Current use of benzodiazepines in anxiety disorders

Abstract

Despite current guidelines, benzodiazepines are still considered by many clinicians to remain good treatment options, in both the acute and the chronic phase of the treatment of anxiety disorders, partially because of their rapid onset of action and their efficacy with a favourable side effect profile, and also because of the sometimes only incomplete therapeutic response and the emergence of side effects of alternative medications. Having experienced good initial symptom relief with benzodiazepine treatment, patients may also be reluctant to taper it down. Clinicians should, however, bear in mind the frequent physiological dependence associated with these substances, and suggest both pharmacological and psychological treatment alternatives before opting for a long-term benzodiazepine treatment, which may remain necessary in certain clinical conditions.

Intranasally Administered Neuropeptide S (NPS) Exerts Anxiolytic Effects Following Internalization Into NPS Receptor-Expressing Neurons

“…By contrast, benzodiazepines act very fast, but are nevertheless improper as long-term anti-anxiety medications owing to their high abuse potential (Ravindran and Stein, 2009;Tan et al, 2010;Cloos and Ferreira, 2009). Hence, there is need for developing effective anxiolytics with a rapid onset of action and lacking benzodiazepine-like side effects.…”

Benzodiazepine use in Belgian nursing homes: a closer look into indications and dosages

“…At the onset of treatment of depression, a benzodiazepine could be used as an adjuvant, as the anti-anxiety effect of some antidepressants can take 2 to 4 weeks [42]. However, to avoid chronic use, this dual therapy should be tapered in time [43].…”

The Role of the Amygdala in Anxiety Disorders

“…Selective Serotonin Re-uptake Inhibitors: Antidepressant drugs, and selective serotonin reuptake inhibitors (SSRIs) in particular, have become first line drugs for many of the anxiety disorders [182,203]. As such, there has been comparatively more work investigating these drugs in humans using advanced imaging techniques.…”

“…Despite the long history and current prevalence of benzodiazepine use for anxiety disorders [182,183], there is a paucity of human neuroimaging studies utilizing this class of drug, especially compared to those using antidepressants. This may have to do with eclipse of benzodiazepines by antidepressants as first line agents for many anxiety disorders [182].…”