Absence of neuropsychologic deficits in patients receiving long-term treatment with alprazolam-XR for panic disorder

Studies to date on the effects of benzodiazepines on neuropsychologic funct ion have yielded conflicting data with respect to the type, severity, and d uration of deficits that may be induced by these agents. As part of a place bo-controlled trial of alprazolam-XR (extended release) administered in com bination with cognitive-behavioral therapy in patients with panic disorder, a battery of tests was used to measure neuropsychologic function. Thirty-e ight outpatients were randomly assigned to receive either alprazolam-XR or placebo. Dosages were titrated up so that the alprazolam group (N = 18) rec eived a mean dose of 4 mg/day (reduced in two patients because of sedative side effects). Neuropsychologic function after 6 weeks of therapy at the ta rget dosage was compared with baseline assessments in each group. Both grou ps showed a statistically significant improvement from baseline to repeated assessments on measures of attention, executive functioning, psychomotor s peed, and visual memory (p < 0.001); these gains were attributed to a pract ice effect. No significant changes were noted in measures of learning, verb al memory, or reaction time, and neither group showed any deterioration fro m baseline to retesting in any aspect of neuropsychologic function. These f indings call into question the assumption that long-term benzodiazepine the rapy produces significant neuropsychologic deficit in patients with diagnos ed anxiety disorders.