinking or behavioral changes in persons treated with triazolam, giving appropriate consideration to all potential causes. Triazolam was banned in Great Britain in 1991.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“which may include depression, paranoia, delirium, and seizures.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“Alprazolam seems to be particularly associated with an immediate and severe withdrawal syndrome and should be tapered gradually.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“The plasma concentrations of triazolam and alprazolam are increased to potentially toxic concentrations by nefazodone (Serzone) and fluvoxamine (Luvox).”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry