A Comparison of the Efficacy and Safety of Alprazolam and Desipramine in Depressed Outpatients

Remick, Ronald A.; Keller, Fritz-Eugen; Buchanan, R. A.; Gibson, Ronald E.; Fleming, J. E. E.

doi:10.1177/070674378803300703

Cited by 21 publications

(11 citation statements)

References 8 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%

“…Dropout rates were estimated to be approximately similar for both medication classes in 4 studies [43,45,47,52]. However, in Hubain et al [52], a significantly greater number of alprazolam-treated patients dropped out of the study (due to ineffectiveness) than amitriptylinetreated patients.…”

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

confidence: 99%

“…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%

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

confidence: 99%

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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show abstract

“…Because of these characteristics, benzodiazepines are best suited for use on an as-needed basis. Alprazolam is one of the most widely used benzodiazepines, and it has been found to confer a unique antidepressant effect, unlike other benzodiazepines, which typically tend toward the opposite 68–70. Thus, for an individual with a mix of depressive symptoms and situational anxiety, alprazolam may be a good option.…”

Section: Treatmentmentioning

confidence: 99%

Management of the psychological comorbidities of dermatological conditions: practitioners' guidelines

Connor¹

2017

CCID

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Dermatological disease can be devastating for patients, and although dermatologists are focused on remedying the cutaneous manifestations of these conditions, it is easy to miss the psychological suffering lurking below. Studies reveal that psychiatric comorbidity in dermatology is highly prevalent. Undetected psychopathology can greatly decrease a patient’s quality of life and even contribute significantly to the clinical severity of their skin disease. For these reasons, it is vital that practitioners learn to detect psychological distress when it is present, and it is equally essential that they understand the treatment options available for effective intervention. Without training in psychiatric diagnosis and psychopharmacology, dermatologists can easily feel overwhelmed or out of their comfort zone when faced with the need to manage such conditions, but with the negative stigma associated with psychiatric disease in general, a psychiatric referral is often refused by patients, and the dermatologist is thus left with the responsibility. Uncertainty abounds in such situations, but this review seeks to alleviate the discomfort with psychodermatological disease and share practical and impactful recommendations to assist in diagnosis and treatment. In a busy dermatology clinic, the key is effective and efficient screening, combined with a repertoire of pharmacological and non-pharmacological treatment options that can be dispersed through an algorithmic approach according to the specific findings of that screening. By implementing these recommendations into practice, dermatologists may begin to gain comfort with the management of psychocutaneous disease and, as a specialty, may expand to fill a hole in patient care that is truly significant for patients, their families, and our communities as a whole.

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“…Unwanted adverse effects can be limited by gradual titration to an effective dose. Alprazolam also has another advantage over the older benzodiazepines in that it may have an antidepressant effect, whereas most other benzodiazepines have a depressant effect [Remick et al, 1988;Schatzberg and Cole, 1978]. Daytime drowsiness is the main side effect of BZ, but this usually subsides after several days of treatment or can be controlled by dosage adjustment.…”

Section: Specific Medicationsmentioning

confidence: 99%

Psychopharmacology in Dermatological Practice: A Review and Update

Lee¹,

Murase²,

Koo³

et al. 2003

Dermatol Psychosom

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A significant proportion of patients seen in an average dermatologic practice have psychosocial issues associated with their skin disease. There are at least two ways to classify psychodermatologic cases: by the category of psychodermatologic disorder and by the nature of the underlying psychopathologic condition. The categories of psychodermatologic disorders are psychophysiologic disorders, primary psychiatric disorders, secondary psychiatric disorders, cutaneous sensory disorders, and the use of psychopharmacologic agents for purely dermatologic (i.e., non-psychiatric) cases. There are four major underlying psychopathologic conditions seen in dermatology: anxiety disorder, depression, psychosis, and obsessive-compulsive disorder (OCD). For the treatment of chronic anxiety, we recommend as first-line therapy Buspar®. Our next best choices then fall to low-dose doxepin or paroxetine, and lastly benzodiazepines. In the pharmacotherapy of depression, selective serotonin reuptake inhibitors (SSRI) or non-selective serotonin reuptake inhibitors and non-tricyclic antidepressants are to be tried first and if those are unsuccessful, tricyclic antidepressants, for which doxepin would be an excellent choice, can be used. For patients with both anxiety/agitation and depression, doxepin and nefazadone (Serzone®) would be excellent first choices with venlafaxine as second-line therapy. For the treatment of dermatologic psychotic disorders, pimozide is still the first choice of the authors, but risperidone may be equally beneficial for treating these patients with fewer side effects. For OCD, SSRIs are the treatments of choice. This paper presents an overview of psychopharmacology for the practicing dermatologist. A short discussion is made of psychodermatologic disorders and the nature of underlying psychopathologic conditions. Pharmacologic recommendations and updates are provided to create a framework for dealing with these challenging patients.

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A Comparison of the Efficacy and Safety of Alprazolam and Desipramine in Depressed Outpatients

Cited by 21 publications

References 8 publications

Benzodiazepines as a Monotherapy in Depressive Disorders: A Systematic Review

Benzodiazepines as a Monotherapy in Depressive Disorders: A Systematic Review

Management of the psychological comorbidities of dermatological conditions: practitioners' guidelines

Psychopharmacology in Dermatological Practice: A Review and Update

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A Comparison of the Efficacy and Safety of Alprazolam and Desipramine in Depressed Outpatients

Cited by 21 publications

References 8 publications

Benzodiazepines as a Monotherapy in Depressive Disorders: A Systematic Review

Benzodiazepines as a Monotherapy in Depressive Disorders: A Systematic Review

Management of the psychological comorbidities of dermatological conditions: practitioners&#39; guidelines

Psychopharmacology in Dermatological Practice: A Review and Update

Contact Info

Product

Resources

About

Management of the psychological comorbidities of dermatological conditions: practitioners' guidelines