공황장애와 범불안장애 약물 치료에서 벤조디아제핀의 처방현황

초록

Objective : Panic disorder (PD) and generalized anxiety disorder (GAD) significantly impair daily functioning and quality of life. Benzodiazepines (BZDs) provide rapid anxiolytic effects through GABA-A receptor modulation but pose risks of dependence, tolerance, and cognitive decline. Guidelines recommend SSRIs and SNRIs as first-line agents, restricting BZDs to short-term use, yet real-world practice often diverges. Methods : A cross-sectional survey of 113 psychiatrists, all lifetime members of the Korean Anxiety Disorders Association, was conducted between August and October 2024. A 16-item questionnaire assessed prescribing patterns, dosage, and duration of BZD use in PD and GAD. Data were analyzed with chi-square tests. Results : In the acute phase, 60% of respondents reported prescribing BZDs in 81%-100% of PD cases, compared with 30.3% in GAD (p<0.001). Maintenance-phase prescriptions declined but often persisted; 21%-40% of PD patients and 0%-20% of GAD patients received BZDs for over one year. Although most psychiatrists considered 3-6 months appropriate, actual use frequently extended to 6-12 months or longer. Dosages were generally comparable to other anxiety disorders, with lower doses preferred in maintenance. Conclusion : BZDs remain widely prescribed in PD and GAD, particularly during acute treatment, despite guideline restrictions. Extended use reflects both clinical needs and patient-related factors, underscoring the necessity for pragmatic, safety-conscious prescribing strategies in real-world practice. (Anxiety and Mood 2025;21(2):48-54)

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