title: Double-blind comparison of buspirone and clorazepate in anxious outpatients. Therapeutic Effects and Effects on Actual Driving Performance of Chronically Administered Buspirone and Diazepam in Anxious Outpatients Efficacy of applied relaxation and cognitive-behavioral therapy in the treatment of generalized anxiety disorder. Controlled comparison of buspirone and oxazepam in generalized anxiety. Comparative assessment of efficacy and withdrawal symptoms after 6 and 12 weeks' treatment with diazepam or buspirone. A placebo-controlled study of enciprazine in the treatment of generalized anxiety disorder: a preliminary report. Analysis of individual symptoms in generalized anxiety--a pooled, multistudy, double-blind evaluation of buspirone. A double-blind comparison of buspirone and diazepam in outpatients with generalized anxiety disorder. Buspirone: multicenter efficacy study. Anxiety in primary care: is short-term drug treatment appropriate? Buspirone and diazepam in anxiety: a controlled study. Alprazolam versus buspirone in the treatment of outpatients with generalized anxiety disorder Efficacy, safety, and tolerability of venlafaxine extended release and buspirone in outpatients with generalized anxiety disorder. A double-blind, controlled trial in primary care patients with generalized anxiety: a comparison between buspirone and oxazepam. Differential effects of the anxiolytic drugs, diazepam and buspirone, on memory function. Evaluation of Buspirone as an Antianxiety Agent: Buspirone and Diazepam versus Placebo* Efficacy and Safety of Lesopitron in Outpatients with Generalized Anxiety Disorder Assessment of the efficacy of buspirone in patients affected by generalized anxiety disorder, shifting to buspirone from prior treatment with lorazepam: a placebo-controlled, double-blind study. A placebo‐controlled double‐blind multicenter trial of two doses of ipsapirone versus diazepam in generalized anxiety disorder A phase II multicenter dose-finding, efficacy and safety trial of ipsapirone in outpatients with generalized anxiety disorder Comparison of buspirone in two separate studies. The effect of social factors on the anxiolytic efficacy of buspirone in male rats, male mice, and men Efficacy of buspirone in generalized anxiety disorder with coexisting mild depressive symptoms. Establishing the maximum tolerated dose of lesopitron in patients with generalized anxiety disorder: a bridging study. Long-term treatment of anxiety and risk of withdrawal. Prospective comparison of clorazepate and buspirone. Treatment of generalised anxiety disorder with a short course of psychological therapy, combined with buspirone or placebo. The safety and efficacy of ipsapirone vs. lorazepam in outpatients with generalized anxiety disorder (GAD): single site findings from a multicenter trial. Gepirone and diazepam in generalized anxiety disorder: a placebo-controlled trial. Buspirone and lorazepam in the treatment of generalized anxiety disorder in outpatients Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: a 12-year prospective study. Imipramine and buspirone in treatment of patients with generalized anxiety disorder who are discontinuing long-term benzodiazepine therapy. [Efficacy and withdrawal of clobazam, lorazepam and buspirone in the treatment of anxiety disorders]. A Clinical Trial of Buspirone and Diazepam in the Treatment of Generalized Anxiety Disorder* Comparison of withdrawal of buspirone and diazepam: A placebo controlled study A multicentre double-blind comparison of hydroxyzine, buspirone and placebo in patients with generalized anxiety disorder Placebo‐controlled comparison of the clinical effects of rapid discontinuation of ipsapirone and lorazepam after 8 weeks of treatment for generalized anxiety disorder Abecarnil for the treatment of generalized anxiety disorder: a placebo-controlled comparison of two dosage ranges of abecarnil and buspirone. Kava-Kava extract LI 150 is as effective as Opipramol and Buspirone in Generalised Anxiety Disorder--an 8-week randomized, double-blind multi-centre clinical trial in 129 out-patients. A comparison of buspirone, diazepam, and placebo in patients with chronic anxiety states. Controlled comparison of the effects and abrupt discontinuation of buspirone and lorazepam Efficacy and safety of two dosing regimens of buspirone in the treatment of outpatients with persistent anxiety.
