Alprazolam, diazepam, imipramine, and placebo in outpatients with major depression
K. Rickels, H. R. Chung, I. B. Csanalosi, A. M. Hurowitz, J. London, K. Wiseman, M. Kaplan and J. D. Amsterdam
Department of Psychiatry, University of Pennsylvania, Philadelphia.
Two hundred forty-one outpatients with a DSM-III diagnosis of major
depressive disorder participated in a six-week double-blind therapeutic
trial of alprazolam, diazepam, imipramine hydrochloride, and placebo. Side
effects were given as a major reason for attrition by patients taking the
three active compounds and ineffectiveness was the reason given by patients
taking placebo. Imipramine-treated patients reported the most and placebo
patients the least number of adverse effects. Imipramine and alprazolam,
but not diazepam, produced significantly more improvement in depressed
symptomatology than did placebo. Mean diazepam scores frequently assumed an
intermediate position between those of imipramine or alprazolam and
placebo. These treatment differences were found to be independent of
initial severity levels of anxiety and depression.