Navigating the evolving landscape in the prescribing of medications for insomnia in Singapore: Principles and considerations from a psychiatrist’s perspective

There are significant challenges for medical practitioners who have to navigate complex clinical, legal, ethical and administrative considerations in the prescription of controlled medications in the treatment of insomnia. This commentary examines the changing landscape and reframing of risks assoc...

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Main Authors: Ho Teck Tan, Chao Tian Tang, Shian Ming Tan
Format: Article
Language:English
Published: Academy of Medicine Singapore 2025-01-01
Series:Annals, Academy of Medicine, Singapore
Online Access:https://annals.edu.sg/navigating-the-evolving-landscape-in-the-prescribing-of-medications-for-insomnia-in-singapore-principles-and-considerations-from-a-psychiatrists-perspective/
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author Ho Teck Tan
Chao Tian Tang
Shian Ming Tan
author_facet Ho Teck Tan
Chao Tian Tang
Shian Ming Tan
author_sort Ho Teck Tan
collection DOAJ
description There are significant challenges for medical practitioners who have to navigate complex clinical, legal, ethical and administrative considerations in the prescription of controlled medications in the treatment of insomnia. This commentary examines the changing landscape and reframing of risks associated with the use of benzodiazepines and Z-drugs in light of recent legal precedents based on the frameworks of the Ethical Code and Ethical Guidelines, and the Prescribing of Benzodiazepines Guidelines (MOH Clinical Practice Guidelines 2/2008). The recent ruling from the Court of Three Judges has shone a spotlight on rigorous justification in instances where there is deviation from established treatment guidelines and thorough risk-benefit analysis, particularly when considering off-label use of medications, which is not uncommon in the clinical setting. While the risks of long-term prescription of benzodiazepines should never be discounted, preservation of a patient’s functioning and current quality of life should also be taken into consideration in the risk-benefit analysis. The complexities of transitioning patients from sedative hypnotics to alternative medications are also addressed, with an advocation for licensed medications with established safety profiles.
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series Annals, Academy of Medicine, Singapore
spelling doaj-art-42f890a41c724a03b490d5288c029e222025-02-03T10:36:01ZengAcademy of Medicine SingaporeAnnals, Academy of Medicine, Singapore2972-40662025-01-01541535610.47102/annals-acadmedsg.2024264Navigating the evolving landscape in the prescribing of medications for insomnia in Singapore: Principles and considerations from a psychiatrist’s perspectiveHo Teck TanChao Tian TangShian Ming Tan There are significant challenges for medical practitioners who have to navigate complex clinical, legal, ethical and administrative considerations in the prescription of controlled medications in the treatment of insomnia. This commentary examines the changing landscape and reframing of risks associated with the use of benzodiazepines and Z-drugs in light of recent legal precedents based on the frameworks of the Ethical Code and Ethical Guidelines, and the Prescribing of Benzodiazepines Guidelines (MOH Clinical Practice Guidelines 2/2008). The recent ruling from the Court of Three Judges has shone a spotlight on rigorous justification in instances where there is deviation from established treatment guidelines and thorough risk-benefit analysis, particularly when considering off-label use of medications, which is not uncommon in the clinical setting. While the risks of long-term prescription of benzodiazepines should never be discounted, preservation of a patient’s functioning and current quality of life should also be taken into consideration in the risk-benefit analysis. The complexities of transitioning patients from sedative hypnotics to alternative medications are also addressed, with an advocation for licensed medications with established safety profiles.https://annals.edu.sg/navigating-the-evolving-landscape-in-the-prescribing-of-medications-for-insomnia-in-singapore-principles-and-considerations-from-a-psychiatrists-perspective/
spellingShingle Ho Teck Tan
Chao Tian Tang
Shian Ming Tan
Navigating the evolving landscape in the prescribing of medications for insomnia in Singapore: Principles and considerations from a psychiatrist’s perspective
Annals, Academy of Medicine, Singapore
title Navigating the evolving landscape in the prescribing of medications for insomnia in Singapore: Principles and considerations from a psychiatrist’s perspective
title_full Navigating the evolving landscape in the prescribing of medications for insomnia in Singapore: Principles and considerations from a psychiatrist’s perspective
title_fullStr Navigating the evolving landscape in the prescribing of medications for insomnia in Singapore: Principles and considerations from a psychiatrist’s perspective
title_full_unstemmed Navigating the evolving landscape in the prescribing of medications for insomnia in Singapore: Principles and considerations from a psychiatrist’s perspective
title_short Navigating the evolving landscape in the prescribing of medications for insomnia in Singapore: Principles and considerations from a psychiatrist’s perspective
title_sort navigating the evolving landscape in the prescribing of medications for insomnia in singapore principles and considerations from a psychiatrist s perspective
url https://annals.edu.sg/navigating-the-evolving-landscape-in-the-prescribing-of-medications-for-insomnia-in-singapore-principles-and-considerations-from-a-psychiatrists-perspective/
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