Effects of clonidine on alprazolam discontinuation in panic patients: a pilot study.
Effects of adjunctive clonidine (0.15 to 0.7 mg/day) on symptoms experienced during and for 4 weeks after gradual alprazolam discontinuation were observed in panic disorder patients after 6 weeks of successful treatment. Twelve of 14 entered patients were considered to have had a sufficient period of discontinuation (2 weeks) and clonidine administration (1 week) for effects to be assessed adequately. Nine of these 12 patients reached zero dose of alprazolam in 3 to 4 weeks. However, 10 of 12 patients experienced new withdrawal symptoms and 11 of 12 experienced recurrent panic attacks during tapering. Although a greater proportion of patients were successfully discontinued in a shorter time than in a previous nonclonidine trial, clonidine did not appear to have a specific effect on relapse or withdrawal. A placebo-controlled trial is needed to discriminate between possible contributions of clonidine and other factors (e.g., physician attitude, placebo effect of pill taking) to this improved outcome.
Fyer
A J
AJ
Anxiety Disorders Clinic, New York State Psychiatric Institute, NY 10032.
Liebowitz
M R
MR
Gorman
J M
JM
Campeas
R
R
Levin
A
A
Sandberg
D
D
Fyer
M
M
Hollander
E
E
Papp
L
L
Goetz
D
D
D000328:Adult; D000525:Alprazolam / Q000009:adverse effects*; D003000:Clonidine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000188:drug therapy; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy* / Q000523:psychology
D003000:Clonidine; D000525:Alprazolam