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Prescription-Event Monitoring of 10 895 Patients Treated with Alprazolam

Published online by Cambridge University Press:  02 January 2018

J. Guy Edwards ,
William H. W. Inman ,
Gillian L. Pearce  and
Nigel S. B. Rawson
J. Guy Edwards*
Affiliation:
Royal South Hants Hospital, Southampton SO9 4PE
William H. W. Inman
Affiliation:
Drug Safety Research Unit, Bursledon Hall, Southampton SO3 8BA
Gillian L. Pearce
Affiliation:
Drug Safety Research Unit, Bursledon Hall, Southampton SO3 8BA
Nigel S. B. Rawson
Affiliation:
Applied Research/Psychiatry, Box 92, Royal University Hospital, Saskatoon, Saskatchewan, Canada S7N 0X0
*
* Correspondence
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Abstract

‘Prescription-event monitoring’ (PEM) is one of two national systems of post-marketing surveillance in operation in Britain. It identified 22 065 patients who had received NHS prescriptions for alprazolam, and data available on 10 895 of these were analysed. The main reasons for treatment with alprazolam were anxiety and depression. The patients provided 3360 patient-years of treatment and 7540 patient-years of follow-up. No serious events clearly associated with treatment were recorded. The main events reported during treatment, albeit infrequently, were drowsiness and depression, although depression is more likely to be due to the disorder being treated than to the drug. Some of the other alleged unwanted effects of alprazolam in published reports were not encountered. Since PEM is unable to determine the dependence potential of alprazolam, further evaluation of this problem is called for.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 158 , Issue 3 , March 1991 , pp. 387 - 392
Copyright
Copyright © Royal College of Psychiatrists, 1991 