abstract: Buspirone , a new nonbenzodiazepine anxiolytic agent , was compared with clorazepate in a double-blind , multicenter trial conducted with 336 out patients who had moderate to severe anxiety . The two treatments were equally effective for relief of symptoms , including anxiety with associated depression . Although both agents were generally well tolerated , the profile of side effects was dissimilar . Drowsiness and depression occurred significantly ( p less than 0.055 ) more frequently with clorazepate , whereas nausea and headache occurred significantly ( p less than 0.055 ) more frequently with buspirone . Clorazepate-treated patients were significantly ( p less than 0.055 ) more likely to have had an adverse experience that was considered drug related or that interfered with the therapeutic effect . In this study , buspirone was shown to be an effective antianxiety agent , causing significantly less sedation than clorazepate Two groups of 12 out patients each ( six men and six women ) with generalized anxiety disorder , participated in this study . Each patient was treated single-blind with placebo during the first 7 days ( baseline ) , followed by a double-blind drug treatment period of 4 consecutive weeks ( active ) and ending again with 7 days single-blind placebo treatment ( washout ) . One group received buspirone 5 mg three times a day in the first week and continued with 10 mg in the morning , 5 mg in the afternoon , and 5 mg in the evening during the second , third , and fourth weeks . The other group received diazepam 5 mg three times a day in all 4 weeks . On the evening of the seventh day of each treatment week the  Hamilton Rating Scale for Anxiety and the Symptom Check List  ( 90 items ) were applied to assess the therapeutic effects , followed by an on-the-road driving test that started 1.5 hours after the last drug or placebo intake . The test consisted of operating an instrumented vehicle over a 100 kilometer highway circuit while attempting to maintain a constant speed and a steady lateral position within the right traffic lane . Two patients in the diazepam group were unable to complete their test after the first and second treatment week , respectively , because of serious sedative reactions . Both buspirone and diazepam were equally effective in reducing overall anxiety symptoms . The specific profiles showed that buspirone also reduced concomitant depressive symptoms and symptoms of interpersonal sensitivity and anger-hostility . In contrast , diazepam was found to be slightly more effective in reducing somatic symptoms and to positively affect sleep disturbances . Moreover , abrupt discontinuation of diazepam result ed in a relapse of psychic anxiety symptoms comparable with the placebo-baseline level and a partial relapse of somatic anxiety symptoms . Chronic treatment with buspirone had no significant effects on lateral position and speed control . In contrast , diazepam significantly impaired control of lateral position in the first 3 weeks of treatment . There was no significant impairment in the fourth treatment week and the placebo-washout week . Speed control was significantly impaired only in the first week . The relevance of the trend toward decreasing performance impairment during chronic treatment remains to be established Nondirective ( ND ) , applied relaxation ( AR ) , and cognitive behavioral ( CBT ) therapies for generalized anxiety disorder ( GAD ) were compared . The latter 2 conditions were generally equivalent in outcome but superior to ND at post assessment . The 3 conditions did not differ on several process measures , and ND created the greatest depth of emotional processing . Follow-up results indicated losses in gains in ND , maintained gains in the other 2 conditions , especially CBT , and highest endstate functioning for CBT . AR and CBT thus contain active ingredients in the treatment of GAD ; support exists for further development of imagery exposure methods or cognitive therapy because of their likely role in promoting maintenance of change with this disorder . Expectancy for improvement was also associated with outcome , suggesting the need for further research on this construct for underst and ing the nature of GAD and its amelioration The anxiolytic activity , the tolerance , and the withdrawal symptoms of buspirone and oxazepam