Rebound anxiety in panic disorder patients treated with shorter-acting benzodiazepines

J Clin Psychiatry. 1987 Oct:48 Suppl:22-8.


Rebound--the relative worsening of symptoms on discontinuation of treatment as compared to baseline symptoms--is distinguished from withdrawal. Case reports and a clinical study are presented to illustrate the management of patients with panic disorder who are taking short- and intermediate-acting benzodiazepines and are experiencing rebound anxiety. The authors present the results of switching over to clonazepam 48 patients with panic disorder who were experiencing rebound effects with alprazolam. Eighty-two percent (39) of the patients rated clonazepam as being "better" than alprazolam due to decreased dosing frequency and lack of interdose anxiety. The authors conclude that clonazepam can be a useful alternative to alprazolam and other short-acting benzodiazepines in the treatment of anxiety disorders. Clonazepam offers the advantage of antipanic efficacy without the relative side effect problems seen with tricyclic antidepressants and monoamine oxidase inhibitors.

Publication types

  • Case Reports
  • Comparative Study
  • Review

MeSH terms

  • Acute Disease
  • Adult
  • Alprazolam / pharmacokinetics
  • Alprazolam / therapeutic use*
  • Anti-Anxiety Agents / pharmacokinetics
  • Anti-Anxiety Agents / therapeutic use
  • Anxiety Disorders / drug therapy*
  • Anxiety Disorders / psychology
  • Clonazepam / pharmacokinetics
  • Clonazepam / therapeutic use*
  • Fear*
  • Female
  • Humans
  • Male
  • Panic*
  • Psychiatric Status Rating Scales
  • Substance Withdrawal Syndrome / etiology*


  • Anti-Anxiety Agents
  • Clonazepam
  • Alprazolam