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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

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

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

Drug Class Review: Atypical Antipsychotic Drugs: Final Update 3 Report [Internet]

Atypical antipsychotic agents are used to treat the symptoms of schizophrenia and bipolar disorder. The purpose of this review is to help policy makers and clinicians make informed choices about their use. Given the prominent role of drug therapy in psychiatric disease, our goal is to summarize comparative data on efficacy, effectiveness, tolerability, and safety. Ten atypical antipsychotics are currently available in the United States and Canada. Clozapine, the prototypic atypical antipsychotic, was introduced in 1989. Since then, 9 other atypical antipsychotics have been brought to market: risperidone (1993), risperidone long-acting injection (2003), olanzapine (1996), quetiapine (1997), ziprasidone (2001), aripiprazole (2002), extended-release paliperidone (2006), asenapine (2009), iloperidone (2009), and paliperidone long-acting injection (2009).

Drug Class Reviews - Oregon Health & Science University.

Version: July 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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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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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

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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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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Drug Class Review: Newer Drugs for Insomnia: Final Report Update 2 [Internet]

Insomnia is a serious health problem that affects millions of people. Population surveys have estimated the prevalence of insomnia to be about 30% to 50% of the general population. About three-fourths of people who have trouble sleeping say that the problem is "occasional," averaging about 6 nights per month, with one-fourth having frequent or chronic insomnia, averaging about 16 nights per month. Individuals with insomnia most often report a combination of difficulty falling asleep and intermittent wakefulness during sleep. Treatment of insomnia involves behavioral changes, such as minimizing habits that interfere with sleep (for example, drinking coffee or engaging in stressful activities in the evening), and pharmacotherapy with sedating antidepressants (for example, trazodone), sedating antihistamines, anticholinergics, benzodiazepines, or nonbenzodiazepine hypnotics. The benzodiazepines and the newer sedative hypnotics zolpidem, zaleplon, zopiclone, and eszopiclone work through gamma-aminobutyric acid receptors. Ramelteon, a hypnotic approved by the United States Food and Drug Administration (FDA) in July 2005, is a selective melatonin receptor (MT1 and MT2) agonist. New nonbenzodiazepine drugs have been sought for multiple reasons, including reduction of the risk of tolerance, dependence, and abuse associated with benzodiazepines. The purpose of this review is to evaluate the comparative evidence on benefits and harms of these medications in people with insomnia to help policymakers and clinicians make informed choices about the use of newer drugs for insomnia.

Drug Class Reviews - Oregon Health & Science University.

Version: October 2008
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Auricular acupuncture treatment for insomnia: a systematic review

This review concluded that the use of auricular acupuncture (AA) to treat insomnia appeared to produce better rates of recovery and improvement than control. However, given the lack of information, it is not possible to draw conclusions about the long-term efficacy and safety of using AA to treat insomnia. The authors’ cautious conclusions appear to reflect the limitations of the evidence presented.

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

Version: 2007

Systematic Reviews in PubMed

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