Skip to main content
SpringerLink
Log in

Role of Benzodiazepines in Anxiety Disorders

  • Chapter
  • First Online:
Anxiety Disorders

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1191))

Abstract

This chapter reviews the role of benzodiazepines (BZs) in the treatment of anxiety disorders, specifically panic disorder with or without agoraphobia, generalized anxiety disorder, and social anxiety disorder (social phobia). BZs pharmacology, classification, efficacy, adverse effects, withdrawal symptoms, possible dependence, and abuse; their positioning among pharmacological treatment; and guidance on how to use them are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bowes HA. The role of Librium in an out-patient psychiatric setting. Dis Nerv Syst. 1960;21(Suppl 3):20–2.

    PubMed  Google Scholar 

  2. Olfson M, King M, Schoenbaum M. Benzodiazepine use in the United States. JAMA Psychiat. 2015;72:136–42.

    Article  Google Scholar 

  3. Rickels K. Should benzodiazepines be replaced by antidepressants in the treatment of anxiety disorders? Facts of fiction? Psychother Psychosom. 2013;82:351–2.

    Article  PubMed  Google Scholar 

  4. Offidani E, Guidi J, Tomba E, Fava GA. Efficacy and tolerability of benzodiazepines versus antidepressants in anxiety disorders: a systematic review and meta-analysis. Psychother Psychosom. 2013;82:355–62.

    Article  PubMed  Google Scholar 

  5. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.

    Book  Google Scholar 

  6. Greenblatt DJ, Shader RI, Abernethy DR. Drug therapy: Current status of benzodiazepines (first of two parts). N Engl J Med. 1983;309:354–8.

    Article  Google Scholar 

  7. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed. Washington, D.C.: American Psychiatric Association; 1980.

    Google Scholar 

  8. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed. Revised. Washington, D.C., American Psychiatric Association, 1987.

    Google Scholar 

  9. Noyes R Jr, Anderson DJ, Clancy J, Crowe RR, Slymen DJ, Ghoneim MM, et al. Diazepam and propranolol in panic disorder and agoraphobia. Arch Gen Psychiatry. 1984;41:287–92.

    Article  PubMed  Google Scholar 

  10. Ballenger JC, Burrows GD, DuPont RL Jr, Lesser IM, Noyes R Jr, Pecknold JC, et al. Alprazolam in panic disorder and agoraphobia: results from a multicenter trial. I. Efficacy in short-term treatment. Arch Gen Psychiatry. 1988;45:413–22.

    Article  CAS  PubMed  Google Scholar 

  11. Noyes R Jr, DuPont RL Jr, Pecknold JC, Rifkin A, Rubin RT, Swinson RP, et al. Alprazolam in panic disorder and agoraphobia: results from a multicenter trial. II. Patient acceptance, side effects, and safety. Arch Gen Psychiatry. 1988;45:423–8.

    Article  PubMed  Google Scholar 

  12. Rifkin A, Pecknold JC, Swinson RP, Ballenger JC, Burrows GD, Noyes R, et al. Sequence of improvement in agoraphobia with panic attacks. J Psychiatr Res. 1990;24:1–8.

    Article  CAS  PubMed  Google Scholar 

  13. Klein DF. Anxiety reconceptualized. In: Klein DF, Raskin J, editors. Anxiety: new research and changing concepts. New York: Raven Press; 1981. p. 235–63.

    Google Scholar 

  14. Munjack DJ, Crocker B, Cabe D, Brown R, Usigli R, Zulueta A, et al. Alprazolam, propranolol, and placebo in the treatment of panic disorder and agoraphobia with panic attacks. J Clin Psychopharmacol. 1989;9:22–7.

    CAS  PubMed  Google Scholar 

  15. Schweizer E, Pohl R, Balon R, Fox I, Rickels K, Yeragani VK. Lorazepam vs. alprazolam in the treatment of panic disorder. Pharmacopsychiatry. 1990;23:90–3.

    Article  CAS  PubMed  Google Scholar 

  16. Charney DS, Woods SW. Benzodiazepine treatment of panic disorder: a comparison of alprazolam and lorazepam. J Clin Psychiatry. 1989;50:418–23.

    CAS  PubMed  Google Scholar 

  17. Tesar GE, Rosenbaum JF, Pollack MH, Otto MW, Sachs GS, Herman JB, et al. Double-blind, placebo-controlled comparison of clonazepam and alprazolam for panic disorder. J Clin Psychiatry. 1991;52:69–76.