were compared in two groups of 14 and 12 out patients , respectively , suffering from generalized anxiety in a double-blind study with r and om allocation of patients . The 6-week active period was preceded and followed by 1 and 2 weeks on placebo , respectively . Clinical assessment s were performed before and after the predrug placebo period and every 2 weeks thereafter and included Hamilton anxiety and depression scales and AMDP anxiety subscale . The initial daily dose was 15 mg buspirone or 45 mg oxazepam in 3 intakes and the mean final daily doses were 22.2 and 55.8 mg , respectively . Results showed a slower anxiolytic activity of buspirone compared to oxazepam with less improvement after 2 weeks of treatment . The rebound anxiety following abrupt discontinuation of the drug and the level of side effects did not significantly differ between the two compounds Fifty-one out- patients presenting with generalised anxiety disorder were included in a double-blind trial , and treated with either buspirone ( a new non-benzodiazepine antianxiety drug ) or diazepam over 6 or 12 weeks , after which they were abruptly withdrawn and continued on placebo to 14 weeks . Ratings of anxiety and other symptoms were administered fortnightly and additional withdrawal symptoms noted . Forty patients completed the study ; 8 of the 11 drop-outs were taking buspirone . Both drugs reduced anxiety , diazepam more rapidly , but with greater withdrawal symptoms , particularly after 6 weeks . Regular treatment with diazepam for 6 weeks leads to a significant risk of pharmacological dependence that is not present with buspirone Enciprazine is a propanolamine derivative with a pre clinical profile similar to buspirone but with less affinity for the postsynaptic dopamine receptor ( Linden et al. 1988 ) . We report on the outcome , using intent-to-treat data , of a 5-week , double-blind trial comparing three dose strengths of enciprazine ( 5 mg t.i.d . , 10 mg t.i.d . , and 20 mg t.i.d . ) to placebo . A dose escalation was permitted after 2 weeks of active drug treatment , which 61 percent of patients overall took advantage of . A " last observation carried forward " ( LOCF ) analysis found a mean improvement in Hamilton Anxiety Scale ( HAM-A ) scores by Week 5 of -11.0 for the combined enciprazine treatment groups , and -4.4 for the placebo group ( p less than .05 ) . Fifty-two percent of enciprazine patients were judged to be " much " or " very much " improved , whereas none of the placebo patients were judged to have comparable improvement . Enciprazine was well-tolerated , with low levels of sedative and asthenic side effects reported . The compound appears to have promise as an anxiolytic agent Pooled data for 427 patients with generalized anxiety disorders were analyzed retrospectively from six double-blind trials evaluating buspirone , a nonbenzodiazepine anxiolytic , in the treatment of generalized anxiety disorder . After a 4- to 7-day washout period , patients were allocated at r and om to receive treatment over a 4-week period . Buspirone dose ranged from 10 to 60 mg . Patients were assessed on entry and at weekly intervals using the 14 symptom groups ( items ) of the Hamilton Anxiety Rating Scale ( HAM-A ) .  Buspirone improved all symptom groups significantly ; onset of anxiolytic activity was observed at week 1 in 3 groups of psychic symptoms of anxiety . Within 2 weeks , 8 of the 14 symptom groups were improved significantly by buspirone versus placebo , and symptoms of anxiety improved further up to the 4-week end point . Psychic symptoms of anxiety improved earlier in general than the somatic symptoms of anxiety . At the end of treatment , analyses of the HAM-A scores indicated that all of the 14 symptom groups ( individual items ) , the total HAM-A score , and the 2 composite Psychic and Somatic Anxiety Factors were significantly improved with buspirone as compared to placebo . The beneficial effects of buspirone were not compromised by any significant side effects The safety and antianxiety and antidepressive effects of buspirone ( average 16.5 mg/day ) were compared in a double-blind trial with those of diazepam ( 15 mg/day ) . The two drugs were nearly equivalent in relieving symptoms of both anxiety and depression in 100 patients .  