Irma Csanalosi

Gepirone in anxiety: a pilot study.

Ten patients suffering from generalized anxiety disorder were treated, after a single-blind placebo washout week, with the nonbenzodiazepine anxiolytic gepirone in a 6-week open label trial. Mean Hamilton Anxiety scores improved from 24.8 to 7.1 (p < 0.01). Other physician- and patient-rated scales showed comparable improvement on a mean maximal dose of 41 mg of gepirone. The medication appeared to be nonsedating and well tolerated. The anxiolytic effect of the medication was very marked in several cases, and gepirone appears to have promise as an anxiolytic agent.

Doxepin and amitriptyline-perphenazine in mixed anxious-depressed neurotic outpatients: A collaborative controlled study

Doxepin was compared to the combination of amitriptyline-perphenazine in a double-blind controlled study conducted with 100 clinic, general practice, and private psychiatric practice outpatients diagnosed as suffering from a mixed anxiety-depressive reaction. The relatively few statistically significant differences found in the study indicated amitriptyline-perphenazine to be more effective than doxepin (main drug effects), general practice patients to improve the most and private psychiatric patients the least (main population effects), and clinic patients to respond better to doxepin, while general practice and private psychiatric patients improved most with the drug combination (drug×population interaction effects).Amitriptyline-perphenazine was found to produce more improvement in high and doxepin in low depressed patients, and doxepin was observed to be more effective in lower than in higher social class patients. Patients on doxepin tended to report more side effects, but to drop out less frequently than patients on the drug combination.

Halazepam and diazepam in neurotic anxiety: A double-blind study

Halazepam (160 mg/day) was compared to diazepam (20 mg/day) and to a placebo in a double-blind study with anxious neurotic outpatients from general family practice and a symptomatic volunteer clinic. One hundred twenty-five patients completed at least 4 weeks of treatment. Halazepam produced the most amount of side effects followed by diazepam, while placebo produced the least amount of side effects. Sedation was the most frequently reported side effect.No significant drug x population interaction effects were found and only very few population effects occurred indicating SVC patients to improve more than GP patients. Treatment differences indicate diazepam to be slightly more effective than halazepam, and both drugs to be superior to placebo according to several outcome criteria. At the 6-week period, diazepam, in fact, was significantly more effective than halazepam according to physician and patient questionnaire ratings. Global ratings of improvement, however, indicated both drugs to be equally effective and to produce significantly more improvement than placebo.Initial levels of anxiety and depression were found to have a differential effect on treatment outcome. Anxious patients with little secondary depression improved more than patients with more marked secondary depression regardless of treatment agent prescribed. High anxious halazepam-treated patients were found to improve significantly more than low anxious halazepam-treated patients, while initial level of anxiety showed little effect on the diazepam response. It would thus seem that in the present study diazepam (20 mg/day) was slightly more efficacious in reducing anxious symptomatology than halazepam (160 mg/day) and particularly in the only mildly anxious patient. Perhaps a daily dosage of 120 mg/day of halazepam might have been more appropriate for most anxious patients.

Ketazolam and Diazepam in Anxiety: A Controlled Study

Ketazolam (both in once-daily and three-times-daily dosing), diazepam, and placebo were compared for effectiveness in relieving anxious symptomatology in a clinical trial conducted with a total of 222 anxious, non-psychotic outpatients. Results indicated that improvement occurred early in treatment, that ketazolam was equally effective in both once-daily and three-times-daily dosing, and that ketazolam was similar in effect to diazepam. Ketazolam (both once-daily and three-times-daily) and diazepam were significantly (P < 0.05) better than placebo in alleviating symptoms of anxiety, as measured by the Hamilton Anxiety Scale, the Covi Anxiety Scale, and a physician-rated measure of global improvement.

Clomipramine and amitriptyline in depressed outpatients

Clomipramine (75–125 mg/day), a relatively new tricyclic anti-depressant, was compared to amitriptyline (75–125 mg/day) in a double-blind 6 week trial carried out with 93 psychiatric and 75 non-psychiatric depressed out patients. Psychiatric patients were initially more depressed, more pretreated, but less chronically ill, took a higher daily dosage of medication, yet reported fewer side effects, dropped out less frequently, and reported more improvement than nonpsychiatric patients. Clomipramine tended to produce more side effects, particularly of sedative nature, was associated with greater dosage deviation and attrition, and appeared slightly faster in its onset of action than amitriptyline. While amitriptyline produced significantly more improvement than clomipramine according to several endpoint measures, a number of improvement criteria showed both agents to be of comparable efficacy.Clomipramine was particularly effective in the less depressed non-psychiatric low somatizing patients, while it produced a particularly poor response in high somatizing patients. Amitriptyline was especially effective in the more depressed psychiatric patients, and was not affected by level of somatic complaints. Both agents produced a high degree of clinical improvement in this non-psychotic depressed population.