    CAS  PubMed  Google Scholar 

  18. Drug treatment of panic disorder. Comparative efficacy of alprazolam, imipramine and placebo. Cross-National Collaborative Panic Study. Second Phase Investigators. (No authors listed) Br J Psychiatry. 1992;160:191–202.

    Article  Google Scholar 

  19. Schweizer E, Rickels K, Weiss S, Zavodnick S. Maintenance drug treatment of panic disorder. I. Results of a prospective, placebo-controlled comparison of alprazolam and imipramine. Arch Gen Psychiatry. 1993;50:51–60.

    Article  CAS  PubMed  Google Scholar 

  20. Nardi AE, Valenca AM, Freire RC, Mochcovitch MD, Amrein R, Sardinha A, et al. Psychopharmacotherapy of panic disorder: 8 week randomized trial with clonazepam and paroxetine. Braz J Med Biol Res. 2011;44:366–73.

    Article  CAS  PubMed  Google Scholar 

  21. Nardi AE, Freire RC, Mochcovitch MD, Amrein R, Levitan MN, King AL, et al. A randomized naturalistic, parallel-group study for the long-term treatment of panic disorder with clonazepam or paroxetine. J Clin Psychopharmacol. 2012;32:120–6.

    Article  CAS  PubMed  Google Scholar 

  22. Freire RC, Amrein R, Mochcovitch MD, Dias GP, Machado S, Versiani M, et al. A 6-year posttreatment follow-up of panic disorder patients: treatment with clonazepam predicts lower recurrence than treatment with paroxetine. J Clin Psychopharmacol. 2017;37:429–34.

    Article  CAS  PubMed  Google Scholar 

  23. Chouinard G, Annable L, Fontaine R, Solyom L. Alprazolam in the treatment of generalized anxiety and panic disorders: a double-blind placebo-controlled studt. Pharmacopsychiatry. 1982;77:229–33.

    Article  CAS  Google Scholar 

  24. Elie R, Lamontagne Y. Alprazolam and diazepam in the treatment of generalized anxiety. J Clin Psychopharmacol. 1984;4:125–9.

    Article  CAS  PubMed  Google Scholar 

  25. Fontaine M, Mercier P, Beaudry P, Annable L, Chouinard G. Bromazepam and lorazepam in generalized anxiety: a placebo-controlled study with measurements of drug plasma concentrations. Acta Psychiatr Scand. 1986;74:451–8.

    Article  CAS  PubMed  Google Scholar 

  26. Spenard J, Caille G, de Montigny C, Vezina M, Oulette J, Lariviere L, et al. Placebo-controlled comparative study of the anxiolytic activity and pharmacokinetics of oral and sublingual lorazepam in generalized anxiety. Biopharm Drug Dispos. 1988;9:457–64.

    Article  CAS  PubMed  Google Scholar 

  27. Kragh-Sorensen P, Holm P, Fynboe C, Schaumburg E, Andersen B, Bech P, et al. Bromazepam in generalized anxiety. Randomized, multi-practice comparisons with both chlorprothixene and placebo. Psychopharmacology (Berl). 1990;100:383–6.

    Article  CAS  Google Scholar 

  28. Bertolino A, Mastucci E, Porro V, Corfiati L, Palermo M, Ecari U, et al. Etizolam in the treatment of generalized anxiety disorder: a controlled clinical trial. J Int Med Res. 1989;17:455–60.

    Article  CAS  PubMed  Google Scholar 

  29. Berlin I, Colombo G, Furlanut M, Benetello P. Double-blind placebo cross-over study of long-acting (chlordesmethyldiazepam) versus short-acting (lorazepam) benzodiazepines in generalized anxiety disorders. Int J Clin Pharmacol Res. 1989;9:203–8.

    Google Scholar 

  30. Wilcox CS, Ryan PJ, Morrissey JL, Cohn JB, DeFrancisco DF, Linden RD, Heiser JF. A fixed-dose study of adinazolam-SR tablets in generalized anxiety disorder. Prog Neuropsychopharmacol Biol Psychiatry. 1994;18:979–93.

    Article  CAS  PubMed  Google Scholar 

  31. Feighner JP, Merideth CH, Hendrickson GA. A double-blind comparison of buspirone and diazepam in outpatients with generalized anxiety disorder. J Clin Psychiatry. 1982;43:103–8.

