Alprazolam and Standard Antidepressants in the Treatment of Depression: A Meta-analysis of the Antidepressant Effect
MANIT SRISURAPANONT, M.D.*, VUDHICHAI BOONYANARUTHEE, M.D.*
Affiliation : *Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Abstract Alprazolam differs from other benzodiazepines by the incorporation of a triazolo ring in the basic chemical structure. Several lines of evidence have supported that alprazolam and stan- dard antidepressants have some similar actions, such as beta-adrenergic receptor down-regulation, antipanic effect. Because of the difference in opinions pertaining to the antidepressant effect of alprazolam, this issue could not reach a firm conclusion. In the present analysis, we carried out a meta-analysis of 11 random controlled studies that compared the antidepressant effect of alprazo- lam and standard antidepressants in depressed patients. The results showed that the weighted mean effect size d (dw) is equal to 0.06. In conclusion, the antidepressant effect of alprazolam is com- parable to that of low-dose tricyclic antidepressants. Very few studies have investigated severely depressed patients. Also, in long-term administration, the lack of a long-term treatment study makes the isssue of alprazolam's benefits and disadvantages still undetermined.
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