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 .
Long-term comparison of alprazolam, lorazepam and placebo in patients with an anxiety disorder.
In a double-blind , placebo-controlled study of 200 patients with moderate to moderately severe anxiety we compared the anxiolytic efficacy and safety of alprazolam and lorazepam . Dosing was flexible and ranged from 1 to 4.5 mg/day of alprazolam and from 2 to 9 mg/day of lorazepam . The mean daily dose at the end of the 16 week study was alprazolam 3.3 mg and lorazepam 5.1 mg . Both active drugs were significantly more effective than placebo in relieving the symptoms of anxiety on the Hamilton Anxiety Rating Scale , with a trend toward more improvement in the alprazolam group in the later weeks of the study . Target Symptoms , Physician 's and Patient 's Global Impressions and the Self Rating Symptom Scale indicate that alprazolam and lorazepam were superior to placebo . The major side effects were sedation and drowsiness ; the frequency was similar for alprazolam and lorazepam and twice as high for active drug as placebo . An overall rating of side effect severity was not significantly different among the three groups
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 .