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References

Angst, J. (1987) Switch from depression to mania, or from mania to depression. Journal of Psychopharmacology, 1, 13–19.Google Scholar
Arana, G. W. Pearlman, C. & Shader, R. I. (1985) Alprazolam-induced mania: two clinical cases. American Journal of Psychiatry, 142, 368–369.Google Scholar
Balter, M. B. Manheimer, D. I. Mellinger, G. D. et al (1984) A cross-national comparison of anti-anxiety/sedative use. Current Medical Research and Opinion (suppl. 4), 5–20.Google Scholar
Block, R. I. & Berchou, R. (1984) Alprazolam and lorazepam effects on memory acquisition and retrieval processes. Pharmacology, Biochemistry and Behavior, 20, 233–241.Google Scholar
Boyd, J. H. & Weissman, M. M. (1982) Epidemiology. In Handbook of Affective Disorders (ed. Paykel, E. S.), pp. 109–125. Edinburgh: Churchill-Livingstone.Google Scholar
Breier, A. Charney, D. S. & Nelson, J. C. (1984) Seizures induced by abrupt discontinuation of alprazolam. American Journal of Psychiatry, 141, 1606–1607.Google Scholar
Browne, J. L. & Hauge, K. J. (1986) A review of alprazolam withdrawal. Drug Intelligence and Clinical Pharmacy, 20, 837–841.CrossRefGoogle ScholarPubMed
Burgess, C. D. & Turner, P. D. (1981) Cardiovascular effects of antidepressants: clinical implications. In Stress and the Heart (ed. Wheatley, D.), pp. 173–190. New York: Raven Press.Google Scholar
Danielson, D. A. Porter, J. B. Lawson, D. H. et al (1981) Drug-associated psychiatric disturbances in medical inpatients. Psychopharmacology, 74, 105–108.Google Scholar
Dawson, G. W. Jue, S. G. & Brogden, R. N. (1983) Alprazolam. A review of its pharmacodynamic properties and efficacy in the treatment of anxiety and depression. Drugs, 27, 132–147.Google Scholar
Edwards, J. G. (1981) Unwanted effects of psychotropic drugs and their mechanisms. In Handbook of Biological Psychiatry, Part VI. Practical Applications of Psychotropic Drugs and Other Biological Treatments (eds van Praag, H. M. Lader, M. H. Raphaelson, O. J. et al), pp. 1–38. New York: Marcel Dekker.Google Scholar
Edwards, J. G. (1989) Drug-related depression: clinical and epidemiological aspects. In Depression – An Integrative Approach (eds Paykel, E. S. & Hirbst, K.), pp. 81–108. London: Heinemann.Google Scholar
Edwards, J. G. Long, S. Sedgwick, E. M. et al (1987) Antidepressants and convulsive seizures: clinical, epidemiological, and pharmacological aspects. Clinical Neuropharmacology, 9, 329–360.CrossRefGoogle Scholar
Feighner, J. P. Aden, G. C. Fabre, L. F. et al (1983) Comparison of alprazolam, imipramine, and placebo in the treatment of depression. Journal of the American Medical Association, 249, 3057–3064.CrossRefGoogle ScholarPubMed
France, R. D. & Krishman, K. R. R. (1984 a) Alprazolam-induced manic reaction. American Journal of Psychiatry, 141, 1127–1128.Google Scholar
France, R. D. & Krishman, K. R. R. (1984 b) Behavioral toxicity with alprazolam. Journal of Clinical Psychopharmacology, 4, 294.CrossRefGoogle Scholar
French, A. P. (1989) Dangerously aggressive behavior as a side effect of alprazolam. American Journal of Psychiatry, 146, 276.Google Scholar
Fyer, A. J. Liebowitz, M. R. Gorman, J. M. et al (1987) Discontinuation of alprazolam treatment in panic patients. American Journal of Psychiatry, 144, 303–308.Google Scholar
Goodman, W. K. & Charney, D. S. (1987) A case of alprazolam, but not lorazepam, inducing manic symptoms. Journal of Clinical Psychiatry, 48, 117–118.Google Scholar
Hall, R. C. W. & Joffe, J. R. (1972) Aberrent response to diazepam: a new syndrome. American Journal of Psychiatry, 129, 738–742.Google Scholar
Inman, W. H. W. Rawson, N. S. B. & Wilton, L. V. (1986) Prescription-event monitoring. In Monitoring for Drug Safety, (2nd edn) (ed. Inman, W. H. W.), pp. 213–235. London: MTP Press.Google Scholar
Johnson, D. A. W. (1983) Benzodiazepines in depression. In Benzodiazepines Divided. A Multidisciplinary Revew (ed. Trimble, M. R.), pp. 247–257. Chichester: John Wiley.Google Scholar
Judd, F. K. Norman, T. R. Marriott, P. F. et al (1986) A case of alprazolam-related hepatitis. American Journal of Psychiatry, 143, 388–389.Google ScholarPubMed
Levy, A. B. (1984) Delirium and seizures due to abrupt alprazolam withdrawal. Journal of Clinical Psychiatry, 45, 38–39.Google Scholar
Lewis, J. A. (1981) Post-marketing surveillance: how many patients? Trends in Pharmacological Science, 2, 93–94.CrossRefGoogle Scholar
Lydiard, R. B. Howell, E. F. Laraia, M. T. et al (1987) Sexual side effects of alprazolam. American Journal of Psychiatry, 144, 254–255.Google Scholar
Munjack, D. J. & Crocker, B. (1986) Alprazolam-induced ejaculatory inhibition. Journal of Clinical Psychopharmacology, 6, 57–58.Google Scholar
Overall, J. E. Biggs, J. Jacobs, M. et al (1987) Comparison of alprazolam and imipramine for treatment of outpatient depression. Journal of Clinical Psychiatry, 48, 15–19.Google Scholar
Rapaport, M. & Braff, D. L. (1985) Alprazolam and hostility. American Journal of Psychiatry, 142, 146.Google Scholar
Rawson, N. S. B. (1987) Prescription-Event Monitoring: a New Method for Studying Drug Safety. PhD thesis, University of Southampton.Google Scholar
Rickels, K. Cohen, D. Csanalosi, I. et al (1982) Alprazolam and imipramine in depressed outpatients: a controlled study. Current Therapeutic Research, 32, 157–164.Google Scholar
Rickels, K. Feighner, J. P. & Smith, W. T. (1985) Alprazolam, amitryptiline, doxepin, and placebo in the treatment of depression. Archives of General Psychiatry, 42, 134–141.Google Scholar
Rickels, K. Chung, H. R. Csanalosi, I. B. et al (1987) Alprazolam, diazepam, imipramine, and placebo in outpatients with major depression. Archives of General Psychiatry, 44, 862–866.Google Scholar
Rosenbaum, J. F. Woods, S. W. Groves, J. E. et al (1984) Emergence of hostility during alprazolam treatment. American Journal of Psychiatry, 141, 792–793.Google Scholar
Roy-Byrne, P. Vittone, B. J. & Uhde, T. W. (1983) Alprazolam-related hepatotoxicity. Lancet, ii, 786–787.Google Scholar
Rush, A. J. Erman, M. K. Schlesser, M. A. et al (1985) Alprazolam vs amitryptiline in depressions with reduced REM latencies. Archives of General Psychiatry, 42, 1154–1159.CrossRefGoogle Scholar
Ryan, H. F. Merrill, B. & Scott, G. E. et al (1968) Increase in suicidal thoughts and tendencies. Association with diazepam therapy. Journal of the American Medical Association, 203, 135–137.Google Scholar
Sangal, R. (1985) Inhibited female orgasm as a side effect of alprazolam. American Journal of Psychiatry, 142, 1223–1224.Google Scholar
Soloman, R. L. Rich, C. L. & Darko, D. F. (1990) Antidepressant treatment and the occurrence of mania in bipolar patients admitted for depression. Journal of Affective Disorders, 18, 253–257.Google Scholar
Warrington, S. J. Padgham, C. & Lader, M. (1989) The cardiovascular effects of antidepressants. Psychological Medicine (monograph supplement 16), 1–40.Google Scholar
Weissman, M. M. Prusoff, B. A. Kleber, H. D. et al (1985) Alprazolam (Xanax) in the treatment of major depression. In Clinical and Pharmacological Studies in Psychiatric Disorders (eds Burrows, G. D. Norman, J. R. & Denneratein, L.), pp. 52–58. London: John Libbey.Google Scholar
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