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Memory functions, alprazolam and exposure therapy: a controlled longitudinal study of agoraphobia with panic disorder

Published online by Cambridge University Press:  09 July 2009

H. V. Curran ,
A. Bond ,
G. O'Sullivan ,
M. Bruce ,
I. Marks ,
P. Lelliot ,
P. Shine  and
M. Lader
H. V. Curran*
Affiliation:
Institute of Psychiatry, London
A. Bond
Affiliation:
Institute of Psychiatry, London
G. O'Sullivan
Affiliation:
Institute of Psychiatry, London
M. Bruce
Affiliation:
Institute of Psychiatry, London
I. Marks
Affiliation:
Institute of Psychiatry, London
P. Lelliot
Affiliation:
Institute of Psychiatry, London
P. Shine
Affiliation:
Institute of Psychiatry, London
M. Lader
Affiliation:
Institute of Psychiatry, London
*
1Address for correspondence: Dr H. Valerie Curran, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
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Synopsis

Benzodiazepines (BZs) produce transient anterograde amnesia when given to normal subjects. The present longitudinal study assessed whether BZs impair memory functions in a clinically anxious group. Eighty-two agoraphobics with panic disorder were randomly allocated to one of four treatment groups resulting from a combination of two drug treatments (alprazolam or placebo) and two psychological treatments (exposure or relaxation). Of these, 38 subjects were assessed on a range of objective and subjective indices of memory and mood at three time points: before treatment, after 8 weeks of treatment and again at 24 weeks when patients had been free of medication from 5–8 weeks.

Alprazolam produced pronounced impairments on a word recall task. At the 24-week medication-free follow-up, alprazolam patients were still impaired on the task compared with placebo patients. Alprazolam did not impair performance on an implicit memory task and did not affect digit span. Differences between psychological treatments emerged mainly in subjective memory effects. Findings are discussed in terms of the specificity of BZ-induced amnesia and differential tolerance to the varying effects of BZs. Implications are drawn out for the patient's ability to function optimally in daily life while taking alprazolam.

Type
Original Articles
Information
Psychological Medicine , Volume 24 , Issue 4 , November 1994 , pp. 969 - 976
Copyright
Copyright © Cambridge University Press 1994

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References

Allen, D., Curran, H. V. & Lader, M. H. (1991). The effects of repeated doses of clomipramine and alprazolam on physiological, psychomotor and cognitive functions in normal subjects. European Journal of Clinical Pharmacology 40, 355–362.CrossRefGoogle ScholarPubMed
Baddeley, A., Sunderland, A. & Harris, J. (1982). How well do laboratory-based psychological tests predict patients performance outside the laboratory? Aging 19, 141–148.Google Scholar
Bennett-Levy, J. & Powell, G. E. (1980). The subjective memory questionnaire (SMQ). An investigation into the self-reporting of ‘ real-life’ memory skills. British Journal of Clinical Psychology 19, 177–188.Google Scholar
Bond, A. J., James, D. C. & Lader, M. H. (1974). Physiological and psychological measures in anxious patients. Psychological Medicine 4, 364–373.CrossRefGoogle ScholarPubMed
Bond, A. J. & Lader, M. H. (1972). Residual effects of hypnotics. Psychopharmacologia 25, 117–132.CrossRefGoogle ScholarPubMed
Bond, A. J. & Lader, M. H. (1974). The use of analogue scales in rating subjective feelings. British Journal of Medical Psychology 47, 211–218.CrossRefGoogle Scholar
Curran, H. V. (1986). Tranquillising memories: a review of the effects of benzodiazepines on human memory. Biological Psychology 23, 179–213.CrossRefGoogle ScholarPubMed
Curran, H. V. (1991). Benzodiazepines, memory and mood: a review. Psychopharmacology 105, 1–8.CrossRefGoogle ScholarPubMed
Curran, H. V. (1992). Memory functions, alertness and mood of long-term benzodiazepine users: a preliminary investigation of the effects of a normal daily dose. Journal of Psychopharmacology 6, 69–75.CrossRefGoogle ScholarPubMed
Curran, H. V. & Gorenstein, C. (1993). Differential effects of lorazepam and oxazepam on priming. International Clinical Psychopharmacology 8, 37–42.CrossRefGoogle ScholarPubMed
Curran, H. V., Silveira, J. & Bond, A. J. (1994). Amnestic effects of alprazolam, of alcohol and of their combination. Manuscript in preparation.Google Scholar
File, S. E. & Lister, R. G. (1983). Does tolerance to lorazepam develop with once weekly dosing? British Journal of Clinical Pharmacology 16, 645–650.CrossRefGoogle ScholarPubMed
Frith, C. D. (1967). The effects of nicotine on tapping. Life Sciences 6, 321–326.CrossRefGoogle ScholarPubMed
Ghoneim, M. M. & Mewaldt, S. P. (1990). Benzodiazepines and human memory: a review. Anaesthesiology 72, 926–938.Google ScholarPubMed
Ghoneim, M. M., Mewaldt, S. P., Berie, J. L. & Hinrichs, J. V. (1981). Memory and performance effects of single and 3-week administration of diazepam. Psychopharmacology 73, 147–151.CrossRefGoogle ScholarPubMed
Golombok, S., Moodley, P. & Lader, M. (1988). Cognitive impairment in long-term benzodiazepine users. Psychological Medicine 18, 365–374.CrossRefGoogle ScholarPubMed
Graf, P., Squire, L. R. & Mandler, G. (1984). The information that amnesic patients do not forget. Journal of Experimental Psychology: Learning, Memory and Cognition 10, 164–178.Google Scholar
Lucki, I., Rickels, K. & Geller, A. M. (1986). Chronic use of benzodiazepines and psychomotor and cognitive test performance. Psychopharmacology 88, 426–433.CrossRefGoogle ScholarPubMed
Marks, I. M., Swinson, R. P., Basoglu, M., Kuch, K., Noshirvani, H., O'Sullivan, G., Lelliot, P., Kirby, G., McNamee, G., Sengun, S. & Wickwire, K. (1993). Alprazolam and exposure alone and combined in panic disorder with agoraphobia. A controlled study in London and Toronto. British Journal of Psychiatry 162, 776–787.CrossRefGoogle ScholarPubMed
Mathews, A. & MacLeod, C. (1985). Selective processing of threat cues in anxiety states. Behavior Research and Therapy 23, 563–569.CrossRefGoogle ScholarPubMed
Morton, S. & Lader, M. (1992). Alpidem and lorazepam in the treatment of patients with anxiety disorders: comparison of physiological and psychological effects. Pharmacopsychiatry 25, 177–181.CrossRefGoogle ScholarPubMed
Sellal, F., Danion, J.-M., Kauffmann-Muller, F., Grange, D., Imbs, J.-L., Van der Linden, M. & Singer, L. (1992). Differential effects of diazepam or lorazepam on repetition priming in healthy volunteers. Psychopharmacology 108, 371–379.CrossRefGoogle ScholarPubMed
Wardle, J. (1990). Behaviour therapy and benzodiazepines: allies or antagonists? British Journal of Psychiatry 156, 163–168.CrossRefGoogle ScholarPubMed