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Treats anxiety and panic disorder.

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Effectiveness of alprazolam in the treatment of panic disorder: a systematic review

Bibliographic details: Feijo de Mello M.  Effectiveness of alprazolam in the treatment of panic disorder: a systematic review. Revista Brasileira de Medicina 2006; 63(11): 606-610

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

Effectiveness and safety of trazodone versus alprazolam for adults' generalized anxiety disorder: a meta-analysis

Bibliographic details: Zhang YQ, Fan KH, Jin WH, Li D, Mi TT.  Effectiveness and safety of trazodone versus alprazolam for adults' generalized anxiety disorder: a meta-analysis. Chinese Journal of Evidence-Based Medicine 2013; 13(1): 100-105 Available from: http://www.cjebm.org.cn/en/oa/DArticle.aspx?type=view&id=20130118

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

The efficacy and safety of alprazolam versus other benzodiazepines in the treatment of panic disorder

We performed a meta-analysis of all single- or double-blind, randomized controlled trials comparing alprazolam to another benzodiazepine in the treatment of adult patients meeting the Diagnostic and Statistical Manual of Mental Disorders, Third or Fourth Edition, criteria for panic disorder or agoraphobia with panic attacks. Eight studies met inclusion criteria, describing a total of at least 631 randomized patients. In the pooled results, there were no significant differences in efficacy between alprazolam and the comparator benzodiazepines on any of the prespecified outcomes: improvement in mean panic attack frequency (between-arm weighted mean difference of 0.6 panic attacks per week; 95% confidence interval [CI], -0.3 to 1.6), improvement in Hamilton Anxiety Rating Scale score (weighted mean difference of 0.8 points; 95% CI, -0.5 to 2.1), and proportion of patients free of panic attacks at the final evaluation (pooled relative risk, 1.1; 95% CI, 0.9-1.4). Statistical heterogeneity on prespecified outcomes was not eliminated by stratification on baseline anxiety level. The available evidence fails to demonstrate alprazolam as superior to other benzodiazepines for the treatment of panic disorder.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Alprazolam for depression

Additional options to help those with depression control their mood, besides psychotherapy and antidepressants, can be important, especially when there is also anxiety involved. One of the drug options is alprazolam, a benzodiazepine. We evaluated the effect of alprazolam for depression. The best evidence currently available suggests that alprazolam may be moderately more effective than a placebo, and as effective as conventional antidepressants, in the treatment of major depression. We cannot conclude whether this is due to its specific antidepressant effect or to a non‐specific effect on sleep and anxiety. There were relatively few short‐term side effects. However, the multiple shortcomings of the currently available evidence, including probable sponsorship bias, publication bias, the age of the studies and the heterogeneity of the results, limit confidence in these findings.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Alcohol Use Disorders: Diagnosis and Clinical Management of Alcohol-Related Physical Complications [Internet]

Alcohol is the most widely used psychotropic drug in the industrialised world; it has been used for thousands of years as a social lubricant and anxiolytic. In the UK, it is estimated that 24% of adult men and 13% of adult women drink in a hazardous or harmful way. Levels of hazardous and harmful drinking are lowest in the central and eastern regions of England (21–24% of men and 10–14% of women). They are highest in the north (26–28% of men, 16–18% of women). Hazardous and harmful drinking are commonly encountered amongst hospital attendees; 12% of emergency department attendances are directly related to alcohol whilst 20% of patients admitted to hospital for illnesses unrelated to alcohol are drinking at potentially hazardous levels. Continued hazardous and harmful drinking can result in dependence and tolerance with the consequence that an abrupt reduction in intake might result in development of a withdrawal syndrome. In addition, persistent drinking at hazardous and harmful levels can also result in damage to almost every organ or system of the body. Alcohol-attributable conditions include liver damage, pancreatitis and the Wernicke’s encephalopathy. Key areas in the investigation and management of these conditions are covered in this guideline.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: 2010
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Drug Class Review: Newer Antiemetics: Final Report Update 1 [Internet]

Nausea and vomiting are major concerns for patients undergoing chemotherapy, radiation therapy and surgery with general anesthesia. Risk factors associated with chemotherapy-induced nausea and vomiting include emetogenicity of the chemotherapy regimen, dose, speed of intravenous infusion, female gender, age under 50 years, history of ethanol consumption, and history of prior chemotherapy. Factors predictive of radiation therapy-induced nausea and vomiting include site of irradiation (in particular, total body irradiation and radiation fields that include the abdomen), total field size, dose per fraction, age, and predisposition for emesis (history of sickness during pregnancy or motion sickness). Female gender, a history of motion sickness or prior postoperative nausea and vomiting, nonsmoking status, and use of postoperative opioids have been suggested as factors predictive of postoperative nausea and vomiting. The objective of this review was to evaluate the comparative effectiveness and harms of newer antiemetic drugs including the 5-HT3 and NK-1 antagonists.

Drug Class Reviews - Oregon Health & Science University.

