공황장애와 범불안장애 치료에서 벤조디아제핀의 다중 처방 양상

Abstract

Objective : This study investigated the prevalence, rationale, and influencing factors of benzodiazepine (BDZ) polypharmacy in the treatment of panic disorder (PD) and generalized anxiety disorder (GAD) among experienced Korean psychiatrists. Methods : A web-based survey was conducted with lifetime members of the Korean Anxiety Disorders Association. Participants reported their BDZ prescribing patterns, the percentage of patients receiving polypharmacy, the reasons for such prescriptions, and their demographic and practice characteristics. Descriptive statistics summarized the prescribing patterns, chi-square tests compared PD and GAD cases, and Spearman’s rank correlations evaluated clinician factors associated with BDZ prescribing. Results : Among 105 respondents treating PD and 99 treating GAD, the majority prescribed a single BDZ (PD: 61.9%, GAD: 67.7%), while 32.4% of PD and 25.3% of GAD patients were prescribed two or more BDZs. Polypharmacy was generally limited to 20% or fewer patients. Common reasons for polypharmacy included managing insomnia (PD: 52.4%), mitigating adverse effects of high-dose monotherapy (PD: 49.5%), and addressing varied anxiety symptoms (GAD: 59.6%). The use of long-acting BDZs to taper short-acting agents occurred more frequently in PD (p=0.028). In PD, both the number of BDZs prescribed and the polypharmacy rate decreased with the physician's age and years of specialist experience. Similarly, in GAD, the rate of polypharmacy declined with increased clinician experience. Conclusion : BDZ polypharmacy was relatively rare and employed for specific clinical needs. Increased physician experience correlated with lower polypharmacy rates, indicating a more conservative prescribing approach. When polypharmacy is necessary, it should be clinically justified, closely monitored, and complemented by non-pharmacological strategies to reduce potential harm. (Anxiety and Mood 2025;21(2):56-61)