ALPRAZOLAM-REINFORCED MEDICATION USE IN OUTPATIENTS WITH ANXIETY

The reinforcing effects of alprazolam were investigated in 14 patients who had generalized anxiety or panic disorder, but were not current u sers/abusers of other psychoactive substances. Using a double-blind ou tpatient choice procedure, color-coded alprazolam (0.5 mg) and placebo capsules were provided to patients for use 'as needed' in the treatme nt of anxiety symptoms. Comparisons of alprazolam and placebo during a 2 week sampling period in which placebo and alprazolam were available sequentially revealed no significant differences on measures of medic ation usage or anxiety levels, although alprazolam did increase subjec tive ratings of drug effects/side effects. During a 4 week choice peri od, alprazolam was strongly preferred over placebo in 11 out of 14 pat ients indicating that alprazolam functioned as a reinforcer. Medicatio n usage ranged from zero to 4.0 mg alprazolam in a day. Variations in daily medication-use were positively correlated with anxiety level flu ctuations for a majority of patients. For a majority of patients, the results indicate that alprazolam functioned as a reinforcer without ac companying signs of abuse or addiction. (C) 1997 Elsevier Science Irel and Ltd.