    CAS  PubMed  Google Scholar 

  32. Jacobson AF, Dominguez RE, Goldstein BJ, Steinbook RM. Comparison of buspirone and diazepam in generalized anxiety disorder. Pharmacotherapy. 1985;5:290–6.

    Article  CAS  PubMed  Google Scholar 

  33. Enkelmann R. Alprazolam versus buspirone in the treatment of outpatients with generalized anxiety disorder. Psychopharmacology (Berl). 1991;105:428–32.

    Article  CAS  Google Scholar 

  34. Rickels K, DeMartinis N, Aufdembrinke B. A double-blind, placebo-controlled trial of abercanil and diazepam in the treatment of patients with generalized anxiety disorder. J Clin Psychopharmacol. 2000;20:12–8.

    Article  CAS  PubMed  Google Scholar 

  35. Rickels K, Downing R, Schweizer E, Hassman H. Antidepressants for the treatment of generalized anxiety disorder. A placebo-controlled comparison of imipramine, trazodone, and diazepam. Arch Gen Psychiatry. 1993;50:884–95.

    Article  CAS  PubMed  Google Scholar 

  36. Hackett D, Haudiquet V, Salinas E. A method for controlling for a high placebo response rate in comparison of venlafaxine XR and diazepam in the short-term treatment of patients with generalized anxiety disorder. Eur Psychiatry. 2003;18:182–7.

    Article  PubMed  Google Scholar 

  37. Feltner DE, Harness J, Brock J, Sambunaris A, Cappelleri JC, Morlock R. Clinical evaluation of daily assessment of symptoms-anxiety (DAS-A): a new instrument to assess the onset of symptomatic improvement in generalized anxiety disorder. CNS Neurosci Ther. 2009;15:12–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Gomez AF, Barthel AL, Hofmann SG. Comparing the efficacy of benzodiazepines and serotonergic anti-depressants for adults with generalized anxiety disorder: a meta-analytic review. Expert Opin Pharmacother. 2018;19:883–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Reinhold JA, Rickels K. Pharmacological treatment for generalized anxiety disorder in adults: an update. Expert Opin Pharmacother. 2015;16:1669–81.

    Article  CAS  PubMed  Google Scholar 

  40. Lydiard RB, Laraia MT, Howell EF, Ballenger JC. Alprazolam in the treatment of social phobia. J Clin Psychiatry. 1988;49:17–9.

    Google Scholar 

  41. Reich J, Yates W. A pilot study of treatment of social phobia with alprazolam. Am J Psychiatry. 1988;145:590–4.

    Google Scholar 

  42. Reiter SR, Pollack MH, Rosenbaum JF, Cohen LS. Clonazepam for the treatment of social phobia. J Clin Psychiatry. 1990;51:470–2.

    Google Scholar 

  43. Ontiveros A, Fontaine R. Social phobia and clonazepam. Can J Psychiatry. 1990;35:439–41.

    Article  CAS  PubMed  Google Scholar 

  44. Munjack DJ, Baltazar PJ, Bohn PG, Cabe DD, Appleton AA. Clonazepam in the treatment of social phobia: a pilot study. J Clin Psychiatry. 1990;51(Suppl):35–40.

    PubMed  Google Scholar 

  45. Davidson JR, Potts N, Richichi E, Krishnan R, Ford SM, Smith R, et al. Treatment of social phobia with clonazepam and placebo. J Clin Psychopharmacol. 1993;13:423–8.

    Article  CAS  PubMed  Google Scholar 

  46. Otto MW, Pollack MH, Gould RA, Worthington JJ 3rd, McArdle ET, Rosenbaum JF. A comparison of the efficacy of clonazepam and cognitive-behavioral group therapy for the treatment of social phobia. J Anxiety Disord. 2000;14:345–58.

    Article  CAS  PubMed  Google Scholar 

  47. Seedat S, Stein MB. Double-blind, placebo-controlled assessment of combined clonazepam with paroxetine compared with paroxetine monotherapy for generalized social anxiety disorder. J Clin Psychiatry. 2004;65:244–8.

    Google Scholar 

  48. Hooper JF. House calls and alprazolam for agoraphobia. Am Fam Physician. 1991;44:1132–4.

    CAS  PubMed  Google Scholar 

  49. Hollenhorst J, Munte S, Friedrich L, Heine J, Leuwer M, Becker H, et al. Using intranasal midazolam spray to prevent claustrophobia. AJR Am J Roentgenol. 2001;176:865–8.

