Original Article

대한불안의학회지 (21권2호 55-61)

Patterns of Multiple Benzodiazepine Prescriptions in the Treatment of Panic Disorder and Generalized Anxiety Disorder

공황장애와 범불안장애 치료에서 벤조디아제핀의 다중 처방 양상

Eunsoo Moon1, Jun Ho Seo2, Min-Kyoung Kim3, Yoon Young Chang4, Hyeon-Ah Lee5, Myung Hee Ahn6, Kang Soo Lee7, Ho-Jun Seo8, Won Kim4, Ho-Suk Suh9, and Kyoung-Uk Lee10

1Department of Psychiatry, Pusan National University School of Medicine, Yangsan, 2Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, 3Department of Psychiatry, CHA Ilsan Medical Center, CHA University, Ilsan, 4Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, 5Department of Psychiatry, College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, 6Division of Psychiatry, Health Screening and Promotion Center, Asan Medical Center, Seoul, 7Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, 8Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, 9Suh Hosuk Yonsei Psychiatry Clinic for Healthy Mind, Seoul, 10Department of Psychiatry, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

Objective : This study investigated the prevalence, rationale, and influencing factors of benzodiazepine (BDZ) polypharmacy in the treatment of panic disorder (PD) and generalized anxiety disorder (GAD) among experienced Korean psychiatrists.

Methods : A web-based survey was conducted with lifetime members of the Korean Anxiety Disorders Association. Participants reported their BDZ prescribing patterns, the percentage of patients receiving poly pharmacy, the reasons for such prescriptions, and their demographic and practice characteristics. Descriptive statistics summarized the prescribing patterns, chi-square tests compared PD and GAD cases, and Spear man’s rank correlations evaluated clinician factors associated with BDZ prescribing.

Results : Among 105 respondents treating PD and 99 treating GAD, the majority prescribed a single BDZ (PD: 61.9%, GAD: 67.7%), while 32.4% of PD and 25.3% of GAD patients were prescribed two or more BDZs. Polypharmacy was generally limited to 20% or fewer patients. Common reasons for polypharmacy included managing insomnia (PD: 52.4%), mitigating adverse effects of high-dose monotherapy (PD: 49.5%), and addressing varied anxiety symptoms (GAD: 59.6%). The use of long-acting BDZs to taper short-acting agents occurred more frequently in PD (p=0.028). In PD, both the number of BDZs prescribed and the poly pharmacy rate decreased with the physician's age and years of specialist experience. Similarly, in GAD, the rate of polypharmacy declined with increased clinician experience.

Conclusion : BDZ polypharmacy was relatively rare and employed for specific clinical needs. Increased physician experience correlated with lower polypharmacy rates, indicating a more conservative prescribing ap proach. When polypharmacy is necessary, it should be clinically justified, closely monitored, and complemented by non-pharmacological strategies to reduce potential harm. (Anxiety and Mood 2025;21(2):56-61)

Keywords

Panic disorder; Generalized anxiety disorder; Benzodiazepine; Polypharmacy.

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