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July 29, 1974

Drugs for Anxiety

JAMA. 1974;229(5):521. doi:10.1001/jama.1974.03230430015009

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To the Editor.—  Your editorial, "Drugs for Anxiety" (228:875, 1974), prompts an uneasy feeling that has been growing on me for some time. Diazepam is cited as a safe drug not particularly subject to abuse when prescribed on an as-needed basis with a cover statement that some psychic distress should not be alarming. This is floridly at variance with my uncollated experience; in fact, so much so that I regard it as virtually a "once on, never off" preparation. I have long prescribed it only for stressful circumstances of clearly brief duration. Despite this precaution, I never prescribe it without a heartfelt sigh, knowing how frequently the initial prescription will be followed not by the requested visits for discussion, but by calls from the pharmacist relaying ever more frequent requests for refills, and then psychotherapy-by-telephone as the patient attempts to justify his need for the drug in three minutes rather