TY - JOUR
T1 - Benzodiazepines as antidepressants
T2 - Does GABA play a role in depression?
AU - Petty, Frederick
AU - Trivedi, Madhukar H.
AU - Fulton, Mark
AU - John Rush, A.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 1995/11/1
Y1 - 1995/11/1
N2 - Benzodiazepines, the most widely prescribed psychotropic drugs, are often used in patients with depressive disorders, either alone or in combination with standard antidepressants. This review evaluates the efficacy of benzodiazepines (alprazolam, diazepam, chlordiazepoxide) as established in acute-phase, randomized controlled trials (RCTs) in major depressive disorder. Metaanalyses using intent-to-treat, as well as adequate treatment exposure samples, revealed an overall efficacy of 47-63% and a drug-placebo difference of 0-27% for all benzodiazepines. Alprazolam, the best studied of the benzodiazepines, had a 27.1% (sd = 6.1%) greater response than placebo, which is comparable to standard antidepressants. Alprazolam, in particular, may be a useful treatment option for patients in whom standard antidepressant medications are contraindicated, poorly tolerated, or possibly ineffective. Alprazolam may have a more rapid onset of action for some patients. Benzodiazepines do not primarily affect biogenic amine uptake or metabolism, although they do augment γ-amino butyric acid (GABA) activity. The antidepressant efficacy of benzodiazepines, which are GABAA receptor agonists, is consistent with the GABA theory of depression.
AB - Benzodiazepines, the most widely prescribed psychotropic drugs, are often used in patients with depressive disorders, either alone or in combination with standard antidepressants. This review evaluates the efficacy of benzodiazepines (alprazolam, diazepam, chlordiazepoxide) as established in acute-phase, randomized controlled trials (RCTs) in major depressive disorder. Metaanalyses using intent-to-treat, as well as adequate treatment exposure samples, revealed an overall efficacy of 47-63% and a drug-placebo difference of 0-27% for all benzodiazepines. Alprazolam, the best studied of the benzodiazepines, had a 27.1% (sd = 6.1%) greater response than placebo, which is comparable to standard antidepressants. Alprazolam, in particular, may be a useful treatment option for patients in whom standard antidepressant medications are contraindicated, poorly tolerated, or possibly ineffective. Alprazolam may have a more rapid onset of action for some patients. Benzodiazepines do not primarily affect biogenic amine uptake or metabolism, although they do augment γ-amino butyric acid (GABA) activity. The antidepressant efficacy of benzodiazepines, which are GABAA receptor agonists, is consistent with the GABA theory of depression.
KW - Alprazolam
KW - GABA
KW - antidepressants
KW - benzodiazepines
KW - depression
KW - diazepam
UR - http://www.scopus.com/inward/record.url?scp=0028856465&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0028856465&partnerID=8YFLogxK
U2 - 10.1016/0006-3223(95)00049-7
DO - 10.1016/0006-3223(95)00049-7
M3 - Article
C2 - 8573660
AN - SCOPUS:0028856465
SN - 0006-3223
VL - 38
SP - 578
EP - 591
JO - Biological Psychiatry
JF - Biological Psychiatry
IS - 9
ER -