공황장애와 범불안장애 치료 시 벤조디아제핀의 내성발생

Abstract

Objective : To evaluate the clinical observations of benzodiazepine (BDZ) tolerance among Korean psychiatrists treating panic disorder (PD) and generalized anxiety disorder (GAD), and to identify associated factors. Methods : A cross-sectional online survey was conducted by lifetime members of the Korean Anxiety Disorders Association. Participants reported on BDZ prescribing patterns, average treatment duration, rates of polypharmacy and PRN prescriptions, and the estimated proportion of patients developing tolerance—defined as the need for progressive dose escalation to maintain therapeutic effect. Group differences were analyzed using chi-square tests, and associations were examined using Spearman’s correlation. Results : Data from 105 specialists in PD and 99 in GAD revealed that most estimated tolerance rates were ≤20% (PD: 71.4%, GAD: 61.6%), with no significant difference between the groups (p=0.558). BDZ prescribing rates were significantly higher for PD patients (p<0.001). In GAD, longer BDZ use and higher rates of polypharmacy were positively associated with tolerance; similar correlations were found in both disorders. Age and the proportion of BDZ prescriptions did not correlate with tolerance rates. Hospital type was not significantly associated with tolerance, although slightly higher rates were reported in university settings. Conclusion : The reported rates of BDZ tolerance were generally low but increased with prolonged use and polypharmacy. These findings highlight the importance of limiting BDZ duration, avoiding unnecessary combinations, and incorporating non-pharmacological treatments to mitigate the risks of tolerance and dependence. (Anxiety and Mood 2025;21(2):68-73)