Long-term treatment of anxiety and risk of withdrawal. Prospective comparison of clorazepate and buspirone.
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.
D000328:Adult; D014151:Anti-Anxiety Agents / Q000009:adverse effects*; D001008:Anxiety Disorders / Q000188:drug therapy* / Q000523:psychology; D002065:Buspirone / Q000009:adverse effects* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003009:Clorazepate Dipotassium / Q000009:adverse effects* / Q000627:therapeutic use; D004311:Double-Blind Method; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010200:Panic; D010349:Patient Compliance; D010352:Patient Dropouts; D010555:Personality Inventory; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology
D014151:Anti-Anxiety Agents; D003009:Clorazepate Dipotassium; D002065:Buspirone