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Comparative Assessment of Efficacy and Withdrawal Symptoms After 6 and 12 Weeks' Treatment with Diazepam or Buspirone

Published online by Cambridge University Press:  02 January 2018

Siobhan M. Murphy ,
Robert Owen  and
Peter Tyrer
Siobhan M. Murphy*
Affiliation:
Mapperley Hospital, Nottingham NG3 6AA, St George's Hospital, Blackshaw Road, London SW17
Robert Owen
Affiliation:
Pastures Hospital, Mickleover, Derbyshire
Peter Tyrer
Affiliation:
Mapperley Hospital, Nottingham NG3 6AA, now at St Charles' Hospital, Exmoor Street, London W10 6DZ
*
∗Correspondence
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Abstract

Fifty-one outpatients presenting with generalised anxiety disorder were included in a double-blind trial, and treated with either buspirone (a new non-benzodiazepine antianxiety drug) or diazepam over 6 or 12 weeks, after which they were abruptly withdrawn and continued on placebo to 14 weeks. Ratings of anxiety and other symptoms were administered fortnightly and additional withdrawal symptoms noted. Forty patients completed the study; 8 of the 11 drop-outs were taking buspirone. Both drugs reduced anxiety, diazepam more rapidly, but with greater withdrawal symptoms, particularly after 6 weeks. Regular treatment with diazepam for 6 weeks leads to a significant risk of pharmacological dependence that is not present with buspirone.

Type
Papers
Information
The British Journal of Psychiatry , Volume 154 , Issue 4 , April 1989 , pp. 529 - 534
Copyright
Copyright © Royal College of Psychiatrists, 1989 

