The efficacy and safety of alprazolam versus other benzodiazepines in the
treatment of panic disorder.
Author(s): Moylan S, Staples J, Ward SA, Rogerson J, Stein DJ, Berk M.
Affiliation(s): School of Medicine, Deakin University, Geelong, Victoria, Australia.
steven.moylan@deakin.edu.au
Publication date & source: 2011, J Clin Psychopharmacol. , 31(5):647-52
We performed a meta-analysis of all single- or double-blind, randomized
controlled trials comparing alprazolam to another benzodiazepine in the treatment
of adult patients meeting the Diagnostic and Statistical Manual of Mental
Disorders, Third or Fourth Edition, criteria for panic disorder or agoraphobia
with panic attacks. Eight studies met inclusion criteria, describing a total of
at least 631 randomized patients. In the pooled results, there were no
significant differences in efficacy between alprazolam and the comparator
benzodiazepines on any of the prespecified outcomes: improvement in mean panic
attack frequency (between-arm weighted mean difference of 0.6 panic attacks per
week; 95% confidence interval [CI], -0.3 to 1.6), improvement in Hamilton Anxiety
Rating Scale score (weighted mean difference of 0.8 points; 95% CI, -0.5 to 2.1),
and proportion of patients free of panic attacks at the final evaluation (pooled
relative risk, 1.1; 95% CI, 0.9-1.4). Statistical heterogeneity on prespecified
outcomes was not eliminated by stratification on baseline anxiety level. The
available evidence fails to demonstrate alprazolam as superior to other
benzodiazepines for the treatment of panic disorder.
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