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Differential effects of alprazolam and imipramine in generalized anxiety disorder: somatic versus psychic symptoms

J Clin Psychiatry. 1988 Aug;49(8):293-301.

Abstract

Some researchers have recently suggested that antidepressants may be superior to benzodiazepines in the alleviation of generalized anxiety. In a 6-week, double-blind, parallel-design study with flexible dosage scheduling, the authors compared the effects of alprazolam with those of imipramine in 60 patients who had generalized anxiety disorder. On rating scales that contained both psychic and somatic symptoms, patients in both treatment groups improved to a similar degree after 2 weeks. However, alprazolam was more effective in attenuating somatic symptoms, and imipramine was more effective in attenuating psychic symptoms such as dysphoria and negative anticipatory thinking. The authors' results suggest that, in generalized anxiety, somatic symptoms and hyperarousal selectively respond to drugs acting on the gamma-aminobutyric acid system, whereas psychic symptoms respond to treatments affecting the noradrenergic or serotonergic systems.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Alprazolam / administration & dosage
  • Alprazolam / adverse effects
  • Alprazolam / therapeutic use*
  • Analysis of Variance
  • Anxiety Disorders / drug therapy*
  • Anxiety Disorders / psychology
  • Clinical Trials as Topic
  • Double-Blind Method
  • Drug Administration Schedule
  • Drug Evaluation
  • Female
  • Humans
  • Imipramine / administration & dosage
  • Imipramine / adverse effects
  • Imipramine / therapeutic use*
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Random Allocation
  • Time Factors

Substances

  • Imipramine
  • Alprazolam