Treatment options and anxiety disorders

Sir, – I note with regret the renewed pressure being applied by the Medical Council to general practitioners regarding their prescribing practices for patients with anxiety ("Doctors warned to reduce prescribing of sedatives", News, September 19th).

The treatment options for patients suffering from anxiety disorders must be informed by the needs of the individual patient, rather than being judged by abstract prescribing statistics.

The unfortunate reality is that there is no “one size fits all” treatment that is effective for all patients with anxiety disorders, which span a wide range of conditions from obsessive compulsive disorder (OCD) to panic disorder. There is no doubting the effectiveness of the class of drugs known as benzodiazepines or minor tranquillisers, which act to rebalance brain chemicals by increasing the GABA neurotransmitter, producing an anxiolytic (calming) effect. These positive effects create a very real risk of abuse and addiction, which are the main dangers associated with the medication, and therefore it is vital that other treatment options, such as anti-depressants and cognitive behavioural therapy (CBT) are considered.

However, there must be scope for a physician to do so taking a patient’s individual circumstances into account, including the fact that the patient may not be able to afford expensive CBT sessions.

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The fact that anxiety disorders are at such a high level reflects a society ill at ease with itself. This is what should be addressed, rather than scapegoating doctors left picking up the pieces. – Yours, etc,

LEOPOLD SMITH,

Balbriggan,

Co Dublin.