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July 1989

The 'Efficacy' of Alprazolam in Panic Disorder and Agoraphobia: A Critique of Recent Reports

Author Affiliations

(Corresponding Author) Institute of Psychiatry London SE58AF, England
Hopital Julio de Matos Lisbon, Portugal
Hôpital Neurologique 58 Blvd Pinel Lyon 3e, France
Departamento Psychiatria Faculdade de Medicine Ave Dr Arnaldo 455 01246 Sao Paulo, Brazil
Department of Psychiatry University of Wisconsin 600 Highland Ave Madison, WI 53792
Department of Psychiatry Hamburg University Martinistrasse 20 Hamburg 2000, West Germany
UCLA Neuropsychiatric Institute 760 Westwood Plaza Los Angeles, CA 90024
Coimbra University Hospital Coimbra 3049, Portugal
Department of Medical Psychology Autonomous University of Barcelona Bellaterra, Spain
Saint Charles Hospital London W106DZ, England
Max Planck Institute of Psychiatry Kraeplinstrasse 19 8000 Munich, West Germany

Arch Gen Psychiatry. 1989;46(7):668-670. doi:10.1001/archpsyc.1989.01810070094015

To the Editor.—  Psychiatrists and psychologists in several countries have helped to compose this letter, which critiques recent reports (in the May 1988 Archives, pp 407-443) by Klerman,1 Ballenger et al,2 Noyes et al,3 Pecknold et al,4 and Lesser et al.5The evaluation of treatment outcome is a complex process, and the same data can lead different observers to contrasting conclusions, as is highlighted by this large trial reported by respected researchers. All five articles claim that alprazolam is "effective," a claim made without qualification in the abstract of Klerman's article.1 Pecknold et al4 even recommend in their abstract that the administration of medication should last at least 6 months, with subsequent taper of at least 8 weeks. This claim of "efficacy" is misleading given the arguable interpretation of the data presented and that busy clinicians often have to rely on abstracts more

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