Gardner, D.L. & Cowdry,
Am. J. Psychiatry. 1985
- Alprazolam-induced dyscontrol in borderline
The short-acting benzodiazepine
alprazolam has been associated with precipitating serious
dyscontrol in one placebo-controlled crossover study of
patients with BPD The authors suggest that
caution be used in prescribing alprazolam to patients with similar histories.
/ carbamazepine and trifluoperazine and tranylcypromine.
Cowdry RW, Gardner DL. -
Intramural Research Program, National Institute of Mental Health, Bethesda
Arch Gen Psychiatry. 1988
- Pharmacotherapy of borderline personality disorder.
Alprazolam, carbamazepine, trifluoperazine, and tranylcypromine.
Physicians rated patients
as significantly improved relative to placebo while receiving tranylcypromine
and carbamazepine. Patients rated themselves as significantly improved
relative to placebo only while receiving tranylcypromine. Patients who
tolerated a full trial of trifluoperazine showed improvement, those receiving
carbamazepine demonstrated a marked decrease in the severity of behavioral
dyscontrol, and those receiving alprazolam had
an increase in the severity of the episodes of serious dyscontrol
SD, Tcheremissine OV, Lieving LM, ... - Department of Psychiatry and Behavioral
Sciences, Houston, USA.
(Berl). 2OO5 - Acute effects of alprazolam
on risky decision making in humans. OBJECTIVES:
The present study was designed to demonstrate a dose-response relationship
between acute alprazolam administration and human risk taking
Alprazolam administration produced dose-related changes in subjective effects,
response rates, and, most importantly, dose-dependently increased selection
of the risky response option
administration produced increases in human risk taking under
Lett Drugs Ther. 2OO5 - Alprazolam (Xanax,
and others) revisited. Alprazolam,
a widely prescribed benzodiazepine, is
effective for treatment of anxiety and panic disorder but sedation, withdrawal
symptoms and abuse are common. SSRIs are also effective and safer.
Cognitive-behavioral therapy is probably more effective in the long term.
— Benzodiazepines and SSRIs are both effective
in reducing symptoms of anxiety. Benzodiazepines have a more rapid onset
randomized controlled trials have shown that cognitive-behavioral therapy
(CBT) is at least as efficacious as drugs for treatment of panic and other
anxiety disorders; improvements are often maintained or increased in the
6-12 months after completion of treatment.
Alprazolam can cause sedation, interfere with psychomotor performance and
impair memory. In one study, a 1-mg dose of alprazolam impaired driving
ability one hour after administration... paradoxical excitement or behavioral
disinhibition may occur in some patients...
are preferred for long-term treatment.
Verster JC, Volkerts ER.
- Utrecht Institute for Pharmaceutical Sciences, Dept. of Psychopharmacology,
University of Utrecht, The Netherlands
CNS Drug Rev. 2OO4 - Clinical
pharmacology, clinical efficacy, and behavioral toxicity of alprazolam...
Alprazolam is a benzodiazepine
derivative that is currently used in the treatment of generalized anxiety,
panic attacks with or without agoraphobia, and depression. Alprazolam has
a fast onset of symptom relief (within the first week); it is unlikely
to produce dependency or abuse...
... alprazolam and imipramine
are significantly more effective than placebo in the treatment of panic
attacks, SSRIs appear to be superior
to either of the two drugs. Therefore, alprazolam
is recommended as a second line treatment option, when SSRIs are not effective
or well tolerated. In addition to its therapeutic effects, alprazolam
produces adverse effects, such as drowsiness and sedation.
is evident from these studies that alprazolam may impair performance in
a variety of skills in healthy volunteers as well as in patients
Patterson JF. - Psychiatry
Service, Harry S. Truman Memorial Veterans Hospital, Columbia
J Clin Psychiatry. 1990
- Withdrawal from alprazolam dependency using
clonazepam: clinical observations.
Clinical observations of
37 alprazolam-dependent patients are presented. Seventeen inpatients and
20 outpatients, the majority suffering from posttraumatic stress disorder,
were withdrawn from alprazolam by means of clonazepam substitution in an
... it was found that
method of discontinuation is safe and effective and, in particular,
does not pose a danger of withdrawal seizures
S, Stein MB. - Anxiety and Traumatic Stress Disorders Program, Psychiatry
Service, VA San Diego Healthcare System
Clin Psychiatry. 2OO4 - Double-blind, placebo-controlled
assessment of combined clonazepam with paroxetine... for generalized social
anxiety disorder. BACKGROUND:
Generalized social anxiety disorder (GSAD) is a pervasive form of social
evidence-based pharmacologic treatments for the disorder, selective serotonin
reuptake inhibitors (SSRIs) have become widely used and are known to be
efficacious. Monotherapy with the benzodiazepine clonazepam is also efficacious
for GSAD, but the adjunctive use of clonazepam with an SSRI to potentially
improve outcomes has not been studied to date.
