Comparison of the efficacy, safety and withdrawal of alpidem and alprazolam in anxious patients.
BACKGROUND
We investigated whether a new non-benzodiazepine anti-anxiety drug, alpidem, produces weaker withdrawal symptoms than alprazolam.


METHODS
Under a double-blind procedure, 122 patients suffering from general anxiety disorders were randomly allocated to either alpidem (50 mg, three times a day) or alprazolam (0.5 mg, three times a day) for six weeks, followed by a two-week placebo withdrawal phase. The diagnosis of withdrawal syndrome (WS) was made, in blind conditions, on the basis of the Withdrawal Symptom Check List (WSCL), after one or two weeks of discontinuation of active treatment.


RESULTS
The WS occurred significantly less frequently in the alpidem group (n = 10, 18%) than in the alprazolam group (n = 26, 48%). Typical withdrawal symptoms on the WSCL were also significantly less severe (P = 0.044) in the alpidem group compared with the alprazolam group.


CONCLUSIONS
Alpidem may be a valid alternative to current benzodiazepine anxiolytic therapy because it produces fewer and weaker withdrawal symptoms than alprazolam and is better tolerated.
Frattola
L
L
University of Milan, San Gerardo Hospital, Italy.
Garreau
M
M
Piolti
R
R
Bassi
S
S
Albizzati
M G
MG
Borghi
C
C
Morselli
P L
PL
D000328:Adult; D000525:Alprazolam / Q000008:administration & dosage / Q000009:adverse effects*; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001008:Anxiety Disorders / Q000188:drug therapy* / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000187:drug effects; D010552:Personality Assessment; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects*; D013375:Substance Withdrawal Syndrome / Q000209:etiology*; D016896:Treatment Outcome
D014151:Anti-Anxiety Agents; D007093:Imidazoles; D011725:Pyridines; C052036:alpidem; D000525:Alprazolam