Azapirones may be less effective than benzodiazepines and we were unable to conclude if azapirones were superior to antidepressants , kava kava or psychotherapy .
Azapirones appeared to be well tolerated .
Azapirones appeared to be useful in the treatment of GAD , particularly for those participants who had not been on a benzodiazepine .
Azapirones may not be superior to benzodiazepines and do not appear as acceptable as benzodiazepines .
Side effects appeared mild and non serious in the azapirone treated group .
Longer term studies are needed to show that azapirones are effective in treating GAD , which is a chronic long-term illness
BACKGROUND Azapirones are a group of drugs that work at the 5-HT1A receptor and are used to treat patients suffering from generalized anxiety disorder ( GAD ) .
However , several studies have shown conflicting results .
Whether azapirones are useful as first line treatment in general anxiety disorders still needs to be answered .
OBJECTIVES To assess the efficacy and the acceptability of azapirones for the treatment of GAD .
Imipramine and buspirone in treatment of patients with generalized anxiety disorder who are discontinuing long-term benzodiazepine therapy.
OBJECTIVE Patients with generalized anxiety disorder ( N=107 ) who had been long-term benzodiazepine users ( average duration of use=8.5 years ) were enrolled in a benzodiazepine discontinuation program that assessed the effectiveness of concomitant imipramine ( 180 mg/day ) and buspirone ( 38 mg/day ) compared to placebo in facilitating benzodiazepine discontinuation . METHOD After a benzodiazepine stabilization period taking either diazepam , lorazepam , or alprazolam , patients were treated for 4 weeks with imipramine , buspirone , or placebo under double-blind conditions while benzodiazepine intake was kept stable ( treatment phase ) . Patients then entered a 4 - 6 week benzodiazepine taper and a 5-week posttaper phase with imipramine , buspirone , and placebo treatment being continued until 3 weeks into the posttaper phase , at which time all patients were switched to placebo for 2 weeks .  Benzodiazepine plasma levels were assayed weekly . Benzodiazepine-free status was assessed 3 and 12 months posttaper . RESULTS Study subjects were long-term benzodiazepine users with an average of three unsuccessful prior taper attempts . The success rate of the taper in this study was significantly higher for patients who received imipramine ( 82.6 % ) , and nonsignificantly higher for patients who received buspirone ( 67.9 % ) , than for patients who received placebo ( 37.5 % ) . The imipramine effect remained highly significant even after the analysis adjusted for three other independent predictors of taper success : benzodiazepine dose , level of anxious symptoms at baseline , and duration of benzodiazepine therapy . CONCLUSIONS Management of benzodiazepine discontinuation can be facilitated significantly by co-prescribing imipramine before and during the benzodiazepine taper . Daily benzodiazepine dose , severity of baseline symptoms of anxiety and depression , and duration of benzodiazepine use were additional significant predictors of successful taper outcome
Azapirones may be less effective than benzodiazepines and we were unable to conclude if azapirones were superior to antidepressants , kava kava or psychotherapy .
Azapirones appeared to be well tolerated .
Azapirones appeared to be useful in the treatment of GAD , particularly for those participants who had not been on a benzodiazepine .
Azapirones may not be superior to benzodiazepines and do not appear as acceptable as benzodiazepines .
Side effects appeared mild and non serious in the azapirone treated group .
Longer term studies are needed to show that azapirones are effective in treating GAD , which is a chronic long-term illness
BACKGROUND Azapirones are a group of drugs that work at the 5-HT1A receptor and are used to treat patients suffering from generalized anxiety disorder ( GAD ) .
However , several studies have shown conflicting results .
Whether azapirones are useful as first line treatment in general anxiety disorders still needs to be answered .
OBJECTIVES To assess the efficacy and the acceptability of azapirones for the treatment of GAD .