Comparative study of the efficacy and safety of trazodone versus clorazepate in the treatment of adjustment disorders in cancer patients: a pilot study

The efficacy of trazodone (mean once-daily dose 111.5 +/- 36.3 mg) versus c lorazepate (mean once-daily dose 17.5 +/- 7.5 mg) to relieve anxious and de pressive symptoms in 18 patients undergoing treatment for breast cancer was investigated in a 28-day randomized, double-blind study, Efficacy was eval uated using the Hospital Anxiety and Depression Scale, the Revised Symptom Check;ist and the European Organization for Research and Treatment of Cance r Quality of Life questionnaire. A successful response to treatment was ach ieved in 91% (10/11) of patients who received trazodone and 57% (four of se ven) of patients who were administered clorazepate (P = 0.1373). Bayesian a nalysis revealed that the prior probability of making a wrong decision in p rescribing trazodone rather than clorazepate reduced from 26% to 8%. Assess ment of the clinical scales suggested a benefit of trazodone compared with clorazepate, although the differences were not significant, Safety of both treatments was similar Trazodone is devoid of an abuse risk and dependence and, therefore, could be a valuable alternative to clorazepate in the treat ment of adjustment disorders in cancer patients.