    Article  CAS  PubMed  Google Scholar 

  50. Haefely W. Biological basis of drug-induced tolerance, rebound, and dependence: contribution of recent research on benzodiazepines. Pharmacopsychiatry. 1986;19:353–61.

    Article  CAS  PubMed  Google Scholar 

  51. O’Brien CP. Response to commentaries. Addiction. 2011;106:895–7.

    Article  Google Scholar 

  52. Nagy LM, Krystal JH, Woods SW, Charney DS. Clinical and medication outcome after short-term alprazolam and behavioral group treatment in panic disorder: 2.5 year naturalistic follow-up study. Arch Gen Psychiatry. 1989;46:993–9.

    Article  CAS  PubMed  Google Scholar 

  53. Pollack MH, Otto MW, Tesar GE, Cohen LS, Meltzer-Brody S, Rosenbaum JF. Long-term outcome after acute treatment with alprazolam or clonazepam for panic disorder. J Clin Psychopharmacol. 1993;13:257–63.

    Article  CAS  PubMed  Google Scholar 

  54. Worthington JJ, Pollack MH, Otto MW, McLean RYS, Moroz G, Rosenbaum JF. Long-term experience with clonazepam in patients with a primary diagnosis of panic disorder. Psychopharmacol Bull. 1998;34:199–205.

    CAS  PubMed  Google Scholar 

  55. Soumerai SB, Simoni-Wastila L, Singer C, Mah C, Gao X, Salzman C, et al. Lack of relationship between long-term use of benzodiazepines and escalation to high dosages. Psychiatr Serv. 2003;54:1006–11.

    Article  PubMed  Google Scholar 

  56. Nardi AE, Valença AM, Freire RC, Amrein R, Sardinha A, Levitan MN, et al. Randomized, open naturalistic, acute treatment of panic disorder with clonazepam or paroxetine. J Clin Psychopharmacol. 2011;31:259–61.

    Article  PubMed  Google Scholar 

  57. Tyrer P, Rutherford D, Huggett T. Benzodiazepine withdrawal symptoms and propranolol. Lancet. 1981;317:520–2.

    Article  Google Scholar 

  58. Starcevic V. Benzodiazepines for anxiety disorders: maximising the benefits and minimising the risks. Adv Psychiatr Treat. 2012;18:250–8.

    Article  Google Scholar 

  59. Balter MB, Ban TA, Uhlenhuth EH. International study of expert judgment on therapeutic use of benzodiazepines and other psychotherapeutic medications: I. Current concerns. Hum Psychopharmacol Clin Exp. 1993;8:253–61.

    Article  Google Scholar 

  60. Uhlenhuth EH, Balter MB, Ban TA, Yang KMS. International study of expert judgment on therapeutic use of benzodiazepines and other psychotherapeutic medications: IV. Therapeutic dose dependence and abuse liability of benzodiazepines in the long-term treatment of anxiety disorders. J Clin Psychopharmacol. 1999;19(Suppl 2):23S–9S.

    Article  CAS  PubMed  Google Scholar 

  61. Labelle A, Lapierre YD. Anxiety disorders. Part 2: pharmacotherapy with benzodiazepines. Can Fam Physician. 1993;39:2205–08, 2011–13.

    Google Scholar 

  62. Starcevic V. Issues in the pharmacological treatment of anxiety disorders. Australas Psychiatry. 2005;13:371–4.

    Article  PubMed  Google Scholar 

  63. Bühler K-E. Euphoria, ecstasy, inebriation, abuse, dependence, and addiction: a conceptual analysis. Med Health Care Philos. 2005;8:79–87.

    Article  PubMed  Google Scholar 

  64. Lader M. Benzodiazepines revisited – will we ever learn? Addiction. 2011;106:2086–109.

    Article  PubMed  Google Scholar 

  65. Tyrer P. Why benzodiazepines are not going away. Commentary on… benzodiazepines for anxiety disorders. Adv Psychiatr Treat. 2012;18:259–62.

    Article  Google Scholar 

  66. Dell’Osso B, Albert U, Atti AR, Carmassi C, Carra G, Cosci F, et al. Bridging the gap between education and appropriate use of benzodiazepines in psychiatric clinical practice. Neuropsychiatr Dis Treat. 2015;11:1885–909.

    PubMed  PubMed Central  Google Scholar 

  67. The American Psychiatric Association Task Forcew on Benzodiazepine Dependency. Benzodiazepine dependence, toxicity, and abuse. The Task Force Report of the American Psychiatric Association. Washington, D.C.: American Psychiatric Association; 1990.

