The Treatment of Anxiety: Realistic Expectations and Risks Posed by Controlled Substances

Shader Richard I. Greenblatt David J. , “Use of Benzodiazepines in Anxiety Disorders,” New England Journal of Medicine, 328, no. 19 (1993): 1398–1405; and Brown Candace S. Rakel Robert E. Wells Barbara G. Downs John M. Akiskal Hagop S. , “A Practical Update on Anxiety Disorders and Their Pharmacologic Treatment,” Archives of Internal Medicine, 151 (1991): 873–84.

DuPont Robert L. , ed., Abuse of Benzodiazepines: The Problems and the Solutions, Supplement 1 to The American Journal of Drug and Alcohol Abuse, Volume 14, (New York: Marcel Dekker, 1988), pp. 1–70.

DuPont Robert L. Saylor Keith E. , “Sedatives/Hypnotics and Benzodiazepines,” in Frances R.J. Miller S.I. , eds., Clinical Textbook of Addictive Disorders (New York: Guilford Press, 1991), pp. 69–102.

The problem of the use of controlled substances in medical practice has recently been reviewed. See Wilford Bonnie B. , ed., Balancing the Response to Prescription Drug Abuse—Report of a National Symposium on Medicine and Public Policy (Chicago: American Medical Association, Department of Substance Abuse, 1990).

National Institute of Mental Health, “Epidemiologic Catchment Area (ECA) Program Community Surveys in Five Sites: St. Louis, MO; Baltimore, MD; New Haven, CT; Durham, NC; and Los Angeles, CA 1980–1985.” Public use tapes.

DuPont Robert L. Rice Dorothy P. Miller Leonard S. Shiraki Sarah S. Rowland Clayton R. Harwood Henrick J. , “The Economic Costs of Anxiety Disorders,” paper presented at a seminar at the National Institutes of Health, Bethesda, Maryland, February 2, 1993, and at the Anxiety Disorders Association of America annual meeting, Charleston, South Carolina, March 19, 1993.

Ballenger James C. , “Panic Disorder: Efficacy of Current Treatments,” in Health Care Reform for Americans with Severe Mental Illnesses: Report of the National Advisory Mental Health Council (Rockville: U.S. Department of Health and Human Services, Public Health Service, National Advisory Mental Health Council, 1993), pp. 88–106; Jenike Michael A. , “Obsessive-Compulsive Disorder: Efficacy of Specific Treatments as Assessed by Controlled Trials,” in Health Care Reform for Americans with Severe Mental Illnesses: Report of the National Advisory Mental Health Council (Rockville: U.S. Department of Health and Human Services, Public Health Service, National Advisory Mental Health Council, 1993), pp. 107–30; American Psychiatric Association, “Anxiety Disorders,” Section 18 in Treatments of Psychiatric Disorders: A Task Force Report of the American Psychiatric Association (Washington, D.C.: American Psychiatric Association, Vol. 3, 1989), pp. 2007–92; and Noyes R. Roth M. Burrows G.D. , eds., Handbook of Anxiety, Volume 4: The Treatment of Anxiety (Amsterdam: Elsevier, 1990).

American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (Washington, D.C.: American Psychiatric Association, 4th ed., 1994).

Jaffe Jerome H. , “Drug Addiction and Drug Abuse,” in Gilman A.G. Rall T.W. Nies A.S. Taylor P. , eds., The Pharmacological Basis of Therapeutics (New York: Pergamon Press, 8th ed., 1990), pp. 522–73; and Griffiths Roland R. Sannerud C.A. , “Abuse of and Dependence on Benzodiazepines and Other Anxiolytic/Sedative Drugs,” in Meltzer H.Y. , ed., Psychopharmacology: The Third Generation of Progress (New York: Raven Press, 1987), pp. 1535–41.

Sellers Edward M. Ciraulo Domenic A. DuPont Robert L. Griffiths Roland R. Kosten Thomas R. Romach Myroslava K. Woody George E. , “Alprazolam and Benzodiazepine Dependence,” submitted to the Journal of Clinical Psychiatry; and see DuPont , supra note 2.