Version: January 2009
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Lactose Intolerance and Health

We systematically reviewed evidence to determine lactose intolerance (LI) prevalence, bone health after dairy-exclusion diets, tolerable dose of lactose in subjects with diagnosed LI, and management.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: February 2010
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Dementia: A NICE-SCIE Guideline on Supporting People With Dementia and Their Carers in Health and Social Care

This guideline has been developed to advise on supporting people with dementia and their carers in health and social care. The guideline recommendations have been developed by a multidisciplinary team of health and social care professionals, a person with dementia, carers and guideline methodologists after careful consideration of the best available evidence. It is intended that the guideline will be useful to practitioners and service commissioners in providing and planning high-quality care for those with dementia while also emphasising the importance of the experience of care for people with dementia and carers.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2007
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Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder (PTSD) [Internet]

To assess efficacy, comparative effectiveness, and harms of psychological and pharmacological treatments for adults with posttraumatic stress disorder (PTSD).

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: April 2013
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Drug Class Review: Second-Generation Antidepressants: Final Update 5 Report [Internet]

We compared the effectiveness and harms of second-generation antidepressants in the treatment of major depressive disorder (MDD), dysthymia, subsyndromal depression, seasonal affective disorder, generalized anxiety disorder, obsessive compulsive disorder, panic disorder, post-traumatic stress disorder, social anxiety disorder, and premenstrual dysphoric disorder.

Drug Class Reviews - Oregon Health & Science University.

Version: March 2011
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Drug Class Review: Drugs for Fibromyalgia: Final Original Report [Internet]

We compared the effectiveness and harms of tricyclic antidepressants, serotonin norepinephrine reuptake inhibitors, selective serotonin reuptake inhibitors, selective serotonin and norepinephrine reuptake inhibitors, noradrenergic and specific serotonergic reuptake inhibitor, norepinephrine and dopamine reuptake inhibitor, serotonin receptor antagonist, antiepileptic drugs, and skeletal muscle relaxants in adults with fibromyalgia.

Drug Class Reviews - Oregon Health & Science University.

Version: April 2011
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Generalised Anxiety Disorder in Adults: Management in Primary, Secondary and Community Care

This clinical guideline is an update of NICE’s previous guidance on generalised anxiety disorder. It was commissioned by NICE and developed by the National Collaborating Centre for Mental Health, and sets out clear evidence- and consensus-based recommendations for healthcare professionals on how to treat and manage generalised anxiety disorder in adults.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2011
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Muscle relaxants for pain management in rheumatoid arthritis

This summary of a Cochrane review presents what we know from research about the effect of muscle relaxants on pain in patients with rheumatoid arthritis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Sleep Disorders (PDQ®): Health Professional Version

Expert-reviewed information summary about causes and management of sleep disorders in people with cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: April 23, 2014

Screening in Primary Care Settings for Illicit Drug Use: Staged Systematic Review for the United States Preventive Services Task Force [Internet]

Illicit drug use and abuse are serious problems among adolescents, adults, and pregnant women in the United States, and approximately 3.2% of the population age 12 and over meet criteria for a drug use disorder. Many individuals with drug use disorders have co-existing mental and physical health conditions.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: January 2008
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Pregnancy and Complex Social Factors: A Model for Service Provision for Pregnant Women with Complex Social Factors

This guideline aims to: identify and describe best practice for service organisation and delivery that will improve access, acceptability and use of services; identify and describe services that encourage, overcome barriers to and facilitate the maintenance of contact throughout pregnancy; describe additional consultations with and/or support and information for women with complex social factors, and their partners and families, that should be provided during pregnancy, over and above that described in the NICE guideline ‘Antenatal care: routine care for the healthy pregnant woman’ (2008) (clinical guideline 62); identify when additional midwifery care or referral to other members of the maternity team (obstetricians and other specialists) would be appropriate, and what that additional care should be.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: September 2010
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Adjustment to Cancer: Anxiety and Distress (PDQ®): Health Professional Version

Expert-reviewed information summary about the difficult emotional responses many cancer patients experience. This summary focuses on normal adjustment issues, psychosocial distress, and adjustment disorders.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: February 19, 2015

Benzodiazepines in Older Adults: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines [Internet]

The use of benzodiazepines has been associated with several adverse effects including, ataxia, dizziness, over-sedation, anterograde amnesia, and dependence. The severity of adverse effects, particularly those associated with the central nervous system, may be greater in older adults. Therefore, close monitoring is typically recommended when benzodiazepines are used by older adults. In addition, several reviews and guidelines recommend that the use of long-acting benzodiazepines by older adults be avoided. High utilization by older adults and documented safety concerns indicate that a review of the evidence on the use of benzodiazepines by older adults is warranted.

Rapid Response Report: Peer-Reviewed Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: January 2011
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Self-Harm: Longer-Term Management

This is the first NICE guideline on the longer-term management of both single and recurrent episodes of self-harm.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2012
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Pain (PDQ®): Health Professional Version

Expert-reviewed information summary about pain as a complication of cancer or its treatment. Approaches to the management and treatment of cancer-associated pain are discussed.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: September 3, 2014

Systematic Reviews in PubMed

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