Short- and Long-Term Use of Benzodiazepines in Patients with Generalized Anxiety Disorder: A Review of Guidelines [Internet]

Excerpt

The mainstay of generalized anxiety disorder (GAD) treatment involves pharmacologic treatment but can also consist of psychological treatment (i.e. cognitive behavioural therapy). First-line pharmacological treatment involves either the selective serotonin reuptake inhibitors (SSRIs) or the selective norepinephrine/noradrenaline reuptake inhibitors (SNRIs). While these are the most effective treatments, they can produce adverse events and they also have a slower onset of action, during which there may be an increase in anxiety. Benzodiazepines (BZDs) are a class of drug that is presumed to indirectly promote gamma-amino butyric acid (GABA) activity and rapidly control the core symptoms associated with GAD. They have been historically effective when used in the short-term treatment of GAD but have to be used with caution due to their adverse effect profile such as drowsiness, falls, confusion, impairment of memory, and incoordination (which can be particularly problematic in the elderly), their tendency for dependence, and potential for substance abuse. For these reasons and to determine their appropriate use, this report will review the evidence for the short- and long-term use of BZDs for the treatment of GAD.