Last month, I met with my doctoral project committee chairman to discuss my progress thus far (or lack thereof). We discussed my topic area, which I’ll describe in a bit, and he gave me some valuable tips for finding relevant information in the clinical literature. Before leaving, I agreed to complete an annotated outline of my literature review by Presidents’ Day. I’ve procrastinated pretty badly so far, and now I really need to get to work.
The literature review is often described as the most difficult component of the doc project. The lit review is important; it summarizes the current state of research and clinical knowledge about one’s topic, and it helps to justify the need for further research. Essentially, with one’s lit review, he/she hopes to say to the reader: “Here’s what we know about this topic so far, and here’s a gap in that knowledge. My research is important because it will fill that gap.” The length of each literature review is different, but in general, they are about 40-60 pages, and they tend to involve at least 60 citations. Yuck.
My doc project will be a survey of patients who take a class of medications called benzodiazepines. Commonly used benzodiazepines include Xanax, Klonopin, Valium, and Ativan. They have a calming, sedative effect, and are often prescribed to treat various anxiety disorders. In the short-term, these drugs reduce anxiety very effectively, however there are some concerns about their long-term use. As is the case with most (if not all) drugs, users quickly develop a tolerance to benzos, and find that they need to take higher and higher dosages to achieve the desired effects. If benzos are used on a long term-basis, patients risk cognitive and intellectual impairments. Furthermore, discontinuing such medications is often a slow, difficult process, and if tapering is not handled properly, withdrawal symptoms can include severe “rebound anxiety,” insomnia, and in some rare cases, seizures. Finally, some research suggests that patients who take benzodiazepines are less likely to learn other coping methods in therapy.
In any case, for my lit review, I need to find as much research as I can about ideal medical standards for benzodiazepine prescriptions, statistics on actual benzo prescriptions (who prescribes what to who for how long), doctors’ attitudes about benzos, and finally, doctor-patient communication. So far, I have four articles on medical standards and a book on discontinuing anxiety medications. It’s barely a start, and there’s still quite a bit of work to be done. Time to get to it.