The Board also alleges that Dr. Shafa provided substandard care in prescribing benzodiazepines to Patient D, who had a history of alcohol abuse. However, the Board’s expert testified that it was not an unreasonable risk to take by prescribing a low dosage of Klonopin to Patient D. (Clark III: 359-40.) Dr. Salzman explained that it is controversial to prescribe benzodiazepines to such a patient, but it would be reasonable to prescribe them if the patient needed them and the patient had a support system, as Patient D did. (Salzman VIII: 1265.) Additionally, Dr. Shafa noted that he discussed the use of alcohol with benzodiazepines, and Patient D did not abuse alcohol while being treated by Dr. Shafa. In both instances when Patient D admitted to abusing Klonopin, Dr. Shafa stopped prescribing it. Dr. Shafa prescribed Klonopin the second time because Patient D expressed increased anxiety before a trip and his wife agreed to distribute the pills to him. The Board did not provide sufficient evidence that Dr. Shafa failed to address or consider Patient D’s substance abuse history, nor did it provide sufficient evidence that Dr. Shafa failed to monitor Patient D’s usage of benzodiazepines. Treatment with Multiple Medications The alleges that Dr. Shafa’s prescribing multiple atypical anti-psychotics at high doses is contrary to accepted medical practice. Specifically, the Board argues that the prescription of Abilify, Zyprexa, Risperdal, and Seroquel in early 2006 was inappropriate. However, Dr. Salzman testified that it was appropriate in Patient D’s circumstances to prescribe four anti-psychotic medications because Dr. Shafa was decreasing Patient D’s dosage of Zyprexa and discontinuing Risperdal to address Patient D’s reported loss of libido. Dr. Clark also testified that the use of three anti-psychotics was controversial but does occur, that Dr. Shafa was in the process of adjusting Patient
The Board also alleges that Dr. Shafa provided substandard care in prescribing benzodiazepines to Patient D, who had a history of alcohol abuse. However, the Board’s expert testified that it was not an unreasonable risk to take by prescribing a low dosage of Klonopin to Patient D. (Clark III: 359-40.) Dr. Salzman explained that it is controversial to prescribe benzodiazepines to such a patient, but it would be reasonable to prescribe them if the patient needed them and the patient had a support system, as Patient D did. (Salzman VIII: 1265.) Additionally, Dr. Shafa noted that he discussed the use of alcohol with benzodiazepines, and Patient D did not abuse alcohol while being treated by Dr. Shafa. In both instances when Patient D admitted to abusing Klonopin, Dr. Shafa stopped prescribing it. Dr. Shafa prescribed Klonopin the second time because Patient D expressed increased anxiety before a trip and his wife agreed to distribute the pills to him. The Board did not provide sufficient evidence that Dr. Shafa failed to address or consider Patient D’s substance abuse history, nor did it provide sufficient evidence that Dr. Shafa failed to monitor Patient D’s usage of benzodiazepines. Treatment with Multiple Medications The alleges that Dr. Shafa’s prescribing multiple atypical anti-psychotics at high doses is contrary to accepted medical practice. Specifically, the Board argues that the prescription of Abilify, Zyprexa, Risperdal, and Seroquel in early 2006 was inappropriate. However, Dr. Salzman testified that it was appropriate in Patient D’s circumstances to prescribe four anti-psychotic medications because Dr. Shafa was decreasing Patient D’s dosage of Zyprexa and discontinuing Risperdal to address Patient D’s reported loss of libido. Dr. Clark also testified that the use of three anti-psychotics was controversial but does occur, that Dr. Shafa was in the process of adjusting Patient
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