Benzodiazepines in the treatment of acute anxiety

A combined approach using psychotherapy in conjunction with a repeated single dose regimen of a rapidly absorbed, short half-life benzodiazepine has been employed in patients with intermittent acute anxiety. The strategy is directed at patient identification of precipitating factors and, encouraged by prompt control of symptoms with a single dose, the development of more effective coping mechanisms. If and when to take each dose is decided by the patient who keeps a diary recording anxiety episodes, associated circumstances, medication and response. In addition to providing a medication record, the diary is used as a starting point for the psychotherapy sessions. Results show that giving the patient control of drug intake has been an effective approach in such patients and enhances patient awareness of and capacity to control episodes of acute anxiety.