Anxiety in primary care: is short-term drug treatment appropriate?

Thirty-six patients with generalised anxiety disorder, panic disorder or agoraphobia with panic attacks, diagnosed by DSM-III criteria, were treated with a new non-benzodiazepine anti-anxiety drug, buspirone, and with diazepam and placebo, in a cross-over design. Each patient took buspirone, diazepam and placebo for one week each in flexible dosage and balanced order. Ratings of symptomatology using the Comprehensive Psychopathological Rating Scale were made after each week's treatment and a sub-scale used for measuring anxiety change alone was used separately. There was no overall difference in efficacy between the drugs, but when the scores for individual symptoms were analysed, diazepam was significantly superior to the other treatments for the symptom of muscle tension only. The results suggest that the common practice of giving short-term therapy with tranquilising drugs for anxiety in primary care is pharmacologically suspect.