A report published in Psychotherapy and Psychosomatics analyzes how the use of benzodiazepines is analyzed in treatment guidelines.
Authors conducted a systematic review for treatment guidelines for anxiety disorders reaching by means of MEDLINE, PubMed, PsycINFO, and Google Scholar using the search terms 'treatment guideline' or 'clinical practice guideline' or 'guideline' in combination with 'anxiety disorder', 'panic disorder', 'generalized anxiety disorder', 'social anxiety disorder', 'social phobia', 'obsessive-compulsive disorder', and 'posttraumatic stress disorder'.
Results suggest that treatment guidelines maintain the distinction between BDZ-related withdrawal symptoms and SSRI/SNRI-related discontinuation symptoms and demonstrate that despite acknowledgement by the majority of guidelines of the SSRI/SNRI-related discontinuation symptoms, these antidepressants are usually not considered to be characterized by dependence.
Authors address that current treatment guidelines for anxiety disorders continue to show bias against benzodiazepines (BDZs) by ignoring the evidence that the withdrawal symptoms during discontinuation of BDZs and SSRIs/ SNRIs are very similar and by relating these symptoms to dependence only when BDZs are involved.
They concluded that this approach is both inconsistent and confusing and may have negative effects on clinical practice in terms of the unjustifiable avoidance of BDZs and overuse of antidepressants.
Treatment guidelines should not shy away from stating clearly that SSRIs/SNRIs, like BDZs, are often (though not always) associated with pharmacological dependence, which is manifested through the withdrawal symptoms during their discontinuation.