Buspirone vs Alprazolam: A Double-Blind Comparative Study of Their Efficacy, Adverse Effects and Withdrawal Symptoms

Summary

Buspirone was compared with alprazolam in the treatment of generalised anxiety disorder in a 7-week double-blind, randomised study of 60 outpatients. All patients received placebo during the first week of the trial, active medication for the following 4 weeks (buspirone 15 mg/day or alprazolam 1.5 mg/day) and placebo for the last 2 weeks of the trial. 13 patients in the buspirone group and 12 in the alprazolam group received increased doses of 25 mg/day buspirone or 2.5 mg/day alprazolam, respectively. The 2 drugs were equally effective and produced significant reductions in anxiety. Buspirone-treated patients experienced fewer adverse effects than alprazolam-treated patients during both the active treatment period and the 2-week withdrawal period following abrupt discontinuation of both drugs. During the active treatment period, the most frequently encountered adverse effects in buspirone recipients were nausea, dizziness and headache, while those in alprazolam recipients were decreased concentration, drowsiness, fatigue, tremor, insomnia and dry mouth. During the 2-week withdrawal period, the most frequently encountered symptoms in buspirone-treated patients were nervousness and insomnia, while those in alprazolam-treated patients were nervousness, insomnia, aches/pain and sweating. While buspirone and alprazolam appear to be equally effective in the treatment of generalised anxiety disorder, the results of this study indicate a superiority of buspirone over alprazolam with regard to adverse effects and withdrawal symptoms.

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References

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 3rd ed., DSM-III-R, Washington, DC, APA, 1987

  2. Cohn J. Long-term studies of buspirone. Internal Medicine for the Specialist (Special Issue), pp. 21–22, 1987

    Google Scholar 

  3. Cohn JB, Bowden CL, Fisher JG, Rodos J. Double-blind comparison of buspirone and clorazepate in anxious out-patients. American Journal of Medicine 80(Suppl. 3): 10–16, 1986

    PubMed  Article  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  5. Cole JO, Orzack MH, Beake B, Bird M, Bartal Y. Assessment of the abuse liability of buspirone in recreational sedative users. Journal of Clinical Psychiatry 43(Sect. 2): 69–74, 1982

    PubMed  CAS  Google Scholar 

  6. Eison AS, Temple DL. Buspirone: Review of its pharmacology and current perspectives on its mechanism of action. American Journal of Medicine 80(Suppl. 3b): 1–9, 1986

    PubMed  Article  CAS  Google Scholar 

  7. Feighner JP, Merideth CH, Hendrickson GA. A double-blind comparison of buspirone and diazepam in out-patients with generalized anxiety disorder. Journal of Clinical Psychiatry 43(Sect. 2): 103–107, 1982

    PubMed  CAS  Google Scholar 

  8. Gammans RE, Mayol RF, Labudde JA. Metabolism and disposition of buspirone. American Journal of Medicine 80(Suppl. 3b): 41–51, 1986

    PubMed  Article  CAS  Google Scholar 

  9. Goldberg HL, Finnerty RJ. Comparison of buspirone in two separate studies. Journal of Clinical Psychiatry 43(Sect. 2): 87–91, 1982a

    PubMed  CAS  Google Scholar 

  10. Goldberg HL, Finneny RJ. The comparative efficacy of buspirone and diazepam in the treatment of anxiety. American Journal of Psychiatry 136: 1184–1187, 1982b

    Google Scholar 

  11. Gorman JM, Papp LA. Chronic anxiety: Deciding the length of treatment. Journal of Clinical Psychiatry 51(Suppl. 1): 11–15, 1990

    PubMed  Google Scholar 

  12. Hamilton M. The assessment of anxiety states by rating. British Journal of Psychology 32: 50–55, 1959

    Article  CAS  Google Scholar 

  13. Murphy SM, Owen R, Tyrer P. Comparative assessment of efficacy and withdrawal symptoms after 6 and 12 weeks’ treatment with diazepam or buspirone. British Journal of Psychiatry 154: 529–534, 1989

