Alprazolam and Oxazepam in the Treatment of Anxious Out-Patients with Depressive Symptoms: A Double-Blind Multicenter Study

Rimón, Ranan; Kultalahti, E.-R.; Kalli, A; Koskinen, T.; Lepola, Ulla; Naarala, Mikko; Tick, E

doi:10.1055/s-2007-1014444

Cited by 9 publications

(6 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Buspirone is classified in the second place as an antidepressant. Clinically buspirone indeed seems to have antidepressant properties [51,52], Although alprazolam is clinically well known because of its antidepressant effects [53][54][55][56], it does not score as an antidepressant in this classification system. From the benzodiazepines, in general, contradictory clinical results with respect to their antidepressant activity are published but nevertheless with a slightly positive outcome.…”

Section: Discussionmentioning

confidence: 99%

“…From the benzodiazepines, in general, contradictory clinical results with respect to their antidepressant activity are published but nevertheless with a slightly positive outcome. [56][57][58][59][60], There are sever al publications in which an antipsychotic effect is de scribed for (higher doses of) benzodiazepines, alone [61] or, more especially, in combination with neuroleptics [62][63][64][65][66]. This automatic classification system did not rec ognize antipsychotic characteristics, but the power in crease from 10/15 to 25/30 Hz may be an indication for this activity.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Classification of Psychotropic Drugs Based on Pharmaco-electrocorticographic Studies in Vigilance-Controlled Rats

1993

View full text Add to dashboard Cite

The effects of a number of psycho-active drugs on electrocorticographic activity (ECoG) of the rat have been studied. Frontoparietal ECoG was recorded during 6-min periods immediately before drug/vehicle administration and starting at 20 and 45 min after administration. For each 6-min recording time, a mean power spectrum was calculated and smoothed. A quotient of the power at 20 and 45 min after and before drug, respectively, was then calculated. These quotients were used as input for an analysis of variance, followed by a t test and a normalization for the degrees of freedom, resulting in so-called n-profiles. Although each drug has its own characteristic n-profile, n-profiles of drugs belonging to the same clinical class have some characteristics in common. An automated classification system of psychotropic drugs, based on parameters extracted from n-profiles by discriminant analysis, is presented. For the antidepressant drug class the success rate of correct classification of antidepressant drugs is between 53 and 88%, for a neuroleptic drug in the neuroleptic drug class the success rate is 87%, for an anxiolytic drug in the anxiolytic drug class 100% and for a psychostimulant drug in the psycho-stimulant drug class between 86 and 100%. For a reliable classification of a drug about 10 n-profiles of active doses are needed. Using n-profiles, it appeared also possible to discriminate between antidepressant, neuroleptic, anxiolytic and psychostimulant drugs based on visual judgement. Moreover, visual evaluation of the n-profiles enables 4 subclasses to be recognized within the antidepressant class, 2 subclasses within the neuroleptic and 2 subclasses within the anxiolytic class.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Classification of Psychotropic Drugs Based on Pharmaco-electrocorticographic Studies in Vigilance-Controlled Rats

1993

View full text Add to dashboard Cite

show abstract

“…In patients with mixed depressive and anxiety disorders, benzodiazepine maintenance is generally discouraged because of the tolerance that develops to most of the anxiolytic effects of these medications. Nevertheless, some studies indicated that alprazolam, a benzodiazepine receptor agonist, is a rapid-onset antidepressant with significant therapeutic efficacy (Cropper et al 1987;Rimon et al 1991), implicating some role of gamma-aminobutyric acid (GABA) in depression, and thus, some potential association between benzodiazepine abuse and depression, and potential self-medication with benzodiazepines.…”

Section: Epidemiological and Clinical Perspectivementioning

confidence: 99%

“…Further, chronic antidepressant treatments, such as tricyclics, SSRis, MAOis, and electroshock, downregulate GABAA receptors in the frontal cortex and upregulate GABAB receptors in the frontal cortex and the hippocampus (an effect also seen with GABA agonists because GABAB receptors do not appear to follow the "classical" rules of receptor regulation), suggesting that antidepressants enhance GABAergic neurotransmission (Pile and Lloyd 1984;Lloyd et al 1985;Petty 1995; however, see Cross and Horton 1987). Finally, GABA-mimetics that are active at both GABAA and GABAB receptors, such as progabide, fengabine, and SL 76002 (Morselli et al 1980;Lloyd and Morselli 1987;Nielsen et al 1990), and a GABAA/benzodiazepine receptor agonist, alprazolam (but not other benzodiazepines; Cropper et al 1987;Rimon et al 1991;Petty et al 1995b), have been shown to be as effective as tricyclics in the treatment of depression and with a faster onset of therapeutic action for alprazolam.…”

