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Inappropriate Guilt Over Benzodiazepine Prescription
Ronald D. Reynolds, MD
New Richmond (Ohio) Family Practice
Arch Fam Med. 1996;5(1):9.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings. |
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I was deeply saddened by the eloquent and cathartic essay by Rastegar1 on his prescription of benzodiazepines to a patient with generalized anxiety disorder (GAD) and panic attacks. He describes his agony over writing a prescription that is clearly appropriate. I fear that many primary care physicians do not understand the biologic nature of GAD and therefore share Rastegar's concerns.
Generalized anxiety disorder affects 5.1% of the US adult population.2 Recent neurobiochemical research has shown that active GAD is characterized by a decreased number of  -aminodutyric acid (GABA) binding sites on lymphocytes3,4 and presumably within the brain. The GABA receptor complex modulates chloride ion channels and contains a benzodiazepine binding site.5 Long-term benzodiazepine administration restores GABA receptor density to normal, coinciding with resolution of anxiety.3,4 Although oversimplified, clinicians might conceive of patients with GAD as having a GABA deficiency underlying their anxiety symptoms. Benzodiazepines could
. . . [Full Text PDF of this Article]
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