    PubMed  Article  CAS  Google Scholar 

  14. Napoliello MJ. Buspirone: Overall tolerance. Proceedings of the Symposium on Anxiety Disorders. An International Update, pp. 87–92, Academy Professional Information Services, Dusseldorf, Germany, 18-19 April, 1985

  15. Newton RE, Casten GP, Alms DR, Benes CO, Marunycz JD. The side-effect profile of buspirone in comparison to active controls and placebo. Journal of Clinical Psychiatry 43(Sect. 2): 100–102, 1982

    PubMed  CAS  Google Scholar 

  16. Peroutka SJ. Selective interaction of novel anxiolytics with 5-hydroxytryptamine 1A receptors. Biological Psychiatry 20: 971–979, 1985

    PubMed  Article  CAS  Google Scholar 

  17. Petracca A, Nisita C, McNair D, Melis G, Guerani G, et al. Treatment of generalized anxiety disorders: preliminary clinical experience with buspirone. Journal of Clinical Psychiatry 51(Suppl. 9): 31–39, 1990

    PubMed  Google Scholar 

  18. Rickels K. Buspirone: clinical profile. Proceedings of the Symposium on Anxiety Disorders. An International Update, pp. 25–30, Academy Professional Information Services, Dusseldorf, Germany, 18-19 April, 1985

  19. Rickels K, Howard K. The Physician’s Questionnaire. A useful tool in psychiatric drug research. Psychopharmacologia 17: 338–344, 1970

    PubMed  Article  CAS  Google Scholar 

  20. Rickels K, Schweitzer EE. Buspirone in the treatment of generalized anxiety disorder. Internal Medicine for the Specialist (Special Issue), pp. 8–13, 1987

    Google Scholar 

  21. Rickels K, Schweitzer E, Csanalosi I, Case WG, Chung H. Long-term treatment of anxiety and risk of withdrawal. Archives of General Psychiatry 45: 444–450, 1988

    PubMed  Article  CAS  Google Scholar 

  22. Rickels K, Weisman K, Norstad N, Singer M, Stoltz D, et al. Buspirone and diazepam in anxiety: a controlled study. Journal of Clinical Psychiatry 43(Sect. 2): 81–86, 1982

    PubMed  CAS  Google Scholar 

  23. Robinson DS. An overview of the safety and side-effect profile of buspirone. Internal Medicine for the Specialist (Special Issue), pp. 35–39, 1987

    Google Scholar 

  24. Strand M, Hetta J, Rosen A, Sorensen S, Malnstrom R, et al. A double-blind controlled trial im primary care patients with generalized anxiety. A comparison between buspirone and oxazepam. Journal of Clinical Psychiatry 51(Suppl. 9): 40–45, 1990

    PubMed  Google Scholar 

  25. Temple DL, Yevich JP, New JS. Buspirone: chemical profile of a new class of anxioselective agents. Journal of Clinical Psychiatry 43(Sect. 2): 4–9, 1982

    PubMed  CAS  Google Scholar 

  26. Wheatley D. Buspirone: multicenter efficacy study. Journal of Clinical Psychiatry 43(Sect. 2): 92–94, 1982

    PubMed  CAS  Google Scholar 

  27. Zung WmWK. A rating instrument for anxiety disorders. Psychosomatics 12: 371–379, 1971

    PubMed  CAS  Google Scholar 

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Correspondence to Dr Evangelos C. Dimitriou.

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Dimitriou, E.C., Parashos, A.J. & Giouzepas, J.S. Buspirone vs Alprazolam: A Double-Blind Comparative Study of Their Efficacy, Adverse Effects and Withdrawal Symptoms. Drug Invest 4, 316–321 (1992). https://doi.org/10.1007/BF03259411

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Keywords

  • Anxiety Disorder
  • Withdrawal Symptom
  • Clinical Psychiatry
  • Buspirone
  • Alprazolam