Benzodiazepines for the treatment of panic disorder and generalized anxiety disorder: clinical issues and future directions.

For several decades, benzodiazepines have shown their effectiveness in the treatment of various manifestations of anxiety. Recent diagnostic systems have divided these manifestations of anxiety into categories and separate pathologies, such as generalized anxiety disorder and panic disorder. Researchers have studied the use and efficacy of benzodiazepine receptor agonists in patients with these distinct diagnostic categories. Clinical studies on generalized anxiety disorder and panic disorder usually suggest equivalent efficacy among benzodiazepine agonists, although truly comparative studies with two or three drugs are scarce. Further work is needed on the differences in side-effects, pharmacokinetics and discontinuation reactions for benzodiazepines. Concerns about benzodiazepine dependency--justified or not--and about discontinuation reactions have motivated the search for newer benzodiazepines without these problems. This paper reviews the efficacy and comparative studies of benzodiazepines that are currently available and discusses recent developments in research on newer benzodiazepines molecules.