BUSPIRONE AND LORAZEPAM IN THE TREATMENT OF GENERALIZED ANXIETY DISORDER IN OUTPATIENTS

In this double-blind, placebo-controlled 10-week trial, the anxiolytic properties of the nonbenzodiazepine buspirone were compared with the benzodiazepine lorazepam and placebo in 125 outpatients with generaliz ed anxiety disorder according to DSM-III. After a 3- to 7-day wash-out period, patients were allocated at random to receive orally 3 x 5 mg buspirone (n = 58), 3 x 1 mg lorazepam (n = 57), or placebo (n = 10) o ver a 4-week period. The study also comprised a 2-week taper period an d a 4-week placebo-control period to assess the stability of clinical improvement. The patient's clinical state was estimated on entry and a t weekly intervals by general practitioners using the Hamilton Rating Scale for Anxiety (HAM-A) and Clinical Global Impression (CGI) assessm ent and by a self-rating scale (State Trait Anxiety Inventory X2 = STA I-X2). Lorazepam treatment resulted in descriptively, but not signific antly, greater improvement on the Hamilton Rating Scale for Anxiety du ring the whole treatment (week 0-4) and taper period (week 5, 6) than did buspirone. After treatment with active drugs had been discontinued , the 4-week placebo control period showed buspirone-treated patients to display a stability of clinical improvement, while the symptoms of lorazepam-treated patients worsened at week 7-10. Both buspirone and l orazepam were more efficacious in reducing anxiety symptoms than place bo during the treatment and taper period; however, in contrast to the active drugs (buspirone, lorazepam): patients of the placebo group sho wed further clinical improvement during the control period, especially in the HAM-A score, so differences between placebo and active drugs b ecame smaller at the end of the study.