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Peer-reviewedCC BY-NC 4.0Clinical Psychopharmacology and Neuroscience

Real-world Longitudinal Patterns of Benzodiazepine Use in Korean Patients with First-onset Panic Disorder: A Multicenter Retrospective Study

  • Young-Chan Kim1
  • Sang-Woo Hahn2
  • Jin Pyo Hong3
  • Kyoung-Uk Lee4
  • Se Joo Kim5
  • Sang-Hyuk Lee6
  • Jong-Chul Yang7
  • Seung Jae Lee8
  • Seon-Cheol Park9
  • Min-Sook Gim10
  • Jeong-Ho Chae11
  • Ho Jun Seo1
11 affiliations
  1. 1Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
  2. 2Department of Psychiatry, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
  3. 3Department of Psychiatry, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Seoul, Korea
  4. 4Department of Psychiatry, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
  5. 5Department of Psychiatry and Institute of Behavioral Science in Medicine, College of Medicine, Yonsei University, Seoul, Korea
  6. 6Department of Psychiatry, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam, Korea
  7. 7Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Korea
  8. 8Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
  9. 9Department of Psychiatry, Hanyang University Guri Hospital, College of Medicine, Hanyang University, Seoul, Korea
  10. 10Samseong Mindforest Clinic, Seoul, Korea
  11. 11Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Abstract

Objective: Although benzodiazepines (BZDs) are recommended only for short-term adjunctive use in panic disorder, long-term use remains common in clinical practice. This study investigated real-world patterns of BZD prescribing and identified clinical factors associated with BZD dose reduction or discontinuation among BZD-initiating patients with first-onset panic disorder.

Methods: This multicenter retrospective longitudinal study included adults with first-onset panic disorder who initiated BZD treatment at psychiatric outpatient clinics between 2011 and 2023. Changes in BZD prescriptions were assessed at baseline, 3 months, and 12 months. Mixed-effects models were used to evaluate longitudinal changes in BZD dose. Logistic regression analyses examined clinical and treatment-related factors associated with BZD dose reduction or discontinuation at 12 months.

Results: Among 733 patients who initiated BZD treatment, 32.3% had reduced or discontinued BZDs at 3 months, and 45.0% had done so at 12 months, while only 16.0% achieved complete discontinuation. Mean BZD dose showed no significant change at 3 months but decreased modestly by 12 months. Initial BZD dose was not significantly associated with long-term discontinuation. Alprazolam use was associated with higher odds of dose reduction or discontinuation, whereas comorbid psychiatric disorders and concomitant buspirone use were associated with lower odds. Antidepressant use did not significantly predict BZD tapering outcomes.

Conclusion: Long-term BZD use frequently persisted among BZD-initiating patients with first-onset panic disorder despite guideline recommendations for short-term adjunctive use. A substantial proportion of patients continue BZDs beyond 12 months in real-world clinical practice, indicating a clear gap between treatment guidelines and actual prescribing patterns.

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Cite

BibTeXRIS
BibTeX
@article{kim2026realworld,
  title = {{Real-world Longitudinal Patterns of Benzodiazepine Use in Korean Patients with First-onset Panic Disorder: A Multicenter Retrospective Study}},
  author = {Young-Chan Kim and Sang-Woo Hahn and Jin Pyo Hong and Kyoung-Uk Lee and Se Joo Kim and Sang-Hyuk Lee and Jong-Chul Yang and Seung Jae Lee and Seon-Cheol Park and Min-Sook Gim and Jeong-Ho Chae and Ho Jun Seo},
  journal = {Clinical Psychopharmacology and Neuroscience},
  year = {2026},
  month = jul,
  doi = {10.9758/cpn.26.1412},
  url = {https://doi.org/10.9758/cpn.26.1412},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Real-world Longitudinal Patterns of Benzodiazepine Use in Korean Patients with First-onset Panic Disorder: A Multicenter Retrospective Study
AU  - Young-Chan Kim
AU  - Sang-Woo Hahn
AU  - Jin Pyo Hong
AU  - Kyoung-Uk Lee
AU  - Se Joo Kim
AU  - Sang-Hyuk Lee
AU  - Jong-Chul Yang
AU  - Seung Jae Lee
AU  - Seon-Cheol Park
AU  - Min-Sook Gim
AU  - Jeong-Ho Chae
AU  - Ho Jun Seo
PY  - 2026
DA  - 2026/07/08
JO  - Clinical Psychopharmacology and Neuroscience
DO  - 10.9758/cpn.26.1412
UR  - https://doi.org/10.9758/cpn.26.1412
AB  - Objective: Although benzodiazepines (BZDs) are recommended only for short-term adjunctive use in panic disorder, long-term use remains common in clinical practice. This study investigated real-world patterns of BZD prescribing and identified clinical factors associated with BZD dose reduction or discontinuation among BZD-initiating patients with first-onset panic disorder.  Methods: This multicenter retrospective longitudinal study included adults with first-onset panic disorder who initiated BZD treatment at psychiatric outpatient clinics between 2011 and 2023. Changes in BZD prescriptions were assessed at baseline, 3 months, and 12 months. Mixed-effects models were used to evaluate longitudinal changes in BZD dose. Logistic regression analyses examined clinical and treatment-related factors associated with BZD dose reduction or discontinuation at 12 months.  Results: Among 733 patients who initiated BZD treatment, 32.3% had reduced or discontinued BZDs at 3 months, and 45.0% had done so at 12 months, while only 16.0% achieved complete discontinuation. Mean BZD dose showed no significant change at 3 months but decreased modestly by 12 months. Initial BZD dose was not significantly associated with long-term discontinuation. Alprazolam use was associated with higher odds of dose reduction or discontinuation, whereas comorbid psychiatric disorders and concomitant buspirone use were associated with lower odds. Antidepressant use did not significantly predict BZD tapering outcomes.  Conclusion: Long-term BZD use frequently persisted among BZD-initiating patients with first-onset panic disorder despite guideline recommendations for short-term adjunctive use. A substantial proportion of patients continue BZDs beyond 12 months in real-world clinical practice, indicating a clear gap between treatment guidelines and actual prescribing patterns.
SN  - 1738-1088
SN  - 2093-4327
ER  -