title: The efficacy and safety of alprazolam versus other benzodiazepines in the treatment of panic disorder.
abstract: We performed a meta-analysis of all single- or double-blind, randomized controlled trials comparing alprazolam to another benzodiazepine in the treatment of adult patients meeting the Diagnostic and Statistical Manual of Mental Disorders, Third or Fourth Edition, criteria for panic disorder or agoraphobia with panic attacks. Eight studies met inclusion criteria, describing a total of at least 631 randomized patients. In the pooled results, there were no significant differences in efficacy between alprazolam and the comparator benzodiazepines on any of the prespecified outcomes: improvement in mean panic attack frequency (between-arm weighted mean difference of 0.6 panic attacks per week; 95% confidence interval [CI], -0.3 to 1.6), improvement in Hamilton Anxiety Rating Scale score (weighted mean difference of 0.8 points; 95% CI, -0.5 to 2.1), and proportion of patients free of panic attacks at the final evaluation (pooled relative risk, 1.1; 95% CI, 0.9-1.4). Statistical heterogeneity on prespecified outcomes was not eliminated by stratification on baseline anxiety level. The available evidence fails to demonstrate alprazolam as superior to other benzodiazepines for the treatment of panic disorder.
authors.affiliation: School of Medicine, Deakin University, Geelong, Victoria, Australia. steven.moylan@deakin.edu.au
authors.forename: Steven
authors.initials: S
authors.lastname: Moylan
authors.forename: John
authors.initials: J
authors.lastname: Staples
authors.forename: Stephanie Alison
authors.initials: SA
authors.lastname: Ward
authors.forename: Jan
authors.initials: J
authors.lastname: Rogerson
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
mesh_terms: D000379:Agoraphobia / Q000188:drug therapy; D000525:Alprazolam / Q000009:adverse effects / Q000627:therapeutic use*; D014151:Anti-Anxiety Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D016584:Panic Disorder / Q000188:drug therapy*; D011569:Psychiatric Status Rating Scales; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D014151:Anti-Anxiety Agents; D001569:Benzodiazepines; D000525:Alprazolam