Scores on the impaired cognition factor of the SCL-56 and confusion factor of the POMS showed significantly greater improvement with buspirone than with diazepam . Side effects , such as sedation and drowsiness , were significantly more frequent and severe with diazepam . Buspirone may be particularly indicated for anxious patients with associated depression The efficacy and safety of buspirone ( Buspar ) , diazepam ( Valium ) , and placebo were compared in a 3-week double-blind study of 131 patients with scores of at least 15 on the Hamilton Rating Scale for Anxiety .  Active drugs were administered orally in 5-mg tablets to a maximum dose of 10 mg t.i.d . Buspirone was given to 43 patients , diazepam to 46 and placebo to 42 . There was significant improvement in all three treatment groups at 1 and 2 weeks , with further significant improvement with both active drugs , but not with placebo , at 3 weeks . The incidence of side effects reported voluntarily by patients was similar with the two active drugs , but drowsiness was significantly more frequent with diazepam Thirty-six patients with generalised anxiety disorder , panic disorder or agoraphobia with panic attacks , diagnosed by DSM-III criteria , were treated with a new non-benzodiazepine anti-anxiety drug , buspirone , and with diazepam and placebo , in a cross-over design . Each patient took buspirone , diazepam and placebo for one week each in flexible dosage and balanced order . Ratings of symptomatology using the Comprehensive Psychopathological Rating Scale were made after each week 's treatment and a sub-scale used for measuring anxiety change alone was used separately . There was no overall difference in efficacy between the drugs , but when the scores for individual symptoms were analysed , diazepam was significantly superior to the other treatments for the symptom of muscle tension only . The results suggest that the common practice of giving short-term therapy with tranquilising drugs for anxiety in primary care is pharmacologically suspect The anxiolytic properties of buspirone were assessed in a 4-week double-blind study in 240 anxious patients , 81 of whom received buspirone , 81 diazepam , and 78 placebo . Patients were required to have scores greater than or equal to 9 on the Covi and greater than or equal to 18 on the Hamilton Rating Scale for Anxiety , and to endorse at least 5 items on a 17-item Anxiety Entry Checklist . Among 212 evaluable patients , those who improved most were married , well-educated females who had both a positive family adjustment and a low level of depression . Diazepam produced relatively equal improvement in females and males . Diazepam seems more effective in reducing somatic symptoms , while buspirone appears more effective in reducing symptoms associated with cognitive and interpersonal problems . Main differences between the drugs were seen in side effect profiles The efficacy and safety of alprazolam and buspirone for treating  generalized anxiety disorder ( GAD ) were compared in a 6-week , double-blind , r and omized ,  placebo-controlled study of 94 out patients . Mean daily doses at the end of the study were 1.9 mg alprazolam and 18.7 mg buspirone . As judged by the Hamilton Anxiety Rating Scale , Hamilton Depression Rating Scale , Physician 's Global Improvement Scale , and other efficacy scales , alprazolam and buspirone were similar in efficacy , but more effective than placebo , for treating anxiety and depression symptoms in these patients . Clinical ly important differences were noted between drugs in the onset of effect , with alprazolam producing rapid and sustained improvement within the first week of treatment and buspirone producing more gradual , continuous improvement throughout the study . Significantly more buspirone-treated than alprazolam-treated patients failed to complete the study , primarily because of side effects or inefficacy . No clinical ly important differences were noted between alprazolam and buspirone in side effects , vital signs , or laboratory test results .  