A patient informs you that she has been taking more phenobarbital than the doctor prescribed because she cannot sleep with the amount he prescribed.She also states that now if she doesn't take the drug,she becomes very anxious,starts to have tremors,and begins to have unusual thoughts that she is being watched.Using your knowledge of the sedative-hypnotic drugs,how would you explain to this patient that she has developed a physical dependency on phenobarbital?

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Physical dependency usually develops when greater therapeutic dosages are taken on a regular basis for more than 1 to 2 months. Once physical dependence develops, the drug must be used continuously to avoid the onset of withdrawal symptoms. Withdrawal symptoms include anxiety, insomnia, cramping, tremors, paranoid behavior, delirium, and convulsions.

A Patient Informs You That She Has Been Taking More