Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-22T07:59:43.607Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of the Efficacy, Safety and Withdrawal of Alpidem and Alprazolam in Anxious Patients

Published online by Cambridge University Press:  02 January 2018

Lodovico Frattola ,
Martine Garreau ,
Roberto Piolti ,
Sirio Bassi ,
Maria G. Albizzati ,
Cristina Borghi  and
Paolo L. Morselli
Lodovico Frattola
Affiliation:
University of Milan, San Gerardo Hospital, Italy
Martine Garreau*
Affiliation:
Clinical Research Department, Synthélabo Recherche, Bagneux, France
Roberto Piolti
Affiliation:
University of Milan, San Gerardo Hospital, Italy
Sirio Bassi
Affiliation:
Neurology Division, Bassini Hospital, Milan, Italy
Maria G. Albizzati
Affiliation:
Neurology Division, Bassini Hospital, Milan, Italy
Cristina Borghi
Affiliation:
Synthélabo Recherche Italy, Milan, Italy
Paolo L. Morselli
Affiliation:
Synthélabo Recherche, Bagneux, France
*
Dr Martine Garreau, Clinical Research Department, Synthélabo Recherche, 31 me Paul Vaillant Couturier, 92200 Bagneux, France
Get access Rights & Permissions [Opens in a new window]

Extract

Background

We investigated whether a new non-benzodiazepine anti-anxiety drug, alpidem, produces weaker withdrawal symptoms than alprazolam.

Method

Under a double-blind procedure, 122 patients suffering from general anxiety disorders were randomly allocated to either alpidem (50 mg, three times a day) or alprazolam (0.5 mg, three times a day) for six weeks, followed by a two-week placebo withdrawal phase. The diagnosis of withdrawal syndrome (WS) was made, in blind conditions, on the basis of the Withdrawal Symptom Check List (WSCL), after one or two weeks of discontinuation of active treatment.

Results

The WS occurred significantly less frequently in the alpidem group (n = 10, 18%) than in the alprazolam group (n = 26, 48%). Typical withdrawal symptoms on the WSCL were also significantly less severe (P = 0.044) in the alpidem group compared with the alprazolam group.

