Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-26T18:57:18.816Z Has data issue: false hasContentIssue false

Key considerations for long-term studies with anxiolytics

Published online by Cambridge University Press:  16 April 2020

Get access

Summary

Long-term (minimum six months) safety and efficacy studies with an anti-anxiety agent are aimed at identifying the emergence of any clinical effects not observed during shorter periods of treatment including the identification of late occurring adverse events, loss of therapeutic benefit, or post-treatment withdrawal effects. There is the need to establish diagnostic criteria for persistent anxiety for patients who truly benefit from long-term therapy. Risk factors predisposing to drug dependence should be assessed prior to continuous use. Ideally, long-term continuous studies should be blinded, comparative and placebo-controlled, with an adequate duration of the withdrawal phase. The treatment response of the elderly in comparison to the overall patient sample should be emphasised.

Type
Research Article
Copyright
Copyright © Elsevier, Paris 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

The opinions expressed in this paper are those of the author and are not necessarily shared by UCB Pharma.

References

American Psychiatric Association Diagnostic and statistical manual of mental disorders 3rd edition (DSM-III) Washington: APA, 1980Google Scholar
Ballenger, JC, Burrows, GD, Dupont, RL Jr, et al.Alprazolam in panic disorder and agoraphobia: results from a multicenter trial. I. Efficacy in short-term treatment. Arch Gen Psychiatry 1988; 45: 413422CrossRefGoogle ScholarPubMed
Busto, U, Sellers, EM, Naranjo, CA, Cappell, H, Sanchez-Craig, M, Sykora, KWithdrawal reaction after long-term therapeutic use of benzodiazepines. N Engl J Med 1986; 315: 854859CrossRefGoogle ScholarPubMed
Cohn, JB, Wilcox, CSLong-term comparison of alprazolam, lorazepam and placebo in patients with anxiety disorder. Pharmacotherapy 1984; 4: 9398CrossRefGoogle ScholarPubMed
Cross-National Collaborative Panic Study, Second Phase Investigators Drug treatment of panic disorder: comparative efficacy of alprazolam, imipramine, and placebo. Br J Psychiatry 1992; 160: 191202CrossRefGoogle Scholar
EEC Directive. Clinical testing requirements for drugs for long-term use. Directive 75/318/EEC, Part 3Google Scholar
Fabre, LF, MacLendon, DM, Stephens, AGComparison of the therapeutic effect, tolerance and safety of ketazolam and diazepam administered for six months to out-patients with chronic anxiety neurosis. J Int Med Res 1981; 9: 191198CrossRefGoogle ScholarPubMed
Geiselmann, B, Linden, MPrescription and intake patterns in long-term and ultra-long-term benzodiazepine treatment in primary care practice. Pharmacopsychiatry 1991; 24: 5561CrossRefGoogle ScholarPubMed
Hamilton, MThe assessment of anxiety states by rating. Br J Med Psychol 1959; 32: 5055CrossRefGoogle ScholarPubMed
Marriott, S, Tyrer, PBenzodiazepine dependence. Avoidance and withdrawal Drug Safety 1993 9 2 93103CrossRefGoogle ScholarPubMed
Mattes, AJ, Horowitz Konig, PShould DSM-III-R GAD criteria be used for studies of anxiolytics?. Biol Psychiatry 1993; 33: 302303CrossRefGoogle ScholarPubMed
Murphy, SM, Owen, R, Tyer, PComparative assessment of efficacy and withdrawal symptoms after 6 and 12 weeks' treatment with diazepam or buspirone. Br J Psychiatry 1989; 154: 529534CrossRefGoogle ScholarPubMed
Rakel, RELong-term buspirone therapy for chronic anxiety: a multicenter international study to determine safety. Southern Med J 1990; 83: 2CrossRefGoogle Scholar
Rickels, K, Case, WG, Downing, RW, Winokur, ALong-term diazepam therapy and clinical outcome. JAMA 1983; 250: 767771CrossRefGoogle ScholarPubMed
Rickels, K, Schweizer, E, Csanalosi, I, Case, WG, Chung, HLong-term treatment of anxiety and risk of withdrawal: prospective comparison of clorazepam and buspirone. Arch Gen Psychiatry 1988; 45: 444450CrossRefGoogle Scholar
Shader, IR, Greenblatt, JDUse of benzodiazepines in anxiety disorders. N Engl J Med 1993; 328: 13981405Google ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.