Posted by Jack Smith on May 26, 2003, at 18:16:49
In reply to Xanax vs Klonopin ... for Social Phobia, GAD, posted by JackT on May 26, 2003, at 12:54:56
> I was wondering if anyone had some opinions on these two benzos specifically for social phobia.
Xanax seems to have a mild AD effect. I believe it does on me and there are studies to back this up, I will list them below. The problem with xanax is its short duration. It only lasts about 4-6 hours, I think less on me. It has an advantage over klonopin in that it kicks in faster but klonopin lasts quite a bit longer, but in my mind lacks any real punch like xanax, that is probably why xanax is more widely abused. Hopefully, these problems will be remedied by Xanax XR purportedly coming out in June.
Also, Xanax is a triazolobenzodiazepine, which, in chemical terms, means that it has a ring with three nitrogen atoms in it in the same place
where ordinary BZs have a ketone group (oxygen atom). What the significance of this is, I have no idea but it seems that this class of benzos have an AD effect(e.g., adinazolam, still used in Europe, I believe, as an antidepressant).JACK
A comparison of the safety and efficacy of alprazolam and desipramine in
moderately severe depression.
Remick RA, Fleming JA, Buchanan RA, Keller FD, Hamilton P, Loomer F,
Miles JEFifty-four patients (34 outpatients, 20 inpatients) fulfilling Research
Diagnostic Criteria for Definite Major Depressive Disorder were enrolled
in a double-blind study comparing the antidepressant effects of
alprazolam versus desipramine. The mean daily dose of alprazolam and
desipramine at study termination was 3.78 mg and 208 mg respectively. As
there were no significant demographic or clinical differences between
outpatients and inpatients, both groups were combined in data analysis.
Using the Hamilton Depression Rating Scale (HAM-D) both drug groups
showed highly significant improvement beginning with the first week of
active drug treatment. HAM-D scores continued to decrease through study
termination (six weeks of active drug). There were no significant
differences when comparing alprazolam and desipramine (outpatients,
inpatients, or both groups combined) on any of the subjective or
objective psychometrics used in this study. Clinically, only twelve of
thirty-four outpatients (35.3%) were felt to be "markedly or moderately"
improved, suggesting that neither the outpatient alprazolam nor
desipramine patients did particularly well with drug treatment. In terms
of drug safety there was no difference between the alprazolam and
desipramine in the number of excessive or serious drug side effects.
However, five of twenty-nine alprazolam patients had to discontinue
therapy because of excessive drowsiness, and two of the alprazolam
outpatients had motor vehicle accidents directly related to this adverse
event. Alprazolam appeared as effective as desipramine in the
pharmacotherapy of this group of depressed outpatient and inpatients.
Alprazolam compared to amitriptyline in the treatment of major
depression.
Eriksson B, Nagy A, Starmark JE, Thelander UIn a double-blind randomized study the therapeutic effect and safety of
alprazolam was compared with amitriptyline in 81 outpatients suffering
from major depression. Variable dosages of both drugs were used, the mean
final dose of alprazolam being 3.05 and that of amitriptyline 130 mg.
Both treatment groups improved steadily, assessed weekly with the use of
the Hamilton Rating Scale for Depression, and no significant differences
were found between the groups, either on comparison between single items
or total scores.
Alprazolam, amitriptyline, doxepin, and placebo in the treatment of
depression.Rickels K, Feighner JP, Smith WT
Five hundred four outpatients suffering from a major depressive episode
were randomly assigned to receive either amitriptyline, doxepin,
alprazolam, or placebo. The study was conducted in three treatment
centers during a six-week period. All three active medications produced
significantly more clinical improvement than did placebo, irrespective of
the patient's initial anxiety, depression, and psychomotor retardation
and irrespective of the patient's assignment to various subtypes of
depression, including the DSM-III melancholia subtype. Compared with
placebo, sedation was reported more frequently with all three
medications, whereas anticholinergic effects were reported more
frequently only for the two tricyclic antidepressants, but not for
alprazolam.
poster:Jack Smith
thread:229231
URL: http://www.dr-bob.org/babble/20030525/msgs/229288.html