ISSN 2586-0151 (Print) | ISSN 2586-0046 (Online)
대한불안의학회지 (21권2호 68-73)
Benzodiazepine Tolerance During Treatment of Panic Disorder and Generalized Anxiety Disorder
공황장애와 범불안장애 치료 시 벤조디아제핀의 내성발생
Eunsoo Moon1, Jun Ho Seo2, Min-Kyoung Kim3, Yoon Young Chang4, Hyeon-Ah Lee5, Myung Hee Ahn6, Kang Soo Lee7, Won Kim4, Ho-Suk Suh8, Kyoung-Uk Lee9, and Ho-Jun Seo10
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, 8Suh Hosuk Yonsei Psychiatry Clinic for Healthy Mind, Seoul, 9Department of Psychiatry, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, College of Medicine, Uijeongbu, 10Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
Objective : To evaluate the clinical observations of benzodiazepine (BDZ) tolerance among Korean psychia
trists treating panic disorder (PD) and generalized anxiety disorder (GAD), and to identify associated factors.
Methods : A cross-sectional online survey was conducted by lifetime members of the Korean Anxiety
Disorders Association. Participants reported on BDZ prescribing patterns, average treatment duration, rates
of polypharmacy and PRN prescriptions, and the estimated proportion of patients developing tolerance—de
f
ined as the need for progressive dose escalation to maintain therapeutic effect. Group differences were ana
lyzed using chi-square tests, and associations were examined using Spearman’s correlation.
Results : Data from 105 specialists in PD and 99 in GAD revealed that most estimated tolerance rates
were ≤20% (PD: 71.4%, GAD: 61.6%), with no significant difference between the groups (p=0.558). BDZ
prescribing rates were significantly higher for PD patients (p<0.001). In GAD, longer BDZ use and higher
rates of polypharmacy were positively associated with tolerance; similar correlations were found in both dis
orders. Age and the proportion of BDZ prescriptions did not correlate with tolerance rates. Hospital type was
not significantly associated with tolerance, although slightly higher rates were reported in university settings.
Conclusion : The reported rates of BDZ tolerance were generally low but increased with prolonged use
and polypharmacy. These findings highlight the importance of limiting BDZ duration, avoiding unneces
sary combinations, and incorporating non-pharmacological treatments to mitigate the risks of tolerance and
dependence. (Anxiety and Mood 2025;21(2):68-73)
Panic disorder; Generalized anxiety disorder; Benzodiazepine; Tolerance.