Conclusions

Alpidem may be a valid alternative to current benzodiazepine anxiolytic therapy because it produces fewer and weaker withdrawal symptoms than alprazolam and is better tolerated.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 165 , Issue 1 , July 1994 , pp. 94 - 100
Copyright
Copyright © Royal College of Psychiatrists, 1994 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
American Psychiatric Association (APA) Task Force (1990) Report on Benzodiazepine Dependence, Toxicity and Abuse. Washington, DC: APA.Google Scholar
Ashton, H. (1984) BDZ withdrawal: an unfinished story. British Medical Journal, 288, 1135–1140.Google Scholar
Bartholini, G. (1988) Non-benzodiazepine anxiolytic and hypnotics: concluding remarks. Pharmacology, Biochemistry and Behavior, 29, 833–834.Google Scholar
Bianchetti, G., Thiercelin, J. F., Jonkman, , et al (1987) Pharmacokinetic profile of alpidem, a new anxiolytic, in healthy volunteers. Proceedings of the Third European Congress of Biopharmaceutics and Pharmacokinetics. Freiburg: abstract no. 339.Google Scholar
Casacchia, M. & Borghi, C. (1993) Life stress event models as a predictor of anti-anxiety action: a review of 5 controlled studies. In Imidazopyridines in Anxiety Disorders: A Novel Experimental and Therapeutic Approach (eds Bartholini, G., Garreau, M., Morselli, P. L., et al), pp. 175–182. New York: Raven Press.Google Scholar
Dimsdale, M., Friedmann, J. C., Morselli, P. L., et al (1988) Alpidem. Drugs of the Future, 13, 106–109.CrossRefGoogle Scholar
ECDEU (1976) Assessment Manual for Psychopharmacology, Revised, 1976 (ed. Guy, W.). Rockville: US Department of Health Education and Welfare, NIMH.Google Scholar
Fontaine, R., Chouinard, G. & Annable, L. (1984) Rebound anxiety in anxious patients after abrupt withdrawal of benzodiazepine treatment. American Journal of Psychiatry, 1141, 848–852.Google Scholar
Frattola, L., Piolti, R., Bassi, S., et al (1992) Effects of alpidem in anxious elderly out-patients: a double-blind, placebo controlled trial. Clinical Neuropharmacology, 15, 477–487.Google Scholar
Fyer, A. J., Liebowitz, M. R., Gorman, J. M., et al (1987) Discontinuation of alprazolam treatment in panic patients. American Journal of Psychiatry, 144, 303–308.Google Scholar
Hamilton, M. (1959) The assessment of anxiety by rating. British Journal of Medical Psychology, 32, 50–55.Google Scholar
Kybuz, E. (1989) Serendipity in drug discovery. The case of BZR ligands. Il Farmaco, 44, 345–382.Google Scholar
Lader, M. (1978) Benzodiazepine: the opium of the masses. Neuroscience, 3, 159–165.CrossRefGoogle ScholarPubMed
Lader, M. & Petursson, H. (1981) Benzodiazepine derivatives – side effects and dangers. Biological Psychiatry, 16, 1195–1200.Google Scholar
Lader, M. & Petursson, H. (1984) Computed axial brain tomography in long-term BDZ users. Psychological Medicine, 14, 203–206.Google Scholar
Langer, S. Z. & Arbilla, S. (1988) Imidazopyridines as a tool for the characterization of benzodiazepine receptors: a proposal for a pharmacological classification as Omega receptor subtypes. Pharmacology, Biochemistry and Behavior, 29, 763–766.CrossRefGoogle ScholarPubMed
Montgomery, S. A. & Åsberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.CrossRefGoogle ScholarPubMed
Morselli, P. L. (1990) On the therapeutic action of alpidem in anxiety disorders: an overview of the European data. Pharmacopsychiatry, 23, 129–134.Google Scholar
Murphy, S. M., Owen, R. T. & Tyrer, P. J. (1984) Withdrawal symptoms after 6 weeks' treatment with diazepam. Lancet, ii, 1389.CrossRefGoogle Scholar
Noyes, R. Jr, Garvey, M. J., Cook, B. L., et al (1988) Benzodiazepine withdrawal: a review of the evidence. Journal of Clinical Psychiatry, 49, 382–389.Google Scholar
Owen, R. T. & Tyrer, P. (1983) Benzodiazepine dependence: a review of the evidence. Drugs, 25, 385–398.Google Scholar
Pancheri, P., Pede, P., Donnini, M., et al (1989) Alpidem, a novel anxiolytic drug: a double blind comparison versus diazepam. New Trends in Experimental and Clinical Psychiatry, 5, 23–30.Google Scholar
Petursson, H. & Lader, M. (1984) Dependence of tranquillizers. In Maudsley Monograph No 28. London: Oxford University Press.Google Scholar
Power, K. G., Jerrom, D. W. A., Simpson, R. J., et al (1985) Controlled study of withdrawal symptoms and rebound anxiety after six week course of diazepam for generalized anxiety. British Journal of Medicine, 290, 1246–1248.Google Scholar
Rickels, K. (1980) Benzodiazepines: clinical use patterns. In Benzodiazepines: A Review of Research Results (eds Sarza, S. I. & Ludford, J. P.). Washington: United States of America Government Printing Office.Google Scholar
Rickels, K., Schweizer, E., Csanalosi, I., et al (1988) Long-term treatment of anxiety and risk of withdrawal. Prospective comparison of clorazepate and buspirone. Archives of General Psychiatry, 45, 444–450.Google Scholar
Roy-Byrne, P. P. & Hommer, D. (1988) Benzodiazepine withdrawal: overview and implications for the treatment of anxiety. American Journal of Medicine, 84, 1041–1052.CrossRefGoogle ScholarPubMed
Spielberger, C. D., Gorsuch, R. L. & Lushene, R., et al (1983) Manual for the State-Trait Anxiety Inventory. Palo Alto: Consulting Psychologists Press.Google Scholar
Tyrer, P., Rutherford, D. & Huggett, T. (1981) Benzodiazepine withdrawal symptoms and propranolol. Lancet, i, 520–522.Google Scholar
Tyrer, P., Owen, R. & Dawling, S. (1983) Gradual withdrawal of diazepam after long-term therapy. Lancet, i, 1402–1406.CrossRefGoogle Scholar
Tyrer, P., Murphy, S. & Riley, P. (1990) The benzodiazepine withdrawal symptom questionnaire. Journal of Affective Disorders, 19, 53–61.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.