Page "Benzodiazepine" Paragraph 8

Guidelines issued by the UK-based National Institute for Health and Clinical Excellence ( NICE ), carried out a systematic review using different methodology and came to a different conclusion.

They questioned the accuracy of studies that were not placebo-controlled.

And, based on the findings of placebo-controlled studies, they do not recommend use of benzodiazepines beyond two to four weeks, as tolerance and physical dependence develop rapidly, with withdrawal symptoms including rebound anxiety occurring after six weeks or more of use.

Nevertheless, benzodiazepines continue to be prescribed for the long-term treatment of anxiety disorders, although specific antidepressants and psychological therapies are recommended as the first-line treatment options with the anticonvulsant drug pregabalin indicated as a second-or third-line treatment and suitable for long-term use.

NICE stated that long-term use of benzodiazepines for panic disorder with or without agoraphobia is an unlicensed indication, does not have long-term efficacy, and is, therefore, not recommended by clinical guidelines.

Psychological therapies such as cognitive behavioural therapy are recommended as a first-line therapy for panic disorder ; benzodiazepine use has been found to interfere with therapeutic gains from these therapies.