Relapse and rebound following discontinuation of benzodiazepine treatment of panic attacks: alprazolam versus diazepam

Article Abstract:

Benzodiazepine is psychotropic drug prescribed to reduce anxiety. A study of the effects of benzodiazepine withdrawal on 40 people with an existing panic attack condition was conducted. A gradual tapering off of medication was followed by an abrupt discontinuation. Medication withdrawal in victims of panic attacks has long been an observed phenomenon but comparatively little research in this area is currently available. In general, the withdrawal process involves three phases: relapse (a return to the original anxious state); rebound (an increase in the level of anxiety exceeding the original baseline condition); and withdrawal associated with the discontinuation of the drug without anxiety. Symptoms of withdrawal are known to vary with the type of medication that is used. Because of the way this study was designed, relapse and rebound stages could not be distinguished and conclusions were based upon the relative change in the status of the patients. The group was divided randomly into three subgroups and each one was given either alprazolam, diazepam (both benzodiazepines) or a placebo for six weeks. This was followed by a two-week tapering off period and then a sudden discontinuation. All subjects were measured for anxiety during these periods. At the end of the gradual reduction period, there was no significant difference in the incidence of panic attacks or in the general anxiety level of the patients. However, following the abrupt discontinuation, the patients who had been taking the alprazolam showed higher rates of generalized anxiety. A higher frequency of panic attacks, which are characterized by more intense anxiety, was not observed in any one group. The results of this study are preliminary and are limited by some of the following factors: small sample size; a wide variety of specific disorders within the patient population; different half-lives (the time required to metabolize half the substance taken) for the two benzodiazepines used. However, the findings indicated that there were more withdrawal difficulties associated with alprazolam than with diazepam. Additional study with a larger and more homogenous patient sampling and more frequent rating intervals was recommended. The relative effects of different benzodiazepines with similar half-lives should also be examined.

Psychological aspects, Drug therapy, Drug withdrawal symptoms, Substance withdrawal syndrome, Diazepam, Alprazolam

---

Response to sodium lactate infusion in alcoholics with panic attacks

Article Abstract:

Research has shown that alcoholism and panic disorder coexist in a significant proportion of patients. Panic disorder, a common psychiatric problem, causes sudden intense periods of fearfulness and a sense of impending doom; symptoms during attacks include shortness of breath, palpitations, chest discomfort and fear of losing control. Panic disorder may lead to alcoholism; patients have reported that drinking helped them face difficult situations. In other individuals, chronic alcohol abuse may increase fearfulness and anxiety and lead to panic disorder. There is some evidence that panic attacks in alcoholics may result from alcohol withdrawal. A means of identifying persons with panic disorder is intravenous infusion of sodium lactate; patients with panic attacks are more likely to respond to lactate with psychological and physiological symptoms of panic than normal controls. The researchers tested whether response to lactate infusion was a reliable indicator of panic disorder in individuals who had already been carefully diagnosed with this condition. Twelve alcoholics with panic disorder, 10 alcoholics without it, and 16 nonalcoholics with panic disorder were included. Lactate-induced panic was observed consistently as anticipated in alcoholics and nonalcoholics with a history of panic attacks. These two groups had similar reactions to the lactate infusion, suggesting that panic disorder is similar in alcoholics and nonalcoholics. The lactate test appeared to be a useful and specific tool for identifying panic disorder. It may be particularly valuable for diagnosis in alcoholics, a group that has been difficult to diagnose by other means because of the overlap between the symptoms of panic disorder and alcoholism.

Diagnosis, Alcoholism, Sodium compounds, Alcoholic myopathy

---

Carbamazepine treatment for benzodiazepine withdrawal

Article Abstract:

Nine patients were given carbamazepine, an anticonvulsant drug, before "cold turkey" withdrawal from benzodiazepine, a mild tranquilizer. Most patients had received long-term benzodiazepine treatment and had abused benzodiazepines; five had taken high doses. None of the patients had difficulties rapidly withdrawing from use of the tranquilizers, nor did any develop significant withdrawal symptoms. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Medication abuse, Prescription drug abuse, Carbamazepine

Similar abstracts:

• Abstracts: Changes on the Stroop test following treatment: relation to word type, treatment condition, and treatment outcome among women with bulimia nervosa
• Abstracts: Group cognitive-behavioral treatment of binge eating disorder: a comparison of therapist-led versus self-help formats
• Abstracts: Systems, attachment, and relationships. A reply to commentaries on 'infant attachment as a dynamic system'
• Abstracts: Perfectionism and relationship adjustment in pain patients and their spouses. Perfectionism, befliefs, and adjustment in dating relationships
• Abstracts: Long-term prediction of marital quality following a relationship education program: Being positive in a constructive way

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.