Alprazolam-treated patients most frequently reported central nervous system-related side effects ( drowsiness and sedation ) , while buspirone-treated patients most frequently reported gastrointestinal system-related side effects ( appetite disturbances and abdominal complaints ) BACKGROUND The objective of this r and omized , double-blind study was to compare the efficacy and safety of venlafaxine extended release ( XR ) and buspirone in out patients with generalized anxiety disorder ( GAD ) but without concomitant major depressive disorder . METHOD Male and female out patients at least 18 years old who met the DSM-IV criteria for GAD and had scores of 18 or higher on the Hamilton Rating Scale for Anxiety ( HAM-A ) were r and omly assigned to treatment with either venlafaxine XR ( 75 or 150 mg/day ) , buspirone ( 30 mg/day in 3 divided doses ) , or placebo for 8 weeks . The primary efficacy variables were changes in anxiety as determined by final on-therapy HAM-A total and psychic anxiety scores and Clinical Global Impressions scale ( CGI ) scores . Other key efficacy variables were HAM-A anxious mood and tension scores and the anxiety subscale scores of the patient-rated Hospital Anxiety and Depression scale ( HAD ) . RESULTS The efficacy analysis included 365 patients and the safety analysis , 405 . At week 8 , adjusted mean HAM-A psychic anxiety , anxious mood , and tension scores were significantly lower for venlafaxine XR-treated patients than for placebo-treated patients . On the HAD anxiety subscale , venlafaxine XR , 75 or 150 mg/day , was significantly more efficacious than placebo at all time points except weeks 1 ( both dosages ) and 2 ( 150-mg/day dosage only ) and significantly more efficacious than buspirone at all time points except week 1 . On the CGI-Improvement scale , scores for venlafaxine XR ( both dosages ) and buspirone were numerically superior to those for placebo at all time points , and statistical significance was observed at weeks 3 , 4 , 6 , and 8 for venlafaxine XR and at weeks 6 and 8 for buspirone . The adverse events were not essentially different between treatment groups . CONCLUSION Venlafaxine XR is an effective , safe , and well-tolerated once-daily anxiolytic agent in patients with GAD without comorbid major depressive disorder . This agent was significantly superior to buspirone on the HAD anxiety subscale . Buspirone demonstrated statistical significance versus placebo on a measure of anxiolytic response Two hundred thirty patients with generalized anxiety and Hamilton Rating Scale for Anxiety ( HAM-A ) scores greater than or equal to 18 were subdivided at r and om , according to a double-blind design , into one group treated with 5 - 10 mg of oral buspirone t.i.d . or one group treated with 10 - 20 mg of oral oxazepam t.i.d . for 6 weeks . No anxiolytic treatment was allowed 3 months prior to trial entry . Analysis of demographic variables revealed no significant imbalance between the two treatment groups . Twenty patients were excluded from efficacy analysis because of treatment withdrawal before the first efficacy evaluation on Day 7 . Another 4 patients were excluded because they were taking concomitant psychotropic medication . The remaining 206 patients displayed a decrease in HAM-A scores ( mean + /- SD ) from 23.9 + /- 4.1 to 10.6 + /- 7.7 in the buspirone group and from 23.9 + /- 4.2 to 11.5 + /- 8.0 in the oxazepam group . The two treatment groups were also found to be virtually identical in an " intent to treat " analysis of all 230 patients as well as in other ratings ( Hamilton Rating Scale for Depression , Raskin Depression Scale , Covi Anxiety Scale , Physicians Question naire , global ratings , and Hopkins Symptom Checklist [HSCL]-56 ) . However , oxazepam was never superior to buspirone in any of the efficacy analyses . Of the 230 patients , 127 spontaneously reported adverse events , including drowsiness , dizziness , headache , nausea , and nervousness . Adverse events were relatively similar in the two groups . In conclusion , buspirone and oxazepam appear to be equally effective in the treatment of generalized anxiety encountered by general practitioners . This outcome , in addition to a previously documented absence of any dependency liability , makes buspirone a clinical ly important anxiolytic drug The effects of the anxiolytic drugs diazepam ( 5 mg ) or buspirone ( 5 or 10 mg ) were studied in comparison with placebo on memory function in 39 subjects diagnosed with generalized anxiety disorder . Neither drug altered the immediate recall of a list of 16 nouns or impaired digit span , a second test of immediate memory . Diazepam selectively impaired the recall of nouns after a 20 min delay when compared with placebo . In contrast , neither