A patient informs you that she has been taking more phenobarbital than the doctor prescribed because the amount that he prescribed was not helping her sleep.She also says that when she does not take the drug,she becomes very anxious,has tremors,and feels like she is being watched.Using your knowledge of sedative-hypnotic drugs,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