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April 9, 1982

Prescribing of Benzodiazepines

Author Affiliations

Jefferson Medical College Philadelphia

JAMA. 1982;247(14):1936. doi:10.1001/jama.1982.03320390020015

To the Editor.—  The report by Hasday and Karch investigating benzodiazepine prescribing in a family medical center states in its opening paragraph that diazepam "is now the most widely prescribed drug in the United States." This was true in 1973, but in 1981 diazepam was the fourth most widely written outpatient prescription, trailing behind cimetidine, propranolol, and ibuprofen (Pharmaceutical Data Services, September 1981).It is surprising to learn that only 65 (3.4%) of 1,886 benzodiazepine prescriptions were written to be "taken as needed" or "taken as directed" in the studied center. This would seem to indicate that there is a low incidence of intermittent anxiety among the population studied, assuming that a pro re nata medication would be more appropriate therapy for an intermittent anxiety disorder.2 In my outpatient experience at several hospitals during my training, I have found far more frequent indication for pro re nata usage of