Long-term treatment of anxiety: benefits and drawbacks

Anxiety disorders are common conditions, often chronic, occurring in the general population with a prevalence of about 3%. Long-term use of tranquilizers varies from 0.5% of the total adult population in Sweden and 1.3% in Denmark to 3.1% in Great Britain and 5% in France. This use is tending to become more and more long-term. Long-term efficacy of benzodiazepine medication has not been established. Adverse effects include psychomotor and cognitive impairment, especially in the elderly; some, but not all, effects show tolerance. Some impairment can be demonstrated even after years of use. Rebound and withdrawal reactions after long-term use are common. Practical guidelines to minimize long-term use are suggested.