The Efficacy and Safety of Clonazepam in Patients with Anxiety Disorder Taking Newer Antidepressants: A Multicenter Naturalistic Study.
OBJECTIVE
This study compared the efficacy and tolerability of clonazepam with other benzodiazepines in patients with anxiety disorders.


METHODS
Inclusion criteria were as follows: age >20 years, diagnosis of anxiety disorder according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision (DSM-IV-TR) criteria, taking only one type of antidepressant, and prescribed one of three oral benzodiazepines (alprazolam, clonazepam, or lorazepam). At baseline and week 6, clinical benefit was evaluated using the Clinical Global Impression-Severity Scale (CGI-S), Clinical Global Impression-Anxiety Scale (CGI-anxiety), and Clinical Global Impression-Sleep Scale (CGI-sleep).


RESULTS
Among 180 patients, no differences in demographic characteristics among the three benzodiazepine groups were noted. After six weeks of treatment, all benzodiazepine groups showed significant improvements in CGI-S, CGI-anxiety, and CGI-sleep scores (p<0.001). There were no differences in mean changes in CGI-S, CGI-anxiety and CGI-sleep among the three benzodiazepine groups. The incidence of side effects was significantly lower in the clonazepam group than with the other benzodiazepines. The incidences of adverse events for the clonazepam, alprazolam, and lorazepam groups were 26.7% (n=20), 48.4% (n=31), and 43.9% (n=18), respectively.


CONCLUSIONS
The present study suggests that clonazepam is as efficacious as other benzodiazepines for the treatment of various anxiety disorders. Furthermore, the safety profile of clonazepam was superior to the other benzodiazepines in this study.
International Health Care Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Sheng-Min
SM
Wang
Department of Psychiatry, Keimyung University School of Medicine, Daegu, Korea.
Jung-Bum
JB
Kim
Department of Psychiatry, Dongguk University College of Medicine, Gyeongju, Korea.
Jeong Kyu
JK
Sakong
Department of Psychiatry, CHA University School of Medicine, Seoul, Korea.
Ho-Suk
HS
Suh
Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kang Seob
KS
Oh
Department of Psychiatry, Inje University Seoul Paik Hospital, Seoul, Korea.
Jong-Min
JM
Woo
Mental Health Clinic Yoo and Kim, Seoul, Korea.
Sang-Woo
SW
Yoo
Yonsei Feel Mental Health Clinic, Seoul, Korea.
Sang Min
SM
Lee
Department of Psychiatry, Wonkwang University Hospital, Iksan, Korea.
Sang-Yeol
SY
Lee
Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Se-Won
SW
Lim
Department of Psychiatry, Gachon University Gil Hospital, Incheon, Korea.
Seong Jin
SJ
Cho
Department of Psychiatry, Institute of Brain Research, Chungnam National University School of Medicine, Daejeon, Korea.
Ik-Seung
IS
Chee
Deparment of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Jeong-Ho
JH
Chae
Department of Psychiatry, Asan Medical Center, Seoul, Korea.
Jin Pyo
JP
Hong
Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.
Kyoung-Uk
KU
Lee
Alprazolam; Anti-anxiety agents; Anxiety disorders; Clonazepam; Lorazepam; Therapy