For a patient who has successfully abstained from alcohol but continues to experience insomnia and anxiety, which treatment would be least appropriate?

The choice of treatment for a patient who has successfully abstained from alcohol and is experiencing insomnia and anxiety needs to be carefully considered, especially because certain medications may pose a higher risk of relapse or be less appropriate in such contexts.

In this case, diazepam is a benzodiazepine, which can lead to sedation and dependence, particularly in individuals with a history of substance use disorders, including alcohol. Even though benzodiazepines can be effective for anxiety and insomnia, they carry the risk of potential misuse and relapse. This is particularly concerning for individuals in recovery from alcohol use disorder, as they may be more vulnerable to the addictive properties of this class of medication.

On the other hand, sertraline, pregabalin, and buspirone are considered safer alternatives for managing anxiety and insomnia in patients with a history of substance use disorder. Sertraline, an SSRI, not only helps alleviate anxiety symptoms but may also aid in managing any underlying depressive symptoms. Pregabalin, an anticonvulsant that also acts as an anxiolytic, has a lower potential for abuse and is often used in such cases. Buspirone, which is specifically indicated for anxiety, does not have the same dependence issues as benzodiazep