공황장애와 범불안장애 치료 시 벤조디아제핀 감량 및 중단: 전문가 설문조사

초록

Objective : We aimed to evaluate the clinical experiences of benzodiazepine (BDZ) tapering and discontinuation in the treatment of panic disorder (PD) and generalized anxiety disorder (GAD) and to identify factors associated with these experiences through a survey of domestic experts. Methods : A web-based survey of psychiatrists in the Korean Academy of Anxiety Disorders yielded 105 responses for PD and 99 for GAD, respectively. Data included physician demographics, BDZ prescribing patterns, and experiences with BDZ tapering and discontinuation. Group differences were analyzed with χ2 tests, and correlates of tapering difficulty were assessed with Spearman’s correlations. Results : Tapering most often began eight weeks after acute stabilization, with no difference between two disorders. Tapering was perceived as moderately difficult in PD, but more often difficult in GAD. Clinicians most often estimated that 21%-40% of their patients experienced tapering difficulties, mainly due to psychological dependence, resistance, and relapse fears. Longer BDZ use, polypharmacy, and maintenance-phase combinations correlated with greater difficulty, while lower-dose maintenance facilitated tapering. In GAD, both PRN prescribing and higher BDZ combination rates during the acute phase were also associated with greater tapering difficulty. Conclusion : Psychiatrists perceived BDZ tapering as more difficult in GAD than in PD. Long-term use, polypharmacy, and combination therapy were key barriers, with PRN prescriptions adding risk in GAD. Conversely, proactive dose reduction after the acute phase facilitated BDZ discontinuation. These findings highlight that psychological dependence is a major obstacle, underscoring the need for early planning, cautious prescribing, and integration of psychosocial interventions to support successful BDZ discontinuation. (Anxiety and Mood 2025;21(2):74-80)

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