Original Article

대한불안의학회지 (21권2호 62-67)

Patterns of pro re nata Prescription of Benzodiazepines in the Treatment of Panic Disorder and Generalized Anxiety Disorder

공황장애와 범불안장애 치료에서 벤조디아제핀 필요 시 처방의 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 aimed to evaluate how Korean psychiatrists specializing in anxiety disorders pre scribe pro re nata (PRN) benzodiazepines (BDZs) for panic disorder (PD) and generalized anxiety disorder (GAD), and to identify clinical factors associated with their PRN prescribing patterns.

Methods : An online survey was conducted among lifetime members of the Korean Anxiety Disorders As sociation. Participants provided demographic information, BDZ prescription rates, the proportion of patients re ceiving PRN prescriptions, treatment duration, the number of BDZs prescribed, and the frequency of polyphar macy. Chi-square tests were used to compare prescribing patterns between PD and GAD, while Spearman’s rank correlations assessed associations with clinical variables.

Results : Responses from 105 psychiatrists treating PD and 99 treating GAD were analyzed. PRN prescrib ing differed significantly between the two groups (p=0.001). In PD, PRN BDZs were most commonly pre scribed to 41%-60% of patients (22.9%), while in GAD, this was true for only 0%-20% of patients (41.4%). In PD, PRN prescribing was inversely correlated with physician age and years of specialty practice. Conversely, In GAD, longer treatment durations were positively correlated with increased PRN prescribing. For both disorders, the frequency of PRN prescribing increased with the number of BDZs used and the rateds of polypharmacy.

Conclusion : PRN BDZ use was more prevalent in PD than in GAD, indicating differences in clinical pre sentation and treatment approaches. In PD, greater clinical experience was associated with lower rates of PRN prescribing, suggesting a shift towards alternative management strategies. When PRN prescribing is clinically justified, it should be accompanied by structured monitoring and risk-mitigation strategies to minimize the po tential for tolerance, misuse, and dependence. (Anxiety and Mood 2025;21(2):62-67)

Keywords

Panic disorder; Generalized anxiety disorder; Benzodiazepine; PRN prescription.

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