Double-blind clinical study comparing alprazolam and doxepin in primary unipolar depression

Ansseau, Marc; Ansoms, C.; Beckers, Goedele M.A.; Bogaerts, M.; Botte, L.; Buck, René De; S, Diricq; Dumortier, A; Jansegers, E.; Owieczka, J.; Stellamans, G.

doi:10.1016/0165-0327(84)90050-8

Cited by 24 publications

(7 citation statements)

References 12 publications

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“…The dropout rate was significantly greater with TCA in 2 studies [46,51]; in Ansseau et al [53], it was significantly more common with diazepam than with amitriptyline due to ineffectiveness after 2 weeks. Adverse reactions, such as anticholinergic symptoms, were significantly more frequent with TCA in 5 studies [42,[44][45][46]53], but no differences were observed between TCA and BZD in 3 other reports [41,47,52].…”

Section: Systematic Review Of Rct On the Efficacy Of Bzd In The Treatmentioning

confidence: 95%

“…Participants were assigned at random to the conditions in all studies, and all were double-blind trials. ITT analyses were performed in 8 reports [19,20,23,28,30,31,42,53], completers' data only were reported in 12 studies [25,27,29,37,39,41,44,45,47,49,50,54], and handling of attrition was not reported in 2 studies [46,48].…”

Section: Meta-analysis On the Efficacy Of Bzd In The Treatment Of Depmentioning

confidence: 99%

“…Fourteen reports compared BZD and TCA in the treatment of depression [41,42], major depressive disorder [43][44][45][46][47], and serious forms of endogenous depression [48][49][50][51][52][53] including 1 with melancholic characteristics [54] (online suppl. Table 1).…”

Section: Systematic Review Of Rct On the Efficacy Of Bzd In The Treatmentioning

confidence: 99%

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Benzodiazepines as a Monotherapy in Depressive Disorders: A Systematic Review

Benasi¹,

Guidi²,

Offidani³

et al. 2018

Psychother Psychosom

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Background: The aim of this paper was to perform a systematic review and, when feasible, a meta-analysis of randomized controlled trials (RCT) which used benzodiazepines (BZD) as a monotherapy versus placebo, antidepressant drugs (AD), or both. Methods: Keyword searches were conducted for identifying RCT comparing BZD and AD, and/or placebo in the treatment of depression, using electronic databases from their inception up to April 2017. We selected reports of RCT in which BZD were compared to AD and/or placebo in the treatment of adult patients with a primary diagnosis of depressive disorder or anxious depression. When feasible, data were subjected to meta-analysis. Results: A total of 38 studies met the criteria for inclusion and were then included in the systematic review. Only 1 study concerned a newer AD, fluvoxamine. For the meta-analysis, we submitted data on response rate from 22 RCT, considering BZD versus placebo (8 comparisons) and BZD versus tricyclic antidepressants (TCA) (20 comparisons). There was a lack of significant differences as to response rate between BZD and placebo, as well as between BZD and TCA. Analysis of individual studies disclosed that, in more than half of the studies comparing BZD to TCA and/or placebo, BZD were significantly more effective than placebo and as effective as TCA. Conclusions: BZD are a therapeutic option in anxious depression and there are no indications that AD are preferable. There is a pressing need for RCT of adequate methodological quality and follow-up comparing BZD to second-generation AD and placebo in anxious depression.

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Section: Systematic Review Of Rct On the Efficacy Of Bzd In The Treatmentioning

confidence: 95%

Section: Meta-analysis On the Efficacy Of Bzd In The Treatment Of Depmentioning

confidence: 99%

See 1 more Smart Citation

Benzodiazepines as a Monotherapy in Depressive Disorders: A Systematic Review

Benasi¹,

Guidi²,

Offidani³

et al. 2018

Psychother Psychosom

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“…First-line treatments in depression are tricyclic antidepressants (TCAs). Clinical studies in depressed patients showed that alprazolam is at least equally effective as TCAs, such as amitriptyline (13,66,76,126,157,249), imipramine (84,86,87,180,212,277), dosulepine (41), desipramine (85,210), or doxepin (9). However, other studies reported that, although alprazolam provided symptom relief, amitriptyline (124,159,227) and imipramine (103,161) were significantly more effective.…”

Section: Depressionmentioning

confidence: 99%

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

2004

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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.

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“…Nonetheless, re cently, alprazolam, a new triazobenzodiaze pine. was purported as effective as tradi tional antidepressants in major depressive disorders [133] or anxious depression [4], A benzodiazepine obviously would present po tentially less side effects than tricyclics. Thus, clinicians may be inclined to select alprazolam for the medically ill who suffers from a major depressive episode.…”

Section: The Use O F Antidepressant Drugsmentioning

confidence: 99%

Management of Depression in Medical Patients

Fava

Sonino

Wise

1988

Psychother Psychosom

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The management of depression in the medically ill is a complex task that requires considerable clinical skills. The aim of this review is to outline evaluation strategies which may lead to a more effective use of current psychiatric diagnostic criteria and to suggest clinical guidelines for the use of antidepressant medications and psychotherapeutic techniques. The multifactorial determinants and modes of expression of depression in the medical patient require further research. Treatment outcome studies involving drug treatment or short-term psychotherapeutic approaches or both are needed. Antidepressant drugs remain the most specific and readily available treatment of major depressive disorders in the setting of medical disease. In case of organic affective syndromes, treatment should be primarily directed to the physical condition.

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Double-blind clinical study comparing alprazolam and doxepin in primary unipolar depression

Cited by 24 publications

References 12 publications

Benzodiazepines as a Monotherapy in Depressive Disorders: A Systematic Review

Benzodiazepines as a Monotherapy in Depressive Disorders: A Systematic Review

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

Management of Depression in Medical Patients

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