A 62-year-old female presents at the practice requesting for a prescription for diazepam. She is currently on diazepam 15 mg nocte to help her sleep and allay anxiety. A doctor she consulted after the death of her husband 5 years ago had started her on diazepam 5 mg nocte but with time, she required increasing doses of the hypnotic. Her previous attempts to discontinue her medication had failed as it resulted in insomnia, anxiety, tremor, irritability, nightmares, and hyperacusis (unpleasant loud distortion of noise) and tinnitus. Physical Exam- Normal Gait and mobility- unimpaired BP- 130/85 mmHg.
Mini-Mental Status Exam- Normal Source: Ariff KM, Hassan ZA. Insomnia: Case Studies In Family Practice. Malaysian Family Physician: the Official Journal of the Academy of Family Physicians of Malaysia. 2006;1(1):11-14.
