Skip to main content
Log in

Alprazolam versus buspirone in the treatment of outpatients with generalized anxiety disorder

  • Original Investigations
  • Published:
Psychopharmacology Aims and scope Submit manuscript

Abstract

The efficacy and safety of alprazolam and buspirone for treating generalized anxiety disorder (GAD) were compared in a 6-week, double-blind, randomized, placebo-controlled study of 94 outpatients. Mean daily doses at the end of the study were 1.9 mg alprazolam and 18.7 mg buspirone. As judged by the Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Physician's Global Improvement Scale, and other efficacy scales, alprazolam and buspirone were similar in efficacy, but more effective than placebo, for treating anxiety and depression symptoms in these patients. Clinically important differences were noted between drugs in the onset of effect, with alprazolam producing rapid and sustained improvement within the first week of treatment and buspirone producing more gradual, continuous improvement throughout the study. Significantly more buspirone-treated than alprazolam-treated patients failed to complete the study, primarily because of side effects or inefficacy. No clinically important differences were noted between alprazolam and buspirone in side effects, vital signs, or laboratory test results. Alprazolam-treated patients most frequently reported central nervous system-related side effects (drowsiness and sedation), while buspirone-treated patients most frequently reported gastrointestinal system-related side effects (appetite disturbances and abdominal complaints).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • American Psychiatric Association (1980) Diagnostic and statistical manual of mental disorders, Third Edition. APA, Washington, DC

    Google Scholar 

  • Ballenger JC, Burrows GD, DuPont RL Jr, Lesser IM, Noyes R, Pecknold JC, Rifkin A Swinson (1988) Alprazolam in panic disorder and agoraphobia: results from a multicenter trial: I. Efficacy in short-term treatment. Arch Gen Psychiatry 45:413–422

    Google Scholar 

  • Chouinard G, Annable L, Fontaine R, Solyom L (1982) Alprazolam in the treatment of generalized anxiety and panic disorders: a double-blind placebo-controlled study. Psychopharmacology 77:229–233

    Google Scholar 

  • Cohn JB (1982) Multicenter double-blind efficacy and safety study comparing alprazolam, diazepam, and placebo in clinically anxious patients. J Clin Psychiatry 42:347–351

    Google Scholar 

  • Cohn JB, Wilcox CS (1984) Long-term comparison of alprazolam, lorazepam and placebo in patients with an anxiety disorder. Pharmacotherapy 4:93–98

    Google Scholar 

  • Cohn JB, Wilcox CS (1986) Low sedation potential of buspirone compared with alprazolam and lorazepam in the treatment of anxious patients: a double-blind study. J Clin Psychiatry 47:409–412

    Google Scholar 

  • Cropper M, Garner A, McEwan GD, Munt DF, Rushbrook LA, Stevens V, Baker AC (1987) A double-blind comparative study of alprazolam and dothiapin hydrochloride in the treatment of anxiety associated with depression. Pharmatherapeutica 5:76–82

    Google Scholar 

  • Fabre LF, McLendon FM (1979) A double-blind study comparing the efficacy and safety of alprazolam with diazepam and placebo in anxious out-patients. Curr Ther Res 26:519–526

    Google Scholar 

  • Feighner JP, Merideth C, Hendrikson GA (1982) A double-blind comparison of buspirone and diazepam in out-patients with generalized anxiety disorder. J Clin Psychiatry 43:103–107

    Google Scholar 

  • Goa KL, Ward A (1986) Buspirone: a preliminary of its pharmacological properties and therapeutic efficacy as an anxiolytic. Drugs 32:114–129

    Google Scholar 

  • Goldberg HL, Finnerty R (1982) Comparison of buspirone in two separate studies. J Clin Psychiatry 43:87–91

    Google Scholar 

  • Gorman JM (1987) Generalized anxiety disorders. In: Klein D (ed) Modern problems of pharmacopsychiatry: anxiety. Karger, Basel, Switzerland, p 131

    Google Scholar 

  • Hamilton M (1959) The assessment of anxiety states by rating. Br J Med Psychol 32:50–55

    Google Scholar 

  • Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–62

    Google Scholar 

  • Imlah MW (1985) An evaluation of alprazolam in the treatment of reactive or neurotic (reactive) depression. Br J Psychiatry 146:515–519

    Google Scholar 

  • Kielholz P (ed) (1977) Der therapeutische Zugang zur Psyche über das betaadrenerge System. Huber, Bern

    Google Scholar 

  • Lesser IM, Rubin RT, Pecknold JC, Rifkin A, Swinson RP, Lydiard RB, Burrows GD, Noyes R Jr, DuPont RL (1988) Secondary depression in panic disorder and agoraphobia. I. Frequency, severity, and response to treatment. Arch Gen Psychiatry 45:437–443

    Google Scholar 

  • Lipman RS, Covi L (1976) Outpatient treatment of neurotic depression: medication and group psychotherapy. In: Spitzer R, Klein D (eds) Evaluation of psychological therapies. John Hopkins University Press, Baltimore, pp 178–218

    Google Scholar 

  • Marks J (1978) The benzodiazepines. Use, overuse, misuse, and abuse. MTP Press, Lancaster, England, p 80

    Google Scholar 

  • Raskin A, Schulterbrandt JG, Reatig N, McKeon J (1970) Differential response to chlorpromazine, imipramine, and placebo. Arch Gen Psychiatry 23:164–173

    Google Scholar 

  • Rickels K, Csanalosi I, Greisman P, Cohen D, Werblowsky J, Ross HA, Harris H (1983) A controlled clinical trial of alprazolam for the treatment of anxiety. Am J Psychiatry 140:82–85

    Google Scholar 

  • Rickels K, Chung HR, Csanalosi IB, Hurowitz AM, London J, Wiseman K, Kaplan M, Amsterdam JD (1987) Alprazolam, diazepam, imipramine, and placebo in out-patients with major depression. Arch Gen Psychiatry 44:862–866

    Google Scholar 

  • Vaisanen E, Jalkanaen E (1987) A double-blind study of alprazolam and oxazepam in the treatment of anxiety. Acta Psychiatr Scand 75:536–541

    Google Scholar 

  • Werner J (1987) Efficacy of alprazolam: a comparison study with bromazepam. Acta Therapeutica 13:47–60

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Enkelmann, R. Alprazolam versus buspirone in the treatment of outpatients with generalized anxiety disorder. Psychopharmacology 105, 428–432 (1991). https://doi.org/10.1007/BF02244440

Download citation

  • Received:

  • Revised:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02244440

Key words

Navigation