Don’t Ask, Don’t Tell, but Benzodiazepines Are Still the Leading Treatments for Anxiety Disorder

Modern guidelines for psychopharmacologic treatment of anxiety disorders have evolved from recommending GABAergic (gammaaminobutryic acid) benzodiazepines to recommending serotonergic agents for first-line use. This trend, along with adverse publicity about the dependence potential of benzodiazepines, might lead one to suspect that benzodiazepines, once prominent in the 1980s but now generic and often disparaged, must have significantly declined in use. Not so. In fact, benzodiazepines are still more widely prescribed than antidepressants for the treatment of anxiety disorders (Table 1), and alprazolam is the single most commonly prescribed agent for mood and anxiety disorders(Table 2).