No abstract available.
Alprazolam* ; Arousal*

Orthostatic tremor is characterized by tremor of legs on standing that disappears on siting down or walking, We have recently seen a 68 year-old woman who showed typical orthostatic tremor, EMG bursts of 4-5 Hz were recorded in the leg muscles only when she was standing, Alprazolam, propranolol and clonazepam were ineffective in the alleviation of her tremor. We believe this to be the first Korean case in the literature.
Aged ; Alprazolam ; Clonazepam ; Female ; Humans ; Leg ; Muscles ; Propranolol ; Tremor* ; Walking

OBJECTIVES: The authors have treated chronic tinnitus patients using a combination of a simplified tinnitus retraining therapy (TRT) and medications, which we called modified TRT. In this clinical setting, we have attempted small-group counseling to find a time-effective equivalent of individual counseling. The aim of the present study was to evaluate the effectiveness of small-group counseling by comparing the treatment outcomes between individual and small-group counseling. METHODS: The patients who had distressing chronic tinnitus with normal hearing or mild hearing loss were included. The subjects were placed into the small-group (group 1:4) or the individual (group 1:1) counseling group, and underwent a modified TRT composed of a single session of directive counseling and ambient sound stimulation. In addition, alprazolam (0.25 mg) and ginkgo biloba extract (80 mg) were administered orally to the subjects for 3 months. The 3- and 6- month outcomes were assessed using the follow-up rates and tinnitus severity scores: awareness, tinnitus handicap inventory (THI), loudness, annoyance, and effect on life. The treatment responses were classified as improvement, no changes, and worsening. RESULTS: Of the total 149 patients (77 in group 1:1; 72 in group 1:4), 104 patients completed the protocol at 3 months, and 55 patients at 6 months. The follow-up rates were similar in both groups. Over the period of 6 months, all scores declined significantly except the loudness score at 3 months in both groups. Treatment responses showed no between-group differences. The success rate based on THI was 70% in group 1:1, and 64% in group 1:4 at 6 months. CONCLUSION: The small-group counseling of our modified TRT was comparable to the individual counseling for tinnitus relief. We suggest that this protocol can be implemented effectively in any crowded otolaryngology clinics.
Alprazolam ; Benzodiazepines ; Counseling* ; Directive Counseling ; Follow-Up Studies ; Ginkgo biloba ; Hearing ; Hearing Loss ; Humans ; Otolaryngology ; Tinnitus*

OBJECTIVE: Base on clinical practice, the authors report a case of tardive dyskinesia arising during the course of treatment with resperidal. METHODS: This article was review and analysis of a case on risperidone-induced tardive dyskinea. RESULTS: Mrs K, a 51-year-old women with a 1-year history of schizophrenic disorder, gradually developed tardive dyskinetic movement of the mouth, lip, and tongue over a 4 month period(From July 1996 to June 1997) while taking risperidone. Initially she was treated with haloperidol and alprazolam. However, the haloperidol was subsequently discontinued because of EPS developed. From 11th March 1997, she was observed to have a severe form of tardive dyskinesia involving her tongue, lip, and mouth. After risperidone was withdrawn at 9th May 1997, her tardive dyskinetic movement was disappeared. CONCLUSIONS: This is, to our knowledge, the first report of the onset of tardive dyskinesia in a patient taking risperidone. However, additional controlled studies of specific questions are needed ; e.g., the dose-response curves for produce tardive dyskinesia and the mechanism of producing risperidone-induced tardive dyskinea and so on.
Alprazolam ; Female ; Haloperidol ; Humans ; Lip ; Middle Aged ; Mouth ; Movement Disorders* ; Risperidone ; Schizophrenia ; Tongue

