Long-term treatment of anxiety and risk of withdrawal. Prospective comparison of clorazepate and buspirone

Arch Gen Psychiatry. 1988 May;45(5):444-50. doi: 10.1001/archpsyc.1988.01800290060008.

Abstract

Risk of withdrawal was investigated in a prospective, double-blind comparison of clorazepate dipotassium, a benzodiazepine with a long half-life, and the nonbenzodiazepine buspirone hydrochloride in the long-term treatment of anxious outpatients. Patients were treated with therapeutic doses of clorazepate dipotassium (15 to 60 mg/d) or buspirone hydrochloride (10 to 40 mg/d) for six continuous months before their tranquilizer therapy was blindly and abruptly stopped. There was a significant increase in symptom severity consistent with a withdrawal reaction for the clorazepate group but not the buspirone group. For the clorazepate group, there was a suggestion that previous discontinuous exposure to benzodiazepines might sensitize patients to subsequent withdrawal effects. For the buspirone group, a higher dropout rate raised questions about patient satisfaction with therapy in this rather chronically anxious population.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anti-Anxiety Agents / adverse effects*
  • Anxiety Disorders / drug therapy*
  • Anxiety Disorders / psychology
  • Buspirone / adverse effects*
  • Buspirone / therapeutic use
  • Clinical Trials as Topic
  • Clorazepate Dipotassium / adverse effects*
  • Clorazepate Dipotassium / therapeutic use
  • Double-Blind Method
  • Drug Tolerance
  • Female
  • Humans
  • Male
  • Outcome and Process Assessment, Health Care
  • Panic
  • Patient Compliance
  • Patient Dropouts
  • Personality Inventory
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Substance Withdrawal Syndrome / diagnosis
  • Substance Withdrawal Syndrome / etiology*
  • Substance Withdrawal Syndrome / psychology

Substances

  • Anti-Anxiety Agents
  • Clorazepate Dipotassium
  • Buspirone