Benzodiazepines in Clinical Practice: Consideration of Their Long-Term Use and Alternative Agents

Despite increasing focus on the use of antidepressants and other agents for the treatment of anxiety,benzodiazepines have remained a mainstay of anxiolytic pharmacotherapy due to their robust efficacy,rapid onset of therapeutic effect, and generally favorable side effect profile. In this article, weexamine issues related to the long-term use of benzodiazepines, including concerns about the developmentof therapeutic tolerance, dose escalation, and adverse cognitive effects. We also consider currentlyavailable alternatives to benzodiazepines and novel mechanisms of action that may prove fruitfulin the development of future generations of anxiolytics.