dose of buspirone altered the delayed recall of the word list . The implication s of such different effects of anxiolytic drugs on memory function for the clinical treatment of anxiety are discussed Buspirone has previously been demonstrated to be efficacious in the treatment of anxiety . This four-week double-blind parallel study compared buspirone to diazepam and placebo in the treatment of 119 out patients diagnosed as having generalized anxiety disorder . After a seven-day placebo washout period , eligible patients were r and omized to one of three treatment groups . Buspirone ( 5 mg ) and diazepam ( 5 mg ) were administered BID and individually titrated to an optimal therapeutic dose by the end of week two . Buspirone and diazepam were equally effective in reducing Hamilton Anxiety ( HAM-A ) total and psychic factor scores from baseline values . Buspirone alone was significantly better than plecebo in reducing the HAM-A somatic factor score . Sixty-seven percent of both active treatment groups who were classified as “ ill ” on the baseline global psychopathology rating scale achieved a “ not ill ” status by study end . There were no significant differences between treatment groups at endpoint on the 56-item Symptom Checklist self-rating scale .  Buspirone was demonstrated to be as effective as diazepam in relieving anxiety in this outpatient sample OBJECTIVE : To compare the relative efficacy and safety of lesopitron 40–80 mg/d versus lorazepam 2–4 mg/d and placebo in a subgroup of patients with anxiety history taken from a larger study of patients with a primary diagnosis of generalized anxiety disorder ( GAD ) . DESIGN : Six-week , r and omized , double-blind , parallel , placebo and lorazepam-controlled , Phase II , single-center , outpatient study . SETTING : Outpatient clinic . PATIENTS : One hundred sixty-one patients with GAD were r and omized in the main study ; 68 with a documented history of GAD or anxiety disorder not otherwise specified were included in the subgroup . METHODS : After a one-week placebo lead-in , patients were r and omized to receive placebo , lesopitron , or lorazepam twice daily for six weeks , followed by a one-week taper period . Efficacy was assessed using the Hamilton Rating Scale for Anxiety ( HAM-A ) and the Clinical Global Impressions scale . Safety was assessed through physical examinations , monitoring of vital signs , 12-lead electrocardiograms , laboratory analyses , and adverse event monitoring . RESULTS : An overall mean improvement in the HAM-A total score between baseline and end point for all three treatment groups was seen , with mean changes of 3.4 ( 95 % CI 2.0 to 4.8 ) , 6.1 ( 95 % CI 4.1 to 8.1 ) , and 6.1 ( 95 % CI 4.6 to 7.6 ) for the placebo , lesopitron , and lorazepam groups , respectively ( omnibus p = 0.044 , uncorrected ) . Positive treatment effects were also observed in the subgroup population on several other measures and suggest that additional therapeutic trials may be warranted . Future trials could be stratified on the basis of referral status ( symptomatic volunteer vs. clinical patient with preexisting illness ) or previous exposure to anxiolytics , and use a fixed-dose rather than flexible-fixed-dose design . CONCLUSIONS : The subgroup analysis represents a comparison of treatment outcome in GAD patients presenting with a history of previous episodes of GAD or anxiety disorder not otherwise specified compared with those who were experiencing their first episode of GAD and reported no anxiety history . Although the overall study analysis was equivocal , for the approximately 40 % of patients with recurrent anxiety disorder , beneficial effects for both lesopitron and lorazepam are suggested Forty-four patients with DSM-III-R generalized anxiety disorder participated in this double-blind , r and omized study . Patients were on a benzodiazepine before the study and were stabilized on 3 to 5 mg/day lorazepam for 5 weeks ( weeks 0 to 5 ) . Thereafter , they were r and omized to 15 mg/day buspirone or placebo for the following 6 weeks ( weeks 6 to 11 ) . During the first 2 weeks of double-blind , r and omized treatment ( weeks 6 to 7 ) , lorazepam was tapered off . During weeks 12 to 13 , patients received single-blind placebo . Assessment included the Hamilton Rating Scale for Anxiety , the State-Trait Anxiety Inventory , the Zung and Eddy