PLACEBO-CONTROLLED COMPARISON OF THE CLINICAL EFFECTS OF RAPID DISCONTINUATION OF IPSAPIRONE AND LORAZEPAM AFTER 8 WEEKS OF TREATMENT FOR GENERALIZED ANXIETY DISORDER

One hundred and sixty patients (mean age 39.8 years; 67% female) diagn osed with generalized anxiety disorder (GAD) who had completed a prosp ective, 8 week, double-blind comparison of lorazepam (mean daily dose 4.2 mg) and ipsapirone (mean daily dose 19.5 mg) were rapidly tapered by a substitution of half-strength medication for 3 days, then substit ution of matched placebo for an additional 11 days. Patients treated w ith ipsapirone showed no rebound anxiety on discontinuation, nor any o ther significant increase in withdrawal symptomatology compared to pat ients who had been prospectively treated with placebo. In contrast, pa tients treated with lorazepam showed significant emergent anxiety and/ or withdrawal-related symptomatology by almost all clinical measures e mployed. Overall, 25% of patients treated with lorazepam showed reboun d anxiety, and 40% of them utilized reserve medication because they fo und drug discontinuation to be intolerable. The clinical implications for discontinuation of benzodiazepines after short-term therapy are di scussed.