    Google Scholar 

  68. Shaffer HJ. Strange bedfellows: a critical view of pathological gambling and addiction. Addiction. 1999;94:1445–8.

    Article  CAS  PubMed  Google Scholar 

  69. Potenza MN. Should addictive disorders include non-substance-related conditions? Addiction. 2006;101(Suppl 1):142–51.

    Article  PubMed  Google Scholar 

  70. American Society of Addiction Medicine. Public Policy Statement: Definition of Addiction. 2011. Available at: https://www.asam.org/advocacy/find-a-policy-statement/view-policy-statement/public-policy-statements/2011/12/15/the-definition-of-addiction

  71. O’Brien CP, Volkow N, Li T-K. What’s in a word? Addiction versus dependence in DSM-V. Am J Psychiatry. 2006;163:764–5.

    Article  PubMed  Google Scholar 

  72. Starcevic V. The importance of distinguishing between dependence and addiction in the context of long-term benzodiazepine use. Aust NZ J Psychiatry. 2016;50:1111–2.

    Article  Google Scholar 

  73. Salzman C, Fisher J, Nobel K, Glassman R, Wolfson A, Kelley M. Cognitive improvement following benzodiazepine discontinuation in elderly nursing home residents. Int J Geriatr Psychiatry. 1992;7:89–93.

    Article  Google Scholar 

  74. Woolcott JC, Richardson KJ, Wiens MO, et al. Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med. 2009;169:1952–60.

    Article  PubMed  Google Scholar 

  75. Wagner AK, Ross-Degnan D, Gurwitz JH, Zhang F, Gilden DB, Cosler L, et al. Effect of New York state regulatory action on benzodiazepine prescribing and hip fracture rates. Ann Intern Med. 2007;146:96–103.

    Article  PubMed  Google Scholar 

  76. Bierman EJM, Comijs HC, Gundy CM, Sonnenberg C, Jonker C, Beekman AT. The effect of chronic benzodiazepine use on cognitive functioning in older persons: good, bad or indifferent? Int J Geriatr Psychiatry. 2007;22:1194–200.

    Article  CAS  PubMed  Google Scholar 

  77. Stewart SA. The effects of benzodiazepines on cognition. J Clin Psychiatry. 2005;66(Suppl 2):9–13.

    CAS  PubMed  Google Scholar 

  78. Albrecht B, Staiger PK, Hall K, Miller P, Best D, Lubman DI. Benzodiazepine use and aggressive behaviour: a systematic review. Aust NZ J Psychiatry. 2014;48:1096–114.

    Article  Google Scholar 

  79. Balon R. Benzodiazepines revisited. Psychother Psychosom. 2013;82:353–4.

    Article  PubMed  Google Scholar 

  80. Starcevic V. The reappraisal of benzodiazepines in the treatment of anxiety and related disorders. Exp Rev Neurotherap. 2014;14:1275–86.

    Article  CAS  Google Scholar 

  81. Balon R, Fava GA, Rickels K. Need for a realistic appraisal of benzodiazepines. World Psychiatry. 2015;14:243–4.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Balon R, Chouinard G, Cosci F, Dubovsky SL, Fava GA, Freire RC, et al. International task force on benzodiazepines. Psychother Psychosom. 2018;87:193–4.

    Article  PubMed  Google Scholar 

  83. Starcevic V. Will the RANZCP clinical practice guidelines for the treatment of anxiety disorders assist in making adequate treatment decisions for panic disorder? Aust NZ J Psychiatry. 2019;53:362–3.

    Article  Google Scholar 

  84. Cowley DS, Ha EH, Roy-Byrne PP. Determinants of pharmacologic treatment failure in panic disorder. J Clin Psychiatry. 1997;58:555–61.

    Article  CAS  PubMed  Google Scholar 

  85. Bruce SE, Vasile RG, Goisman RM, Salzman C, Spencer M, Machan JT, et al. Are benzodiazepines still the medication of choice for patients with panic disorder with or without agoraphobia? Am J Psychiatry. 2003;160:1432–8.

    Article  PubMed  Google Scholar 

  86. Pollack MH, Van Ameringen M, Simon NM, Worthington JW, Hoge EA, Keshaviah A, et al. A double-blind randomized controlled trial of augmentation and switch strategies for refractory social anxiety disorder. Am J Psychiatry. 2014;171:44–53.

