Report in Brief
Long-term BZD use in GAD is not recommended unless:
The maximum daily dose for long-term BZD therapy in GAD is uncertain.
Caution is advised for the elderly, children, and for pregnant or breastfeeding woman.
- What are the guidelines associated with the short- and long-term use of benzodiazepines for patients with generalized anxiety disorder (GAD)?
The short-term use of benzodiazepines for the treatment of generalized anxiety disorder is recommended as adjunctive therapy to antidepressants until their effectiveness is apparent or in times of acute crisis or increased anxiety. One guideline specified a daily dosage of alprazolam ranging between 1.5 mg and 6 mg when used to control the anxiety associated with first-line use of antidepressants. Long-term use of benzodiazepines is only recommended in patients who do not respond to or cannot tolerate numerous first-line therapies. No recommendations were provided on the maximum daily doses for long-term BZD treatment for GAD. For special populations, the guidelines generally advise against the use of BZDs in the elderly (or to use at lower adult doses if required), to use them sparingly in children and adolescents, and to use them with caution during the first and third trimesters of pregnancy, during labour and delivery, and when breastfeeding.