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June 10, 1983

Comparison of Alprazolam, Imipramine, and Placebo in the Treatment of Depression

Author Affiliations

From the Department of Psychiatry, University of California, San Diego School of Medicine; San Luis Rey Hospital, Encinitas, Calif; and the Feighner Research Institute, San Diego (Dr Feighner); San Diego Neuropsychiatric Medical Clinical and Human Relations Center, Inc (Dr Aden); the Departments of Psychiatry, Baylor University, Houston, and the University of Texas at Houston, and Fabre Clinic, Houston (Dr Fabre); Department of Psychiatry and Pharmacology, University of Pennsylvania, Philadelphia (Dr Rickels); and the University of Oregon Health Science Center, Portland (Dr Smith). Dr Smith is also in private practice in Portland.

JAMA. 1983;249(22):3057-3064. doi:10.1001/jama.1983.03330460039029

Alprazolam is the first of the triazolobenzodiazepines to be studied in a large population of depressed patients. In a six-week, double-blind multicenter comparison of alprazolam, imipramine hydrochloride, and placebo in the treatment of 723 patients with depression, the two active drugs were statistically more effective than placebo. Alprazolam was at least as effective as imipramine in relieving depressive symptoms, significantly more effective in relieving somatic symptoms, and showed an earlier onset of activity in some measurements. Anticholinergic side effects were reported most often by patients receiving imipramine, while drowsiness was the only side effect reported most often in the alprazolam group. The Feighner Diagnostic Criteria and prestudy and poststudy intercenter conferences with videotaped patient interviews ensured interrater reliability.

(JAMA 1983;249:3057-3064)