Section: Depression and Drug Dependence 151mentioning

confidence: 99%

Neurobiological Similarities in Depression and Drug Dependence: A Self-Medication Hypothesis

Markou

1998

Neuropsychopharmacology

697

407

View full text Add to dashboard Cite

Epidemiological and clinical data indicate high comorbidity between depression and drug dependence that may reflect an attempt to self-medicate with drugs of abuse. The present review examines whether these two psychiatric disorders are related by attempting to identify similarities in the neurobiology of depression and drug dependence. Emphasis is put on the neuromechanisms that may mediate specific core symptoms of both disorders that reflect alterations in reward and motivational processes. First, the epidemiological and clinical data on the comorbidity of the two disorders are reviewed briefly. Then, the neuroadaptations associated with psychomotor stimulant, opiate, ethanol, nicotine, and benzodiazepine dependence in animals are reviewed. Finally, the neurotransmitter systems whose function appears to be altered in depression (i.e., serotonin, norepinephrine, acetylcholine, dopamine, gamma-aminobutyric acid, corticotropin releasing factor, neuropeptide Y, and somatostatin), as revealed primarily by animal studies, are discussed. It is concluded that drug dependence and depression may be associated with alterations in some of the same neurotransmitter systems and, in particular, with alterations of neurotransmitter function in limbic-related brain structures. Thus, these two psychiatric disorders may be linked by some shared neurobiology. Nevertheless, it remains unclear whether drug abuse and depression are different symptomatic expressions of the same preexisting neurobiological abnormalities, or whether repeated drug abuse leads to the abnormalities mediating depression (i.e., drug-induced depressions). The hypothesis of self-medication of non-drug- and drug-induced depressions with drugs of abuse is also discussed as a potentially important explanatory concept in understanding the observed clinical comorbidity of these two psychiatric disorders.

show abstract

“…Alprazolam has been shown to be at least equally effective in the treatment of GAD as other benzodiazepines, such as oxazepam (218,272), diazepam (4,49,61,62,71,83,95,171,213), lorazepam (50,51,119,269), clobazam (40,118), etizolam (19,30,200), bromazepam (19), and the partial benzodiazepine agonist abecarnil (170). Alprazolam has also been shown to be at least equally effective as TCAs, such as imipramine (121,178).…”

Section: Generalized Anxiety Disorder (Gad)mentioning

confidence: 99%

Clinical Pharmacology, Clinical Efficacy, and Behavioral Toxicity of Alprazolam: A Review of the Literature

2004

View full text Add to dashboard Cite

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. No tolerance to its therapeutic effect has been reported. At discontinuation of alprazolam treatment, withdrawal and rebound symptoms are common. Hence, alprazolam discontinuation must be tapered. An exhaustive review of the literature showed that alprazolam is significantly superior to placebo, and is at least equally effective in the relief of symptoms as tricyclic antidepressants (TCAs), such as imipramine. However, although alprazolam and imipramine are significantly more effective than placebo in the treatment of panic attacks, Selective Serotonin Reuptake Inhibitors (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. Since alprazolam is widely used, many clinical studies investigated its cognitive and psychomotor effects. It is evident from these studies that alprazolam may impair performance in a variety of skills in healthy volunteers as well as in patients. Since the majority of alprazolam users are outpatients, this behavioral impairment limits the safe use of alprazolam in patients routinely engaged in potentially dangerous daily activities, such as driving a car.

show abstract

Alprazolam and Oxazepam in the Treatment of Anxious Out-Patients with Depressive Symptoms: A Double-Blind Multicenter Study

Cited by 9 publications

References 3 publications

Classification of Psychotropic Drugs Based on Pharmaco-electrocorticographic Studies in Vigilance-Controlled Rats

Classification of Psychotropic Drugs Based on Pharmaco-electrocorticographic Studies in Vigilance-Controlled Rats

Neurobiological Similarities in Depression and Drug Dependence: A Self-Medication Hypothesis

Clinical Pharmacology, Clinical Efficacy, and Behavioral Toxicity of Alprazolam: A Review of the Literature

Contact Info

Product

Resources

About