Two primary outcomes of efficacy and acceptability showed a possible advantage of benzodiazepines over placebo .
Low- quality evidence shows a possible superiority of benzodiazepine over placebo in the short-term treatment of panic disorders .
Due to these limitations , our results regarding the efficacy of benzodiazepines versus placebo provide only limited guidance for clinical practice .
BACKGROUND Panic disorder is characterised by recurrent unexpected panic attacks consisting of a wave of intense fear that reaches a peak within a few minutes .
Panic disorder is a common disorder , with an estimated lifetime prevalence of 1 % to 5 % in the general population and a 7 % to 10 % prevalence in primary care setting s. Its aetiology is not fully understood and is probably heterogeneous .
Panic disorder is treated with psychological and pharmacological interventions , often used in combination .
Although benzodiazepines are frequently used in the treatment of panic disorder , guidelines recommend antidepressants , mainly selective serotonin reuptake inhibitors ( SSRIs ) , as first-line treatment for panic disorder , particularly due to their lower incidence of dependence and withdrawal reaction when compared to benzodiazepines .
Despite these recommendations , benzodiazepines are widely used in the treatment of panic disorder , probably because of their rapid onset of action .
OBJECTIVES To assess the efficacy and acceptability of benzodiazepines versus placebo in the treatment of panic disorder with or without agoraphobia in adults .
A comparison of a β2-adrenoceptor antagonist (ICI 118,551), diazepam and placebo in the treatment of acute anxiety
The effect of β 2-adrenoceptor antagonism in acute anxiety neurosis was investigated by comparing the effects of ICI 118,551 , a specific β2-adrenoceptor antagonist , diazepam and placebo in a double-blind , parallel group study . Sixty-three patients , who fulfilled criteria for Anxiety Disorder ( DSM III ) and were psychotropic drug- free ( apart from six using hypnotics ) , were entered . Anxiety symptoms were rated using the Hamilton Anxiety Scale ( HAS ) and Spielberger State Anxiety Scale . Assessment s were made at entry and following a 7-day single-blind placebo treatment phase , at the end of which only 51 wished to continue and had sufficient symptoms ( HAS score > 16 or reduction < 25 % on placebo ) for entry to the next phase . Following a double- blind , r and om allocation they then received ICI 118,551 ( 50 mg ) , diazepam ( 2 mg ) or placebo thrice daily for 4 weeks . Symptoms were assessed after 2 and 4 weeks in this active treatment phase ( i.e. at weeks 3 and 5 of the study ) . Thirty-five patients completed the study . A statistically significant improvement in HAS score was seen for all patients but there were no significant differences between treatments . Treatments did not differ in their effects on blood pressure or heart rate . β2-Adrenoceptor antagonism does not seem to have important effects on anxiety symptoms in anxiety neurosis
Two primary outcomes of efficacy and acceptability showed a possible advantage of benzodiazepines over placebo .
Low- quality evidence shows a possible superiority of benzodiazepine over placebo in the short-term treatment of panic disorders .
Due to these limitations , our results regarding the efficacy of benzodiazepines versus placebo provide only limited guidance for clinical practice .
BACKGROUND Panic disorder is characterised by recurrent unexpected panic attacks consisting of a wave of intense fear that reaches a peak within a few minutes .
Panic disorder is a common disorder , with an estimated lifetime prevalence of 1 % to 5 % in the general population and a 7 % to 10 % prevalence in primary care setting s. Its aetiology is not fully understood and is probably heterogeneous .
Panic disorder is treated with psychological and pharmacological interventions , often used in combination .
Although benzodiazepines are frequently used in the treatment of panic disorder , guidelines recommend antidepressants , mainly selective serotonin reuptake inhibitors ( SSRIs ) , as first-line treatment for panic disorder , particularly due to their lower incidence of dependence and withdrawal reaction when compared to benzodiazepines .
Despite these recommendations , benzodiazepines are widely used in the treatment of panic disorder , probably because of their rapid onset of action .
OBJECTIVES To assess the efficacy and acceptability of benzodiazepines versus placebo in the treatment of panic disorder with or without agoraphobia in adults .