Double-Blind Study of Prazepam in the Treatment of Anxiety

Dunlop, Edwin; Weisberg, Jerry

doi:10.1016/s0033-3182(68)71849-1

Cited by 11 publications

(3 citation statements)

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“…Consistent with the pharmacological activity of prazepam in animals (1, 2), the tranquilizer is effective in treating a variety of anxiety states in man (3)(4)(5)(6)(7)(8)(9)(10). Earlier reports dealt with the metabolism of prazepam in man (11-13) and the dog (14,15) and with the biotransformation of prazepam by the 9000Xg fractions prepared from human, canine, and rodent livers (13, 16).…”

mentioning

confidence: 84%

Prazepam Metabolism in the Rat

Viau¹,

Epps²,

Carlo³

1973

Journal of Pharmaceutical Sciences

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mentioning

confidence: 84%

Prazepam Metabolism in the Rat

Viau¹,

Epps²,

Carlo³

1973

Journal of Pharmaceutical Sciences

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“…Chlordiazepoxide was less effective than the new benzodiazepines in 61 % of the studies, equivalent in 31%, and more effective in 8%. [8][9][10][11][12][13][14][15][16][17][18][19][20] The variance in results emphasizes the difficulties in interpreting large numbers of comparative clinical trials. The differences between drugs may be real or illusory, and this very often depends on the size and nature of the study population and the relative dosages of each drug.…”

Section: Clinical Differencesmentioning

confidence: 99%

Is Chlordiazepoxide the Rational Choice Among Benzodiazepines?

1982

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Diazepam is frequently the subject of review by various agencies and institutions charged with determining whether or not to substitute another, more economical drug--in most instances, chlordiazepoxide. A review of the comparative literature has shown that, on clinical and pharmacokinetic grounds, chlordiazepoxide is not the drug of choice for all clinical indications recommended for the benzodiazepines as a class, particularly for use as an antianxiety agent. There is evidence that the antianxiety effect of chlordiazepoxide is related to the appearance of its two active metabolites, which may explain the observed delay in its onset of action. When chlordiazepoxide's reduced clearance in the elderly and in patients with liver disease is considered along with its limited range of indications, substitution of diazepam with chlordiazepoxide is clearly not reasonable. Diazepam and lorazepam are preferred choices in acute anxiety because they are themselves active anxiolytics. Oxazepam is recommended in alcoholic cirrhotics because its plasma clearance does not seem to be significantly affected by liver disease. Diazepam is recommended for chronic anxiety because of the rapid onset of action of diazepam itself and the smooth transition to the nondrug state via its longer-acting active metabolite.

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“…After oral intake of prazepam, the plasma appearance of desmethyldiazepam is very slow (plasma peak 6h later), possibly reducing the sedative effect (Greenblatt et al 1983). The anxiolytic properties of prazepam at a daily dose of 20-60mg have been demonstrated in many controlled studies, as both superior to placebo (Kingstone et al 1966;Sugerman et al 1971;Goldberg and Finnerty 1977;Rickels et al 1977;Warnecke 1977;Weir 1978;Fabre et al 1980) and at least equal to reference benzodiazepines (Dunlop and Weisberg 1968;Shaffer et al 1968;Kingstone et al 1969;Barbizet 1979;Fabre et al 1980).…”

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confidence: 99%

Duration of benzodiazepine clinical activity: Lack of direct relationship with plasma half-life

et al. 1984

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The anxiolytic activity and tolerance of two dosage schedules of prazepam, a long plasma half-life benzodiazepine, were compared under double-blind conditions in two groups of 10 inpatients each who met Research Diagnostic Criteria for Generalized Anxiety Disorder and presented chronic and severe symptomatology. Patients received prazepam 40 mg per day on one of two dosage schedules: divided dosage (DD) - 10 mg in the morning and at noon and 20 mg in the evening; or single dosage (SD) - 40 mg in the evening. The 3 weeks of therapy were preceded and followed by 1 week of wash-out for baseline and follow-up assessments, which were performed weekly with the Hamilton Anxiety Scale, Clinical Global Impression, rating of morning drowsiness and evening worsening of symptoms, and patient self-rating of anxiety by means of a visual analogue scale performed both in the morning and in the afternoon. The results showed a clear superiority of the DD over the SD schedule: better anxiolytic efficacy on the Hamilton Anxiety Scale (P less than 0.0005) and on both morning and afternoon visual analogue scales (P less than 0.01 and P less than 0.0002); less morning drowsiness (P less than 0.0001); and steadier anxiolytic effect during the daytime, as globally rated by the investigator (P less than 0.0001) or measured by morning-afternoon differences on the visual analogue scale (P less than 0.005). These results suggest that plasma pharmacokinetics alone may not be sufficient to predict the duration of benzodiazepine anxiolytic activity.

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Double-Blind Study of Prazepam in the Treatment of Anxiety

Cited by 11 publications

References 0 publications

Prazepam Metabolism in the Rat

Prazepam Metabolism in the Rat

Is Chlordiazepoxide the Rational Choice Among Benzodiazepines?

Duration of benzodiazepine clinical activity: Lack of direct relationship with plasma half-life

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