Benzodiazepines for the treatment of anxiety and mood disorders

The benzodiazepines play a major role in the treatment of anxiety in the primary care setting. Used alone, they are faster-acting than the antidepressants or behavior therapy, and they can be a critical adjunct to these therapies. Nonspecific in their action, they alleviate symptoms of anxiety regardless of the cause. Common side effects are sedation, psychomotor impairment, and anterograde amnesia, although these often abate with time. Some degree of physical dependence is likely to develop with long- term treatment, and an attempt should be made to taper the dosage every 4 months; two or three unsuccessful attempts suggest the need for chronic benzodiazepine therapy. The taper should be progressively more gradual, especially after long-term treatment.