OBJECTIVE: This study compared the efficacy and tolerability of clonazepam with other benzodiazepines in patients with anxiety disorders. METHODS: Inclusion criteria were as follows: age >20 years, diagnosis of anxiety disorder according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision (DSM-IV-TR) criteria, taking only one type of antidepressant, and prescribed one of three oral benzodiazepines (alprazolam, clonazepam, or lorazepam). At baseline and week 6, clinical benefit was evaluated using the Clinical Global Impression-Severity Scale (CGI-S), Clinical Global Impression-Anxiety Scale (CGI-anxiety), and Clinical Global Impression-Sleep Scale (CGI-sleep). RESULTS: Among 180 patients, no differences in demographic characteristics among the three benzodiazepine groups were noted. After six weeks of treatment, all benzodiazepine groups showed significant improvements in CGI-S, CGI-anxiety, and CGI-sleep scores (p<0.001). There were no differences in mean changes in CGI-S, CGI-anxiety and CGI-sleep among the three benzodiazepine groups. The incidence of side effects was significantly lower in the clonazepam group than with the other benzodiazepines. The incidences of adverse events for the clonazepam, alprazolam, and lorazepam groups were 26.7% (n=20), 48.4% (n=31), and 43.9% (n=18), respectively. CONCLUSION: The present study suggests that clonazepam is as efficacious as other benzodiazepines for the treatment of various anxiety disorders. Furthermore, the safety profile of clonazepam was superior to the other benzodiazepines in this study.
Alprazolam ; Anti-Anxiety Agents ; Antidepressive Agents* ; Anxiety Disorders* ; Anxiety* ; Benzodiazepines ; Clonazepam* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Incidence ; Lorazepam

A 56 year-old female patient with major depressive disorder, single episode with unremarkable findings on past medical and psychiatric history visited due to various depressive symptoms. Mirtazapine of 15 mg/day at evening was administered for the control of her depressive symptoms along with alprazolam of 0.5 mg/day at morning and evening for the control of anxiety. On fifth hospitalized day, she complained of creeping and crawling sensation on both legs which was aggravated at night after about one hour of mirtazapine intake and improved with movement. She also had a difficulty in falling a sleep as well as onset of discomfort on both legs. We rendered her discomfort as restless legs syndrome (RLS) due to mirtazapine disposition. Therefore, we maintained mirtazapine of 15 mg/day at evening and added clonazepam of 1 mg/day at morning and evening for the control of RLS. After 7 days observation, the patient complained of aggravated natures of RLS and wanted to stop the drug. Though the effectiveness of mirtazapine for control of depressive symptoms, the drug was switched to paroxetine of 20 mg/day at 16th hospitalized day and 4 days later the RLS was completely terminated.
Alprazolam ; Anxiety ; Clonazepam ; Depression ; Depressive Disorder, Major ; Female ; Humans ; Leg ; Middle Aged ; Paroxetine ; Restless Legs Syndrome* ; Sensation

OBJECTIVE: The purpose of this study was to examine the efficacy and safety of coadministration of nefazodone (NEF) and benzodiazepine (BZD) in the clinical setting, particularly during the initial period of treatment. METHODS: This study was based on data collected in an open, multi-center, 8-week, clinical trial of NEF in depressed patients and focused on the first 2 weeks of treatment and the concurrent use of two BZDs: alprazolam (ALP), metabolized largely by the same cytochrome P450-3A4 isoform that metabolizes NEF and lorazepam (LOR), eliminated by conjugation with glucuronic acid and less likely to interact with NEF. Patients receiving NEF alone (NEF-mono group, n=) and those receiving adjunctive BZD therapy (BZD-combi group, n=) were selected and their data were reviewed for demographic and clinical characteristics at baseline and various outcome measures at weeks 1 and 2. The BZD-combi group consisted of patients receiving alprazolam (ALP-combi subgroup, n=) and those receiving lorazepam (LOR-combi subgroup, n=). Efficacy was analysed according to the individual groups and subgroups. In addition, the efficacy at each time point was compared between NEF-mono and BZD-combi groups as well as between ALP-combi and LOR-combi subgroups. Safety and tolerability were judged by reported adverse effects and were compared. RESULTS: In NEF-mono and BZD-combi groups, the mean daily dose for NEF was less than 200 mg/day (range, 50-500 mg/day) and did not differ between groups and subgroups. The mean daily doses for BZDs were 0.61 mg/day (range, 0.25-1.5 mg/day) for ALP and 1.49 mg/day (range, 0.5-2.5 mg/day) for LOR. Sleep, anxiety and depression in both NEF-mono and BZD-combi groups were, in general, significantly improved compared to baseline. Furthermore, BZD-combi group showed greater improvement in anxiety and sleep but not in depression compared to NEF-mono group. Within the BZD-combi group, there was no significant difference in clinical effects between ALP-combi and LOR-combi subgroups. In terms of safety and tolerability, there was no evidence to suggest that BZD combination caused daytime sedation or any other particular adverse events more severely than NEF alone. Also, there was no significant difference in the side effect profiles of ALP-combi and LOR-combi subgroups. CONCLUSION: These results suggest that combining low doses of ALP or LOR with NEF is beneficial for the control of insomnia and anxiety without substantial adverse effects, at least during the early period of treatment of depression when therapeutic dosages of NEF are not yet reached.
Alprazolam ; Anxiety ; Benzodiazepines* ; Cytochromes ; Depression* ; Glucuronic Acid ; Humans ; Lorazepam ; Outcome Assessment (Health Care) ; Sleep Initiation and Maintenance Disorders

