To the Editor: Steven E. Bruce, Ph.D., et al. (1) suggested that despite current practice guidelines, benzodiazepines are being used more frequently than selective serotonin reuptake inhibitors (SSRIs) to treat panic disorder. One possible explanation for this discrepancy is that some physicians are prescribing benzodiazepines as needed for patients who experience infrequent panic attacks. (I can offer only anecdotal evidence drawn from working with dozens of physicians in emergency rooms and psychiatric and general/family medicine settings.) I would argue that this approach is reasonable because these patients only need to take a benzodiazepine periodically rather than having to take an SSRI every day for at least a year (according to APA recommendations ). The obvious advantages of this regimen are its lower cost and less frequent side effects. The disadvantage, many would argue, is that periodic use of benzodiazepines can escalate into physical dependence and abuse (2). However, this argument is based somewhat on myth because there are "no data to suggest that long-term therapeutic use of benzodiazepines by patients commonly leads to dose escalation or recreational abuse" (3).