공황장애와 범불안장애 치료에서 벤조디아제핀 필요 시 처방의 양상

Abstract

Objective : This study aimed to evaluate how Korean psychiatrists specializing in anxiety disorders prescribe pro re nata (PRN) benzodiazepines (BDZs) for panic disorder (PD) and generalized anxiety disorder (GAD), and to identify clinical factors associated with their PRN prescribing patterns. Methods : An online survey was conducted among lifetime members of the Korean Anxiety Disorders Association. Participants provided demographic information, BDZ prescription rates, the proportion of patients receiving PRN prescriptions, treatment duration, the number of BDZs prescribed, and the frequency of polypharmacy. Chi-square tests were used to compare prescribing patterns between PD and GAD, while Spearman’s rank correlations assessed associations with clinical variables. Results : Responses from 105 psychiatrists treating PD and 99 treating GAD were analyzed. PRN prescribing differed significantly between the two groups (p=0.001). In PD, PRN BDZs were most commonly prescribed to 41%-60% of patients (22.9%), while in GAD, this was true for only 0%-20% of patients (41.4%). In PD, PRN prescribing was inversely correlated with physician age and years of specialty practice. Conversely, In GAD, longer treatment durations were positively correlated with increased PRN prescribing. For both disorders, the frequency of PRN prescribing increased with the number of BDZs used and the rateds of polypharmacy. Conclusion : PRN BDZ use was more prevalent in PD than in GAD, indicating differences in clinical presentation and treatment approaches. In PD, greater clinical experience was associated with lower rates of PRN prescribing, suggesting a shift towards alternative management strategies. When PRN prescribing is clinically justified, it should be accompanied by structured monitoring and risk-mitigation strategies to minimize the potential for tolerance, misuse, and dependence. (Anxiety and Mood 2025;21(2):62-67)