ABSTRACT
Several dierent types of medications are often used to treat GAD-speci- cally, benzodiazepines (e.g., urazepam, diazepam, chlordiazepoxide), buspirone, tricyclic antidepressants (TCAs) (e.g., amitriptyline, imipramine, doxepin, opipramol), selective serotonin reuptake inhibitors (SSRIs) (e.g., paroxetine. escitalopram), and venlafaxine (a selective serotonin and norepinephrine reuptake inhibitor) [5-7]. Among these available therapies, benzodiazepines have long been the mainstay of pharmacologic treatment for GAD. While eective, benzodiazepines are associated with excessive sedation and motor impairment [8]; their long-term use is also associated with a risk of physical dependence as well as withdrawal when therapy is discontinued [6]. In one study comparing 4554 persons prescribed benzodiazepines with 13,662 persons receiving other (i.e., non-benzodiazepine) medications who were matched on age, sex, and calendar month in which therapy was initiated, Oster and colleagues found that patients in the former group had a 15% higher risk of an accident-related medical event; those who lled three or more prescriptions for benzodiazepines had a 30% higher risk compared with those who lled only one such prescription [9].
