Case Discussion
Clinical teaching and practical ideas for your next study session.
After the Drowsy-Driving Near-Miss: Delayed Sleep-Wake Phase Disorder, Hypnotics, and Bipolar Safety
A patient with bipolar disorder and a delayed sleep schedule has a drowsy-driving near-miss after sedative use. Learn why stronger hypnotics do not correct the underlying timing problem, how to triage driving risk, and how to advance the clock while monitoring for mood destabilization.
Panic or Benzodiazepine Withdrawal? A Safer Triage Decision
When a patient taking alprazolam presents with terror, tachycardia, and tremor after missed doses, the key question is not whether the symptoms resemble panic. It is whether the pattern signals withdrawal requiring medical monitoring, how to distinguish physical dependence from benzodiazepine use disorder, and how to move from rescue treatment to a supervised long-term plan.
Alcohol Withdrawal Hallucinations: Hallucinosis or Delirium?
Hallucinations after alcohol cessation do not by themselves establish withdrawal delirium. This case discussion uses serial attention, awareness, arousal, and symptom fluctuation to distinguish alcohol-induced hallucinosis from delirium—and to guide monitoring, assessment tools, and safe adjunctive antipsychotic use.
When the World Feels Unreal: PTSD, Dissociation, and Fear Extinction
A trauma survivor with nightmares, cue-triggered panic, memory gaps, nightly alcohol use, and fear of an ex-partner requires more than a quick PTSD label. This case shows how to protect safety, separate overlapping diagnoses, and use fear-extinction principles in trauma-focused care without overlooking dissociation or brain injury.