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References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington DC: APA.Google Scholar
Asberg, M., Montgomery, S. A., Perris, C., et al (1978) A Comprehensive Psychopathological Rating Scale. Acta Psychiatrica Scandinavica, 271, 5–27.CrossRefGoogle Scholar
Busto, U., Sellers, E. M., Naranjo, C. A., et al (1986) Withdrawal reaction after long-term therapeutic use of benzodiazepines. New England Journal of Medicine, 315, 854–859.CrossRefGoogle ScholarPubMed
Cohn, J. B. & Wilcox, C. S. (1986) Low sedation potential of buspirone compared with alprazolam and lorazepam in the treatment of anxious patients: a double-blind study. Journal of Clinical Psychology, 47, 409–412.Google ScholarPubMed
Cox, R. D. (1970) The Analysis of Binary Data. London: Methuen.Google Scholar
Feighner, J. P., Merideth, C. H. & Hendrickson, G. A. (1982) A double-blind comparison of buspirone and diazepam in outpatients with generalised anxiety disorder. Journal of Clinical Psychiatry, 43, 103–107.Google Scholar
Fontaine, R., Chouinard, G. & Annable, L. (1984) Rebound anxiety in anxious patients after abrupt withdrawal of benzodiazepine treatment. American Journal of Psychiatry, 141, 848–852.Google ScholarPubMed
Griffith, J. D., Jasinski, D. R., Casten, G. P., et al (1986) Investigation of the abuse liability of buspirone in alcohol dependent patients. American Journal of Medicine, 80 (suppl. 3b), 30–35.CrossRefGoogle ScholarPubMed
Jacobson, A. F., Dominguez, R. A., Goldstein, B. J., et al (1985) Comparison of buspirone and diazepam in generalised anxiety disorder. Pharmacotherapy, 5, 290–296.CrossRefGoogle Scholar
Lader, M. (1982) Psychological effects of buspirone. Journal of Clinical Psychiatry, 43 (section 2), 62–67.Google ScholarPubMed
Montgomery, S. A. & Åsberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.CrossRefGoogle ScholarPubMed
Olajide, D. & Lader, M. (1987) A comparison of buspirone, diazepam and placebo in patients with chronic anxiety states. Journal of Clinical Psychopharmacology, 7, 148–152.CrossRefGoogle ScholarPubMed
Peroutka, S. J. (1985) Selective interaction of novel anxiolytics with 5-hydroxytryptamine 1A receptors. Biological Psychiatry, 20, 971–979.CrossRefGoogle Scholar
Petursson, H. & Lader, M. H. (1981) Withdrawal from long-term benzodiazepine treatment. British Medical Journal, 283, 643–645.CrossRefGoogle ScholarPubMed
Pevnick, J. S., Jasinski, D. R. & Haertaen, C. A. (1978) Abrupt withdrawal from therapeutically administered diazepam. Archives of General Psychiatry, 35, 995–998.CrossRefGoogle ScholarPubMed
Power, K. G., Jerrom, D. W. A., Simpson, R. J., et al (1985) Controlled study of withdrawal symptoms and rebound anxiety after a six week course of diazepam for generalised anxiety. British Medical Journal, 290, 1246–1248.CrossRefGoogle ScholarPubMed
Riblet, L. A., Eison, A. S., Eison, M. S., et al (1984) Neuro-pharmacology of buspirone. Psychopathology, 17 (suppl. 3), 69–78.CrossRefGoogle Scholar
Rickels, K., Weisman, K., Norstad, N., et al (1982) Buspirone and diazepam in anxiety: a controlled study. Journal of Clinical Psychiatry, 43, 81–86.Google ScholarPubMed
Rickels, K., Csanalosi, I., Chung, H., et al (1985) Buspirone, clorazepate and withdrawal. 138 Annual Meeting of the American Psychiatric Association, Dallas, May 18–24. Abstract number NR74, p. 51. Washington DC: APA.Google Scholar
Rickels, K., Schweizer, E. & Case, W. G. (1989) Withdrawal problems with antianxiety drugs: nature and management. In Psychopharmacoiogy of Anxiety (ed. Tyrer, P.). London: Oxford University Press.Google Scholar
Rifkin, A., Quitkin, F. & Klein, D. F. (1976) Withdrawal reaction to diazepam. Journal of the American Medical Association, 236, 2172–2173.CrossRefGoogle ScholarPubMed
Rodrigo, E. K. & Williams, P. (1986) Frequency of self-reported ‘anxiolytic withdrawal’ symptoms in a group of female students experiencing anxiety. Psychological Medicine, 16, 467–472.CrossRefGoogle Scholar
Royal College of Psychiatrists (1988) Benzodiazepines and dependence: a College statement. Bulletin of the Royal College of Psychiatrists, 12, 107–109.Google Scholar
Schuckit, M. A. (1984) Clinical studies of buspirone. Psychopathology, 17 (suppl. 3), 61–68.CrossRefGoogle ScholarPubMed
Schweizer, E., Rickels, K. & Lucki, I. (1986) Resistance to the antianxiety effects of buspirone in patients with a history of benzodiazepine use. New England Journal of Medicine, 314, 719–720.Google Scholar
Tyrer, P., Rutherford, D. & Huggett, T. (1981) Benzodiazepine withdrawal symptoms and propranolol. Lancet, i 520–522.CrossRefGoogle Scholar
Tyrer, P., Owen, R. & Dawling, S. (1983) Gradual withdrawal of diazepam after long-term therapy. Lancet, i 1402–1406.CrossRefGoogle Scholar
Tyrer, P., & Owen, R. (1984) Anxiety in primary care: is short-term drug treatment appropriate? Journal of Psychiatric Research, 18, 73–78.CrossRefGoogle ScholarPubMed
Tyrer, P., Owen, R. & Cicchetti, D. V. (1984) The Brief Scale for Anxiety: a subdivision of the Comprehensive Psychopathological Rating Scale. Journal of Neurology, Neurosurgery and Psychiatry, 47, 970–975.CrossRefGoogle ScholarPubMed
Tyrer, P., & Murphy, S. (1987) The place of benzodiazepines in psychiatric practice. British Journal of Psychiatry, 151, 719–723.CrossRefGoogle ScholarPubMed
Vandermaelen, C. P., Matheson, G. K., Wilderman, R. C., et al (1986) Inhibition of serotonergic dorsal raphe neurons by systemic and iontophoretic administration of buspirone, a non-benzodiazepine anxiolytic. European Journal of Pharmacology, 129, 123–130.CrossRefGoogle ScholarPubMed
Winokur, A., Rickels, K., Greenblatt, D. J., et al (1980) Withdrawal reactions from long-term low dosage administration of diazepam. Archives of General Psychiatry, 37, 101–105.CrossRefGoogle ScholarPubMed
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