At the end of the 10-week double-blind treatment, there was a trend favoring
the paroxetine/clonazepam group, who had a 79% response rate compared with
a 43% response rate for the paroxetine/placebo group.
no significant differences on other outcome measures were noted between
the 2 groups during treatment...
of clonazepam with an SSRI, in contrast to findings in panic disorder,
did not lead to more rapid resolution of symptoms in GSAD. On the other
hand, there is some evidence that the clonazepam-added group had superior
global outcomes, although power to detect
such differences in this study was small. These observations suggest that
a role for adjunctive benzodiazepines in patients with GSAD (e.g., for
augmenting SSRI partial response or nonresponse) is deserving of further
KM, Davidson JR, Potts NL,... - Department of Psychiatry and Behavioral
Sciences, Duke University Medical Center, Durham
Clin Psychopharmacol. 1998 - Discontinuation
of clonazepam in the treatment of social phobia.
with social phobia who responded well to 6 months of open-label treatment
with clonazepam were assigned to receive either continuation treatment
(CT) with clonazepam for another 5 months, or to undergo discontinuation
efficacy was compared between the CT and DT groups using three different
social phobia scales. Benzodiazepine withdrawal symptoms were also measured....
the end of 11 months of treatment with clonazepam, however, a more rapid
withdrawal rate was associated with greater distress. This
study offers preliminary evidence to suggest that continuation therapy
with clonazepam in the treatment of social phobia is safe and effective,
producing a somewhat greater clinical benefit than a slow-taper discontinuation
regime.... The study can be taken as supportive of benefit for longterm
clonazepam treatment in social phobia, as well as being compatible with
a reasonably good outcome after short-term treatment and slow taper.
JJ 3rd, Pollack MH, Otto MW,... - Department of Psychiatry, Massachusetts
General Hospital, Boston
Bull. 1998 - Long-term experience with
clonazepam in patients with a primary diagnosis of panic disorder.
204 patients followed over a 2-year period, 46 percent were receiving clonazepam
alone or in combination with an antidepressant... The main variables assessed
in this analysis included global severity of the panic disorder and stability
of clonazepam dose. All treatment groups tended to improve over time without
significant differences in outcome between groups. Clonazepam doses remained
stable over time. Results of this study
suggest that treatment of panic disorder with the HPB clonazepam achieved
and maintained a therapeutic benefit similar to that obtained with alternative
pharmacologic treatments, without the development of tolerance as manifested
by dose escalation or worsening of clinical status.
Anxiety Disorder treatments - Sertraline
Dahl AA, Ravindran A, Allgulander
C,... - Department of Clinical Cancer Research, University of Oslo, Norway.
Acta Psychiatr Scand. 2OO5
- Sertraline in generalized anxiety disorder:
efficacy in treating the psychic and somatic anxiety factors.
OBJECTIVE: The objective
was to study the efficacy of sertraline on symptoms of psychic and somatic
anxiety in patients suffering from moderate-to-severe generalized anxiety
METHOD: Out-patients with
DSM-IV GAD were randomized to 12 weeks of double-blind treatment with placebo...
RESULTS: Treatment with
sertraline resulted in significantly greater ... improvement than placebo
on both psychic and somatic anxiety factors.
treatment demonstrated efficacy for both the psychic and somatic anxiety
symptoms of GAD.
O. - Department of Mental Health, Kyorin University, School of Health Sciences.
Shinkeigaku Zasshi. 2OO4 - [Pharmacotherapy for anxiety disorders]
are considered to be a first-line treatment for the most of anxiety disorders
benzodiazepines are still widely used in clinical practice despite the
risk of dependence and strong recommendation for their use as a second-line.
of the SSRIs and the benzodiazepines is widely used. Recently it has been
suggested that the combination of SSRI and benzodiazepine is rational,
because each drug has a different mechanism of action.... Recent Imaging
studies suggested the hyperactivity of the amygdala in the patients with
generalized social anxiety disorder and
successful treatment with cognitive behavioral therapy or SSRI might
significantly reduce the hyperactivity of the amygdala.
was suggested that the rational combination of SSRIs and benzodiazepines
seems to be an effective and practical way of treatment for most anxiety
Anxiety Disorder treatments
(SSRI) Struzik L, Vermani M, Coonerty-Femiano
A,... - Faculty of Medicine,University of Toronto, Canada.
Expert Rev Neurother. 2OO4
- Treatments for generalized anxiety disorder.
Generalized anxiety disorder
is characterized by excessive chronic anxiety
in association with many somatic symptoms. The disorder has
pervasive effects on quality of life, including work, social and educational
aspects and requires long-term therapy. Available studies in patients are
the DSM III R and fourth edition, which have defined generalized anxiety
disorder and demonstrate the efficacy of benzodiazepines,
azapirones, some antidepressants and psychotherapy. Benzodiazepines are
effective anxiolytics for short-term use but are accompanied by many adverse
events. The antidepressants, paroxetine and venlafaxine (Effexor),
have demonstrated efficacy in patients with generalized anxiety disorder
with mild side-effect profiles...
Long-term efficacy has been
shown with venlafaxine in the treatment of this chronic condition, confirming
that as in depression, the goal must not just be remission beyond simple
symptom resolution but also on to improved functioning and quality of life.
Psychotherapy with applied relaxation, cognitive therapy and cognitive
behavioral therapy show the most promise in resolving and maintaining treatment
gains in the long-term...
on current evidence, the recommended approach to achieving long-term benefits
for patients with generalized anxiety disorder is antidepressant therapy
with paroxetine or venlafaxine in combination with cognitive behavioral
Warning: All the information
in this site is aimed at helping people understand a "rather particular"
and puzzling kind of disease But more especially,
to support everyone affected by it, sick or not. In any case, it
to see a therapist who specialises in this
field they can confirm or give an alternative diagnosis The name of what
you’ve got doesn’t matter so much, getting the right treatment for the
right patient does .
last update august 2007 Copyright
federation - All rights reserved
Alain Tortosa, psychotherapist, founder president of the Aapel