Buspirone vs Alprazolam: A Double-Blind Comparative Study of Their Efficacy, Adverse Effects and Withdrawal Symptoms

Abstract

Buspirone was compared with alprazolam in the treatment of generalised anxiety disorder in a 7-week double-blind, randomised study of 60 outpatients. All patients received placebo during the first week of the trial, active medication for the following 4 weeks (buspirone 15 mg/day or alprazolam 1.5 mg/day) and placebo for the last 2 weeks of the trial. 13 patients in the buspirone group and 12 in the alprazolam group received increased doses of 25 mg/day buspirone or 2.5 mg/day alprazolam, respectively. The 2 drugs were equally effective and produced significant reductions in anxiety. Buspirone-treated patients experienced fewer adverse effects than alprazolam-treated patients during both the active treatment period and the 2-week withdrawal period following abrupt discontinuation of both drugs. During the active treatment period, the most frequently encountered adverse effects in buspirone recipients were nausea, dizziness and headache, while those in alprazolam recipients were decreased concentration, drowsiness, fatigue, tremor, insomnia and dry mouth. During the 2-week withdrawal period, the most frequently encountered symptoms in buspirone-treated patients were nervousness and insomnia, while those in alprazolam-treated patients were nervousness, insomnia, aches/pain and sweating. While buspirone and alprazolam appear to be equally effective in the treatment of generalised anxiety disorder, the results of this study indicate a superiority of buspirone over alprazolam with regard to adverse effects and withdrawal symptoms.