The efficacy of azapirones is uncertain due to the lack of meta-analysable data for the primary outcome and low- quality evidence for secondary efficacy outcomes .
A small amount of moderate- quality evidence suggested that the acceptability of azapirones for panic disorder was lower than for placebo .
If further research is to be conducted , studies with larger sample sizes , with different azapirones and with less risk of bias are necessary to draw firm conclusions regarding azapirones for panic disorder
BACKGROUND Panic disorder is common in the general population .
It is often associated with other psychiatric disorders , such as drug dependence , major depression , bipolar disorder , social phobia , specific phobia and generalised anxiety disorder .
Azapirones are a class of drugs used as anxiolytics .
They are associated with less drowsiness , psychomotor impairment , alcohol potentiation and potential for addiction or abuse than benzodiazepines .
However , azapirones are not widely used in the treatment of panic disorder and evidence for their efficacy is unclear .
It is important to find out if azapirones are effective and acceptable in the treatment of panic disorder .
OBJECTIVES To assess the effects of azapirones on panic disorder in adults , specifically:1 .
to determine the efficacy of azapirones in alleviating symptoms of panic disorder , with or without agoraphobia , in comparison with placebo;2 .
to review the acceptability of azapirones in panic disorder , with or without agoraphobia , in comparison with placebo ; and 3 .
to investigate adverse effects of azapirones in panic disorder with or without agoraphobia , including general prevalence of adverse effects , compared with placebo .
Therapeutic Effects and Effects on Actual Driving Performance of Chronically Administered Buspirone and Diazepam in Anxious Outpatients
Two groups of 12 out patients each ( six men and six women ) with generalized anxiety disorder , participated in this study . Each patient was treated single-blind with placebo during the first 7 days ( baseline ) , followed by a double-blind drug treatment period of 4 consecutive weeks ( active ) and ending again with 7 days single-blind placebo treatment ( washout ) . One group received buspirone 5 mg three times a day in the first week and continued with 10 mg in the morning , 5 mg in the afternoon , and 5 mg in the evening during the second , third , and fourth weeks . The other group received diazepam 5 mg three times a day in all 4 weeks . On the evening of the seventh day of each treatment week the  Hamilton Rating Scale for Anxiety and the Symptom Check List  ( 90 items ) were applied to assess the therapeutic effects , followed by an on-the-road driving test that started 1.5 hours after the last drug or placebo intake . The test consisted of operating an instrumented vehicle over a 100 kilometer highway circuit while attempting to maintain a constant speed and a steady lateral position within the right traffic lane . Two patients in the diazepam group were unable to complete their test after the first and second treatment week , respectively , because of serious sedative reactions . Both buspirone and diazepam were equally effective in reducing overall anxiety symptoms . The specific profiles showed that buspirone also reduced concomitant depressive symptoms and symptoms of interpersonal sensitivity and anger-hostility . In contrast , diazepam was found to be slightly more effective in reducing somatic symptoms and to positively affect sleep disturbances . Moreover , abrupt discontinuation of diazepam result ed in a relapse of psychic anxiety symptoms comparable with the placebo-baseline level and a partial relapse of somatic anxiety symptoms . Chronic treatment with buspirone had no significant effects on lateral position and speed control . In contrast , diazepam significantly impaired control of lateral position in the first 3 weeks of treatment . There was no significant impairment in the fourth treatment week and the placebo-washout week . Speed control was significantly impaired only in the first week . The relevance of the trend toward decreasing performance impairment during chronic treatment remains to be established
The efficacy of azapirones is uncertain due to the lack of meta-analysable data for the primary outcome and low- quality evidence for secondary efficacy outcomes .
A small amount of moderate- quality evidence suggested that the acceptability of azapirones for panic disorder was lower than for placebo .
If further research is to be conducted , studies with larger sample sizes , with different azapirones and with less risk of bias are necessary to draw firm conclusions regarding azapirones for panic disorder
BACKGROUND Panic disorder is common in the general population .
It is often associated with other psychiatric disorders , such as drug dependence , major depression , bipolar disorder , social phobia , specific phobia and generalised anxiety disorder .
Azapirones are a class of drugs used as anxiolytics .
They are associated with less drowsiness , psychomotor impairment , alcohol potentiation and potential for addiction or abuse than benzodiazepines .
However , azapirones are not widely used in the treatment of panic disorder and evidence for their efficacy is unclear .
It is important to find out if azapirones are effective and acceptable in the treatment of panic disorder .
OBJECTIVES To assess the effects of azapirones on panic disorder in adults , specifically:1 .
to determine the efficacy of azapirones in alleviating symptoms of panic disorder , with or without agoraphobia , in comparison with placebo;2 .
to review the acceptability of azapirones in panic disorder , with or without agoraphobia , in comparison with placebo ; and 3 .
to investigate adverse effects of azapirones in panic disorder with or without agoraphobia , including general prevalence of adverse effects , compared with placebo .