    Article  PubMed  Google Scholar 

  87. Fava GA, Gatti A, Belaise C, Guidi J, Offidani E. Withdrawal symptoms after selective serotonin reuptake inhibitor discontinuation: a systematic review. Psychother Psychosom. 2015;84:72–81.

    Article  PubMed  Google Scholar 

  88. Fava GA, Benasi G, Lucente M, Offidani E, Cosci F, Guidi J. Withdrawal symptoms after serotonin-noradrenaline reuptake inhibitor discontinuation: systematic review. Psychother Psychosom. 2018;87:195–203.

    Article  PubMed  Google Scholar 

  89. Nielsen M, Hansen EH, Gøtzsche PC. What is the difference between dependence and withdrawal reactions? A comparison of benzodiazepines and selective serotonin re-uptake inhibitors. Addiction. 2012;107:900–8.

    Article  PubMed  Google Scholar 

  90. Starcevic V, Brakoulias V, Viswasam K, Berle D. Inconsistent portrayal of medication dependence, withdrawal and discontinuation symptoms in treatment guidelines for anxiety disorders. Psychother Psychosom. 2015;84:379–80.

    Article  PubMed  Google Scholar 

  91. Starcevic V. Is the need for medications with calming effects ever going to disappear? Aust NZ J Psychiatry. 2013;47:971.

    Article  Google Scholar 

  92. Rosen CS, Greenbaum MA, Schnurr PP, Holmes TH, Brennan PL, Friedman MJ. Do benzodiazepines reduce the effectiveness of exposure therapy for posttraumatic stress disorder? J Clin Psychiatry. 2013;74:1241–8.

    Article  CAS  PubMed  Google Scholar 

  93. Posternak MA, Mueller TI. Assessing the risks and benefits of benzodiazepines for anxiety disorders in patients with a history of substance abuse or dependence. Am J Addict. 2001;10:48–68.

    Article  CAS  PubMed  Google Scholar 

  94. Mueller TI, Pagano ME, Rodriguez BF, Bruce SE, Stout RL, Keller MB. Long-term use of benzodiazepines in participants with comorbid anxiety and alcohol use disorders. Alcohol Clin Exp Res. 2005;29:1411–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  95. Benasi G, Guidi J, Offidani E, Balon R, Rickels K, Fava GA. Benzodiazepines as a monotherapy in depressive disorders: a systematic review. Psychother Psychosom. 2018;87:65–74.

    Article  PubMed  Google Scholar 

  96. Goddard AW, Brouette T, Almai A, Jetty P, Woods SW, Charney D. Early coadministration of clonazepam with sertraline for panic disorder. Arch Gen Psychiatry. 2001;58:681–6.

    Article  CAS  PubMed  Google Scholar 

  97. Pollack MH, Simon NM, Worthington JJ, Doyle AL, Peters P, Toshkov F. Combined paroxetine and clonazepam treatment strategies compared to paroxetine monotherapy for panic disorder. J Psychopharmacol. 2003;17:276–82.

    Article  CAS  PubMed  Google Scholar 

  98. Shader RI, Greenblatt DJ. Use of benzodiazepines in anxiety disorders. N Engl J Med. 1993;328:1398–405.

    Article  CAS  PubMed  Google Scholar 

  99. Hoehn-Saric R, McLeod DR, Zimerli WD. Differential effects of alprazolam and imipramine in generalized anxiety disorder: somatic versus psychic symptoms. J Clin Psychiatry. 1988;49:293–301.

    CAS  PubMed  Google Scholar 

  100. Rickels K, Rynn M. Pharmacotherapy of generalized anxiety disorder. J Clin Psychiatry. 2002;63(Suppl 14):9–16.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Neurosciences and Anesthesiology, Wayne State University, Detroit, MI, USA

    Richard Balon

  2. Discipline of Psychiatry, Nepean Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia

    Vladan Starcevic

Authors
  1. Richard Balon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vladan Starcevic
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Richard Balon .

Editor information

Editors and Affiliations

  1. College of Medicine, Korea University, Gyeonggido, Korea (Republic of)

    Yong-Ku Kim

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Balon, R., Starcevic, V. (2020). Role of Benzodiazepines in Anxiety Disorders. In: Kim, YK. (eds) Anxiety Disorders. Advances in Experimental Medicine and Biology, vol 1191. Springer, Singapore. https://doi.org/10.1007/978-981-32-9705-0_20

Download citation

Publish with us

Policies and ethics

Search

Navigation