DuPont Robert L. , “Aiming Straight: Benzodiazepines, Addiction, and Public Policy,” New Jersey Medicine, 90, no. 11 (1993): 823–26; and Tracy Orleans C. Slade John , eds., Nicotine Addiction: Principles and Management (New York: Oxford Press, 1993).

DuPont Robert L. , The Selfish Brain: Learning From Addiction (Washington, D.C.: American Psychiatric Press, forthcoming).

DuPont Robert L. , “Benzodiazepines and Chemical Dependence: Clinical Guidelines,” in Practical Clinical Management: Drug Abuse Education for the Primary Care Physician (Baltimore: Medical and Chirurgical Faculty of Maryland, 1990), pp. 53–59.

Wheatley David , ed., The Anxiolytic Jungle: Where Next? (Chichester, West Sussex: John Wiley & Sons, 1990).

Rosenbaum Jerrold , ed., “Long-Term Treatment of Mood and Anxiety Disorders,” Psychiatric Annals, 24, no. 6 (1994); DuPont Robert L. , “Choosing the Right Treatment for the Patient with Anxiety,” Modem Medicine, 60, no. 4 (1992): 64–76; and see American Psychiatric Association, supra note 7.

Saylor Keith E. DuPont Robert L. Brouillard Mary , “Self-Help Treatment of Anxiety Disorders,” in Noyes R. Roth M. Burrows G.D. , eds., Handbook of Anxiety, Volume 4: The Treatment of Anxiety (Amsterdam: Elsevier, 1990), pp. 483–96.

Ballenger James C. Burrows Graham D. DuPont Robert L. Lesser Ira M. Noyes Russell Pecknold John C. Rifkin Arthur Swinson Richard P. , “Alprazolam in Panic Disorder and Agoraphobia: Results from a Multicenter Trial—I. Efficacy in Short-Term Treatment,” Archives of General Psychiatry, 45 (1988): 413–22.

These issues, including the controversies about the use of BZs, have been recently explored. See Smith David E. Wesson Donald R. , The Benzodiazepines—Current Standards for Medical Practice (Lancaster: MTP Press, 1985); Roy-Byrne Peter P. Cowley Deborah S. , eds., Benzodiazepines in Clinical Practice: Risks and Benefits (Washington, D.C.: American Psychiatric Press, 1991); and American Psychiatric Association, Treatments of Psychiatric Disorders: A Task Force Report of the American Psychiatric Association (Washington, D.C.: American Psychiatric Association, Vol. 3, 1989).

Sheehan David V. Raj Ashok , “Benzodiazepine Treatment of Panic Disorder,” in Noyes R. Roth M. Burrows G.D. , eds., Handbook of Anxiety, Volume 4: The Treatment of Anxiety (Amsterdam: Elsevier, 1990), pp. 169–206; and Zorumski Charles F. Isenberg Keith E. , “Insights into the Structure and Function of GABA-Benzodiazepine Receptors: Ion Channels and Psychiatry,” American Journal of Psychiatry, 148, no. 2 (1991): 162–71.

DuPont Robert L. Swinson Richard P. Ballenger James C. Burrows Graham D. Noyes Russell Rubin Robert T. Rifkin Arthur Pecknold John C. , “Discontinuation of Alprazolam after Long-Term Treatment of Panic Related Disorders,” Journal of Clinical Psychopharmacology, 12, no. 5 (1992): 352–54.

Busto Usoa E. Sellers Edward M. Naranjo C.A. Cappell H. Sanchez-Craig M. Sykora K. , “Withdrawal Reaction After Long-Term Therapeutic Use of Benzodiazepines,” New England Journal of Medicine, 315 (1986): 854–59; and see DuPont , supra note 20.

