ALPRAZOLAM WITHDRAWAL SYMPTOMS IN AGORAPHOBIA WITH PANIC DISORDER - OBSERVATIONS FROM A CONTROLLED ANGLO-CANADIAN STUDY

The study examines the effect of discontinuing alprazolam in panic dis order+agoraphobia patients. Fifty-seven alprazolam and 50 placebo agor aphobia+panic disorder patients, who had participated in an 8 week dou ble-blind controlled study of alprazolam at average doses of 5 mg dail y, were withdrawn gradually from their medication over the subsequent 8 weeks. The effects of discontinuation of medication on anxiety, pani c, depression, phobia and withdrawal symptoms were examined during the taper phase and over the following 6 months. Alprazolam patients dete riorated on anxiety, panics, Hamilton depression and phobia. There was no difference between the two drug groups on rebound. Serious withdra wal symptoms did not arise, but weight loss, sweating and muscle twitc hing were more common in alprazolam patients. The deterioration in alp razolam patients persisted up to 6 months post-taper. A high dose of a lprazolam at week 8 was the best predictor of subsequent deterioration . Discontinuation of alprazolam leads to recurrence of the original di sorder in some patients. Rebound and severe withdrawal reactions were not found during gradual taper of alprazolam, but minor withdrawal sym ptoms did arise. The study shows the importance of using gradual taper to minimize withdrawal effects.