When alprazolam was compared with placebo for reduction in symptoms all estimates indicated a positive effect for alprazolam .
The RD of all-cause withdrawals did not differ between alprazolam and placebo .
Alprazolam appears to reduce depressive symptoms more effectively than placebo and as effectively as tricyclic antidepressants .
Whilst the rate of all-cause withdrawals did not appear to differ between alprazolam and placebo , and withdrawals were less frequent in the alprazolam group than in any of the conventional antidepressants combined group , these findings should be interpreted with caution , given the dependency properties of benzodiazepines
BACKGROUND The ' off-label ' effect of alprazolam on depression has not been systematic ally evaluated .
OBJECTIVES To determine the antidepressant effect , including tolerability and acceptability , of alprazolam as monotherapy for major depression , when compared to placebo and conventional antidepressants in out patients and patients in primary care .
Long-term therapeutic use of benzodiazepines. I. Effects of abrupt discontinuation.
We compared the effect of abrupt discontinuation of therapeutic doses of short half-life and long half-life benzodiazepines in 57 benzodiazepine-dependent patients ( daily use , greater than 1 year ) . Despite the use of a mean daily dose of 14.1 mg of diazepam equivalents , there were notable residual symptoms of anxiety and depression present at intake ( Hamilton Rating Scale for Anxiety score , 17.0 ; Hamilton Rating Scale for Depression score , 14.0 ) . Benzodiazepine intake was stabilized for 3 weeks before double-blind assignment to placebo ( n = 47 ) , or continued benzodiazepine use ( n = 10 ) . Clinical assessment s were performed daily , including  benzodiazepine plasma levels . Depending on the outcome criteria used , anywhere from 58 % to 100 % of patients were judged to have experienced a withdrawal reaction , with a peak severity at 2 days for short half-life and 4 to 7 days for long half-life benzodiazepines .  Relapse onto benzodiazepines  occurred in 27 % of patients who were receiving long half-life benzodiazepines and in 57 % of patients who were receiving short half-life benzodiazepines . Baseline predictors of relapse were nonpanic diagnoses , a higher  benzodiazepine dose , and a higher Eysenck neuroticism score . A short half-life and higher daily doses were associated with greater withdrawal severity , as were personality traits , such as dependency and neuroticism , less education and higher baseline levels of anxious and depressive symptoms . Patients who were able to remain free of benzodiazepines for at least 5 weeks obtained lower levels of anxiety than before benzodiazepine discontinuation . These results provide a detailed picture of the symptoms , time course , and multidimensional determinants of the benzodiazepine withdrawal syndrome
When alprazolam was compared with placebo for reduction in symptoms all estimates indicated a positive effect for alprazolam .
The RD of all-cause withdrawals did not differ between alprazolam and placebo .
Alprazolam appears to reduce depressive symptoms more effectively than placebo and as effectively as tricyclic antidepressants .
Whilst the rate of all-cause withdrawals did not appear to differ between alprazolam and placebo , and withdrawals were less frequent in the alprazolam group than in any of the conventional antidepressants combined group , these findings should be interpreted with caution , given the dependency properties of benzodiazepines
BACKGROUND The ' off-label ' effect of alprazolam on depression has not been systematic ally evaluated .
OBJECTIVES To determine the antidepressant effect , including tolerability and acceptability , of alprazolam as monotherapy for major depression , when compared to placebo and conventional antidepressants in out patients and patients in primary care .