I’ve been practicing in family medicine for less than 5 years, one common thing that I’ve struggled with is patients who come into the clinic taking a daily scheduled benzodiazepine to treat anxiety. From my understanding benzodiazepines are not an appropriate or effective maintenance treatment for anxiety.
Usually this patient has taken the medication longer than a year and it’ll be a shorter acting medication taken 3-4 times a day. These patients are generally not taking what I would consider a maintenance medication (SSRI, SNRI, etc.). The most confusing part is that many of them feel like their current therapy is ineffective yet are not willing to try starting a maintenance medication, CBT, and weaning off of the benzo.
My problem with the situation is that I feel like most of the patients are truly addicted to the medications, treatment is not effective, and I’m essentially being forced into a role of helping them continue their addiction or a stop along the way until they find someone who will continue their prescription.
Is there really a role for daily benzodiazepines? Do you have patients who use this type of medication as their primary treatment for anxiety? Outside of offering to start a new medication, start CBT, and tapering off of the benzo over several months is there a better way to approach this situation?
I’m especially frustrated today as I had a patient file a formal complaint last week because I reportedly disrespected them by not understanding the severity of their anxiety.
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