Question:
Are benzodiazepines still the medication of choice for patients with panic
disorder with or without agoraphobia?
Answer:
OBJECTIVE: Recently, pharmacological treatment guidelines for panic disorder
have changed as newer treatment options have become available. The authors
examined how the use of psychotropic drugs has shifted over the course of 10
years to determine if prescribing patterns have changed to reflect these
revised treatment guidelines.
METHOD: A total of 443 patients with panic disorder were enrolled in the
Harvard/Brown Anxiety Research Project, a prospective longitudinal study of
anxiety disorders. These patients were interviewed over the course of 10
years to examine their use of psychotropic medications.
RESULTS: **Despite efforts aimed at increasing the use of selective
serotonin reuptake inhibitors (SSRIs) in patients with panic disorder (e.g.,
APA's practice guideline for panic disorder, Food and Drug Administration
approval of particular SSRIs for the treatment of panic disorder), only a
modest increase in their use was found**.
Treatment patterns for psychotropic drugs appear to have remained stable
over the past decade, with **benzodiazepines being the most commonly used
medication for panic disorder**.
In comparison, **SSRI use throughout the follow-up period has remained
low**. Patients using an SSRI did not have a more favorable clinical course
than those using a benzodiazepine, nor were there significantly better rates
of remission in patients using SSRIs and benzodiazepines concomitantly.
CONCLUSIONS: **These results highlight a gap between pharmacological
treatment guidelines and actual delivery of care in that recommendations to
use SSRIs to treat panic disorder are not being followed**.
Factors potentially associated with promoting and ignoring treatment
recommendations are discussed.
Count me out! I've *gotten* panic attacks from benzos! YMMV. Mine
sure did.
