This Editor's Choice Supplement provides a valuable overview into the informed use of high-potency benzodiazepines in patients with anxiety disorders in primary care. These agents are useful as monotherapy or in combination with other therapies for a wide range of disorders. The articles by Dr. Jerrold F. Rosenbaum and Dr. Guy Chouinard give us firsthand insight, from those involved in the research over the past 2 decades, into the scientific basis for use of the benzodiazepines, issues pertinent to the selection and management of specific agents, and successful discontinuation of these agents. Dr. Georges Moroz then highlights recent advances in formulations of clonazepam and alprazolam that improve their clinical utility and minimize side effects. In our articles, Dr. Jonathan R. T. Davidson and I provide practical guidance regarding the recognition, assessment, and treatment of common anxiety disorders, including the use of benzodiazepines. Ms. Alicia Doyle and Dr. Mark H. Pollack provide a practical review of the issues in optimizing long-term management of anxiety disorder patients using panic disorder as a model. Finally, Dr. Michael W. Otto and colleagues review the mechanisms by which cognitive-behavioral therapy (CBT) treats anxiety disorders, evidence of the efficacy of such treatment, and considerations about combining CBT with pharmacotherapy, including benzodiazepines. Together, the authors of this Supplement provide a superb update that equips the primary care clinician with an understanding of mechanisms of action and pharmacotherapeutic properties and practical guidance for initiating, monitoring and adjusting, and discontinuing benzodiazepine therapy in patients with anxiety disorders.
Larry Culpepper, MD, MPH
Editor in Chief
The Primary Care Companion to the Journal of Clinical Psychiatry