OBJECTIVES: This study investigated the consensus about treatment strategies for comorbid conditions in generalized anxiety disorder (GAD). METHODS: The executive committee of the Korean Medication Algorithm Project for GAD developed questionnaires about treatment strategies for patients with panic disorder based on guidelines or algorithms and clinical trial studies previously published in foreign countries. This study analyzed the treatment strategies for comorbid conditions in GAD. Fifty-five (65%) of 84 experts on a committee reviewing GADs responded to the questionnaires. We classified the consensus of expert opinions into three categories (first-line, second-line, and third-line treatment strategies) and identified the treatment of choice according using a chi2 test and 95% confidence interval. RESULTS: The consensus about treatment strategies in the case of GAD with comorbid depression recommended a selective serotonin reuptake inhibitor (SSRI) and a serotonin norepinephrine reuptake inhibitor (SNRI) as the first-line drug treatment. An SSRI, an SNRI and a benzodiazepine (e.g. alprazolam, clonazepam) are recommended in GAD patients with other comorbid anxiety disorders. CONCLUSION: This study provided information about the consensus among Korean experts with regard to treatment strategies for comorbid conditions of GAD.
Alprazolam ; Anxiety ; Anxiety Disorders ; Benzodiazepines ; Comorbidity ; Consensus ; Depression ; Expert Testimony ; Humans ; Norepinephrine ; Panic Disorder ; Surveys and Questionnaires ; Serotonin

The purpose of this study was to evaluate the effect of alprazolam on the stress that Korean raccoon dogs (Nyctereutes procyonoides koreensis) may experience while caught in a live trap by measuring their serum cortisol response. The animals were placed in a live trap with or without being pretreated with oral doses of alprazolam. In both groups, pre-trap blood samples were initially collected without anesthesia before the animals were positioned in the live trap; then post-trap blood samples were collected after the animals had remained in the live trap for 2 h. Changes in cortisol levels were observed using a chemiluminescent immunoassay. The level of cortisol increased in the control group and decreased in the alprazolam-pretreatment group (p < 0.05). In this study, we demonstrated that alprazolam pretreatment reduced stress during live trap capture.
Alprazolam/*therapeutic use ; Animals ; Anti-Anxiety Agents/*therapeutic use ; Anxiety/*drug therapy ; Hydrocorti ; *Raccoon Dogs ; Republic of Korea ; Restraint, Physical/*veterinary

Multiple randomized, double-blind, placebo-controlled trials have explored the efficacy of pregabalin for the treatment of generalized anxiety disorder (GAD) and this novel drug was recently approved in Europe. Short-term efficacy of pregabalin as a treatment modality for GAD is well supported by the positive results of several placebocontrolled studies, and most studies confirmed that pregabalin is superior to placebo and comparable with lorazepam, alprazolam and venlafaxine for the treatment of patients with GAD. Especially, pregabalin has a rapid speed of onset combined with equal efficacy in treating both psychic and somatic symptoms of GAD. Additionally, pregabalin has demonstrated potential for the prevention of relapses of GAD. Efficacy in the elderly patients was also shown in a separate placebo-controlled study. Pregabalin has a favorable safety and tolerability profiles relative to benzodiazepines and has minimal potential for drug-drug interactions, abuse and dependence. In the future, research should target further elucidating the efficacy of pregabalin for GAD in relapse prevention, longterm treatment and special populations. Additional studies are needed to guide clinicians in practical issues of how best to use pregabalin as a newer option for the pharmacotherapy of GAD.
Aged ; Alprazolam ; Anxiety ; Anxiety Disorders ; Benzodiazepines ; Cyclohexanols ; Europe ; gamma-Aminobutyric Acid ; Humans ; Lorazepam ; Recurrence ; Pregabalin ; Venlafaxine Hydrochloride