Pecknold John C. Swinson Richard P. Kuch Klaus Lewis Carl P. , “Alprazolam in Panic Disorder and Agoraphobia: Results from a Multicenter Trial—III. Discontinuation Effects,” Archives of General Psychiatry 45 (1988): 429–36; see American Psychiatric Association, supra note 18; and see Busto , supra note 21.

See DuPont , supra note 15.

DuPont Robert L. , Use of Benzodiazepines: Risks and Benefits (Rockville: DuPont Associates, P.A., 1989); and DuPont Robert L. , Getting Off Benzodiazepines: A Patient's Guide (Rockville: DuPont Associates, P.A., 1990).

DuPont Robert L. McGovern John P. , A Bridge to Recovery—An Introduction to 12-Step Programs (Washington, D.C.: American Psychiatric Press, 1994).

Al-Non Family Group Headquarters, Al-Non Faces Alcoholism (New York: Al-Non Family Group Headquarters, Inc., 1990).

Dilsaver Steven C. Greden J.F. , “Antidepressant Withdrawal Phenomena: A Review,” Biological Psychiatry, 19 (1984): 237–56.

See DuPont , supra note 20.

See American Psychiatric Association, supra note 18.

Ciraulo Domenic A. Sands Brian F. Shader Richard I. , “Alcoholics' Use of Benzodiazepines,” American Journal of Psychiatry, 146, no. 5 (1989): 683–84.

Hollander Eric Hatterer Julie Klein Donald F. , “Antidepressants for the Treatment of Panic and Agoraphobia,” in Noyes R. Roth M. Burrows G.D. , eds., Handbook of Anxiety, Volume A: The Treatment of Anxiety (Amsterdam: Elsevier, 1990), pp. 207–31.

Stone Michael H. , “Psychotherapy for the Treatment of Anxiety Disorders,” in Noyes R. Roth M. Burrows G.D. , eds., Handbook of Anxiety, Volume 4: The Treatment of Anxiety (Amsterdam: Elsevier, 1990), pp. 389–404.

See DuPont , supra note 12.

DuPont Robert L. , “Thinking About Stopping Treatment for Panic Disorder,” Journal of Clinical Psychiatry, 51, no. 12, supp. A (1990): 38–45; and see Jaffe , supra note 9.

See DuPont , supra note 11; and see DuPont , supra note 12.

DuPont Robert L. , Benzodiazepines: The Social Issues (Rockville: Institute for Behavior and Health, 1986); DuPont Robert L. Saylor Keith E. , “Depressant Substances in Adolescent Medicine,” Pediatrics in Review, 13, no. 10 (1992): 381–86; see DuPont , supra note 11, at 825; and see DuPont , supra note 15, at 66.

Miller Norman S. , ed., Treating Coexisting Psychiatric and Addictive Disorders: A Practical Guide (Center City, MN: Hazelden Publishing, 1994).

DuPont Robert L. , “The Twelve Step Approach,” in Miller Norman S. , ed., Treating Coexisting Psychiatric and Addictive Disorders: A Practical Guide (Center City, MN: Hazelden Publishing, 1994), pp. 177–97.

DuPont Robert L. , “Anxiety and the BZs,” ADAA Reporter, IV, no. 3 (1993): 1.

Pollack Mark H. Otto Michael W. , “Long-Term Pharmacologic Treatment of Panic Disorder,” Psychiatric Annals, 24, no. 6 (1994): 291–98.

Klerman Gerald L. Weissman Myrna M. , “The Course, Morbidity, and Costs of Depression,” Archives of General Psychiatry, 49 (1992): 831–34.

DuPont Robert L. , “Policy Concerns: Addiction, Anxiety and Benzodiazepines: A Public Policy Perspective,” in Wilford Bonnie B. , ed., Balancing the Response to Prescription Drug Abuse—Report of a National Symposium on Medicine and Public Policy (Chicago: American Medical Association, Department of Substance Abuse, 1990), pp. 109–17; see DuPont , supra note 11; and see DuPont , supra note 13.