Adinazolam-SR in panic disorder with agoraphobia: relationship of daily dose to efficacy

BACKGROUND

We report the results from a multicenter, double-blind, randomized, fixed-dose study designed to evaluate the relationship between daily dose and efficacy of adinazolam-SR in patients with panic disorder with agoraphobia.

METHOD

Patients (N = 315) were randomized to one of four treatment groups (placebo, N = 83; 30-mg group, N = 79; 60-mg group, N = 81; and 90-mg group, N = 72) and then treated twice daily for 4 weeks. All treatment groups were comparable demographically. Primary efficacy measures included total number of panic attacks, global improvement score using the Clinical Global Impressions (CGI) scale, phobic anxiety dimension of the Symptom Checklist-90 phobic cluster, overall phobia state using the Phobia Scale, and severity of illness on the CGI.

RESULTS

The 60- and 90-mg/day adinazolam-SR treatment groups showed superior results when compared with the placebo group at Week 4 while the 30-mg group did not. Treatment with adinazolam-SR was well tolerated, with sedation the only treatment-emergent symptom that occurred more frequently in patients treated with adinazolam-SR than placebo.

CONCLUSION

These results suggest that adinazolam-SR at doses of 60-mg/day or greater administered twice daily is a safe and effective treatment in selected patients with panic disorder with agoraphobia.

Onset of action of amoxapine and doxepin in outpatients with "mixed anxiety/depression"

In a parallel-group double-blind study, 142 outpatients with "mixed anxiety/depression" were treated with amoxapine or doxepin for 4 weeks in mean maximum daily dosages of 260 mg and 130 mg, respectively. Patients in both groups improved significantly during treatment as shown by changes in the Hamilton, Zung, Patient Self-Evaluation, and Clinical Global Impressions scales. From 24 to 31 of the 71 subjects receiving amoxapine and 16 to 24 of the 71 receiving doxepin were rated as "unquestionably improved" at the end of the treatment period on these scales. The time to achieve this degree of response was significantly shorter with amoxapine on both the CGI (p = .018) and Hamilton (p = .005) scales. Side effects were roughly comparable with two exceptions: doxepin-treated patients experienced more daytime drowsiness (p less than or equal to .05) and amoxapine-treated patients experienced more constipation (p less than or equal to .01).

Amitriptyline-perphenazine and doxepin in depressed outpatients: a controlled double-blind study

Amitriptyline-perphenazine (100/8-150/12 mg/day) and doxepin (100-150 mg/day) were compared for clinical efficacy and safety in a sample of 130 nonpsychotic depressed outpatients. Maximum study duration was 4 weeks; 19 amitriptyline-perphenazine and 29 doxepin patients completed less than or equal to 3 weeks of treatment and 45 amitriptyline-perphenazine and 37 doxepin patients completed 4 weeks of treatment. Patients in both groups showed significant improvement in depression, but amitriptyline-perphenazine produced greater improvement than doxepin on several measures of depressive symptomatology. The incidence of anticholinergic and sedative side effects was higher in the amitriptyline-perphenazine treated group.

Amoxapine and imipramine in the treatment of depressed outpatients: a controlled study

In a double-blind, controlled study 158 outpatients with unipolar depression were treated for six weeks with amoxapine, imipramine, or placebo to assess the antidepressant effects of the new dibenzooxazepine compound, amoxapine. Forty-five amoxapine, 43 imipramine, and 27 placebo patients completed at least four weeks of treatment. Active drugs produced significantly more improvement at treatment endpoint, according to several physician-rated measures, but patient-rated measures failed to differentiate among treatments. Both active drugs at daily doses up to 200 mg produced an equal amount of moderate and marked global improvement, and both produced significantly more side effects than did placebo.

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.

Amitriptyline once daily vs three times daily in depressed outpatients

Two dosage schedules of amitriptyline hydrochloride, once daily vs three times daily, were compared in a group of 124 nonpsychotic depressed outpatients. After four weeks of treatment, patients on the once daily schedule had improved significantly more than patients receiving multiple doses on both physician and patient measures. The two groups did not differ in their attrition rates nor in reporting of side effects. Since treatment response to the tricyclic antidepressants is often delayed, once-daily dosage seems to offer a distinct advantage over more conventional multiple doses in depressed outpatients.

Loxapine in neurotic anxiety: some modifiers of treatment response

The authors describe a double-blind trial of six weeks duration which was designed to compare the anxiolytic properties of chlordiazepoxide, loxapine and placebo in a total of 135 anxious neurotic out-patients.

Thiothixene and thioridazine in anxiety

Thiothixene and thioridazine, established anti-psychotic agents (5), have been reported to possess antidepressant (4, 7, 8, 9, 17) and anxiolytic (3, 15, 16) properties. The present study is primarily concerned with the latter claim. It was initiated to assess the role of both these major tranquillizers—thiothixene, a thioxanthene derivative, and thioridazine, a phenothiazine derivative—in the symptomatic treatment of anxious neurotic out-patients.