New patient asking for a benzodiazepine prescriptionBMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a658 (Published 28 August 2008) Cite this as: BMJ 2008;337:a658
- Simon de Lusignan, head of general practice and primary care, course director biomedical informatics1,
- Nicola Buxton, general practice teaching fellow2,
- Andy Kent, MBBS course director and reader in psychiatry3
- 1Division of Community Health Sciences, St George’s, University of London, London SW17 0RE
- 2Division of Community Health Sciences, St George’s
- 3Division of Mental Health, St George’s
- Correspondence to: S de Lusignan
- Accepted 3 May 2007
Your final patient on a Friday is a 26 year old man who is new to the list. He asks you for a repeat prescription for two months of diazepam, 5 mg up to four a day. He says he has been taking these for a while for his “nerves” and he has run out. You do not hold this patient’s records.
What issues you should cover
You have to weigh up whether the risks of prescribing diazepam to this particular patient outweigh those of not prescribing. You should be as helpful as possible while checking whether he genuinely needs the prescription.
Is it appropriate to prescribe diazepam to this patient?
History—Is any information available about his previous consumption and medical history? This may be a repeat prescription slip or packaging giving details of the drug and amount prescribed. It may be possible to speak confidentially to his previous doctor or pharmacist by telephone while he waits (or early the next week). Most genuine patients can provide information about their previous general practitioner or pharmacy and are willing …