A recent study led by Patricia Berney, MD of the Geneva University Hospitals shows that antidepressants are becoming the prescribers choice over benzodiazepine drugs like Valium. This is a drastic shift from just a decade ago when the benzo drugs like Valium were considered the most effective treatment for anxiety disorders. What is interesting about the study isn’t that antidepressant prescriptions are soaring. Rather, the study shows that doctors are choosing antidepressants without any solid evidence showing that they are more effective than benzodiazepines like Valium.
Before any drug gets approval from the FDA or other regulatory agencies, it must be thoroughly tested for efficacy, risks and side effects. In recent years, there have been many developments in newer, safer antidepressant drugs. However, there haven’t been any major breakthroughs in benzodiazepine drugs. Valium was the norm a decade ago and remains the norm. But the antidepressants of the past (like Elavil and Sinequan) have been replaced by new generation of SSRIs and NRIs like Effexor and Wellbutrin. Yet, as the study points out, just because antidepressants have improved, it doesn’t mean that they are better than safe benzodiazepines like Valium.
Patients like to believe that their doctors are prescribing medications based on clinical studies which show that the medicine is the best choice for their specific condition. But, in many cases, prescribing is a guesswork process. To date, there haven’t been any significant studies which directly compare benzo drugs like Valium with antidepressants. It is up to doctors to make educated guesses as to which drug will work best. In a lot of cases, a doctor has a preference for one type of drug and will prescribe that one in almost all cases. If you went to 5 different doctors with the same condition, you could end up with 5 different prescriptions for types of benzodiazepines and antidepressants!
As a patient, you can’t be expect to make a diagnosis or prescribe your own medicine. Thanks to the popularity of shows like Doctor House and Scrubs, there are already too-many amateur doctors who think they know more than their health care providers. But, patients should be expected to actively participate in the treatment process. You should make sure to tell your doctor all of your symptoms, even the ones which you think are unrelated or are embarrassing. These symptoms include sexual problems like impotence, binge eating (especially if at certain times of the day), relationship problems, and so forth.
After getting your prescription for Valium or an antidepressant, the treatment process shouldn’t stop. It is the patient’s responsibility to take the medicine as directed and report all side effects and changes to the doctor. If you are suffering from panic attacks but your doctor has given you antidepressants, then you will obviously want to bring this to the doctor’s attention so your treatment can be adjusted. But if you are incredibly sleepy from Valium, then you may need to be switched to an antidepressant. There is no one best medicine for dealing with anxiety disorders. Yes, further studies are needed but even then a lot of the prescription process will still be guesswork.