Role of benzodiazepines in the treatment of anxiety disorders in 2014.

BACKGROUND This article aims at determining the place of benzodiazepines in the current treatment of anxiety disorders in opposition to antidepressants, neuroleptics and anticonvulsants. Belgium and France are the only two European countries which prescribe the most benzodiazepines despite the dissuasion of the international guidelines (NICE) issued in the nineties concerning the high risk of dependance of these molecules. What about the respect of these guidelines and the use of benzodiazepines in general practice in 2014? METHODS Review of the literature with the following key words "anxiety disorder, benzodiazepines, anxiolytic, treatment" in the international database of PubMed, Medline, PsycINFO, PsycARTICLES and consulting of various reference books. RESULTS No class of molecules could measure up to benzodiazepines until now, neither from the point of view of efficiency, nor from the point of view of cost-efficiency. This is why the guidelines (NICE) discourage the few available alternatives in the general practice. International figures from Belgium and France show a continuous increase in the use of benzodiazepines in the treatment of anxiety disorders, even after the nineties. Given the fact that benzodiazepines differ from one another at the level of their action profile (graphical representation in "stars") and are therefore able to relieve several symptoms simultaneously, these molecules still respond nowadays to many expectations of the clinical practitioners. CONCLUSIONS The divergence between the guidelines and the practice confirm the irreplaceability of benzodiazepines at the present time. Nevertheless, the expectation of new molecules with fewer side effects should be investigated in further research.