Self-Rating Scale of Anxiety Symptoms , the Hamilton Rating Scale for Depression , and the Rome Depression Inventory , completed at weeks 0 , 5 , 6 , 7 , 8 , 9 , 11 , and 13 . Side effects were assessed through the Dosage Treatment Emergent Symptoms at the same times . The  benzodiazepine-withdrawal syndrome was evaluated through a 27-symptom checklist ( Clinical -Rated Benzodiazepine Withdrawal Symptom Schedule ) at weeks 0 , 5 , 6 , 7 , 11 , and 13 . The results showed that buspirone was more effective than placebo and comparable to lorazepam . Buspirone-treated patients showed no rebound anxiety or benzodiazepine-withdrawal syndrome compared with placebo . Buspirone caused fewer side effects than lorazepam and was not different from placebo in this respect . Finally , buspirone maintained its anxiolytic effect for at least 2 weeks after the discontinuation of treatment Ipsapirone is a partial 5-HT1A , agonist which appears promising for the pharmacologic treatment of anxiety . In this four-week , double-blind , 19-center study , 249 out patients with generalized anxiety disorder were r and omized to one of four treatments : ipsapirone , 5 or 10 mg t.i.d . , diazepam 5 mg t.i.d . , or placebo . Both active treatments were significantly superior to placebo in reducing anxiety symptoms , although response to ipsapirone was not significant until week 2 while diazepam had a more rapid onset . Five mg t.i.d . was the optimal ipsapirone dose . At 10 mg t.i.d . adverse experiences prompted more patients to discontinue treatment . Adverse experiences that were reported significantly more often for ipsapirone than placebo included asthenia , nausea , dizziness , paresthesias and sweating . Sedation was the most common diazepam-related side effect . The results of this study when combined with others suggest that 5 mg t.i.d . of ipsapirone is an effective and well-tolerated anxiolytic without many of the risks of benzodiazepine therapy . Dosage escalation by patients is unlikely because of an increased risk of side effects Benzodiazepines have been prescribed for the treatment of  Generalized Anxiety Disorder ( GAD ) for nearly three decades due to their proven anxiolytic efficacy , despite a considerable side effect and abuse liability profile . A new class of compounds , the azapirones , have been developed as an alternative to benzodiazepine treatment . Ipsapirone is a novel anxiolytic azapirone which has high specificity for the 5-HT1A receptor and which has the potential for offering certain advantages over buspirone . The present 5-week study investigated three doses of ipsapirone ( 2.5 mg , 5.0 mg and 7.5 mg tid ) versus placebo in 267 GAD out patients .  Efficacy was evaluated using the Hamilton Anxiety Rating Scale ( HAM-A ) , Zung Anxiety Scale ( Zung-A ) , and Clinical Global Impression ( CGI ) . The study design consisted of a 1-week placebo run-in , a 4-week double-blind treatment period , and a 1-week placebo washout . The 5.0 mg group demonstrated consistently superior improvement in all efficacy variables during the treatment period , with significant differences ( p < 0.05 ) from placebo and , at times , the 2.5 mg and 7.5 mg groups . Incidence of adverse events , primarily dizziness , nausea , sedation , and asthenia , was found to be dose proportional , with significant increase in the 7.5 mg group , which may account for the diminished effectiveness seen with this dose . Our results suggest that ipsapirone may represent a viable treatment for GAD Two double-blind studies are described in which buspirone was compared with placebo and diazepam ( Study A ) or clorazepate ( Study B ) in out patients with moderate to severe anxiety . Results , assessed on the Hamilton Rating Scales for Depression and Anxiety , the SCL-56 , the Profile of Mood States , and the Covi and Raskin scales , indicated that buspirone consistently relieved both anxiety and associated depression . In Study B , trends in favor of buspirone were seen on several SCL-56 items and the Hamilton somatic factor ; significant differences in this direction were found for several POMS items . Sedation was seen less often with buspirone than either diazepam or clorazepate Earlier findings suggest that housing conditions in laboratory animals and life events in humans influence the efficacy of anxiolytic drugs . Here we report on the impact of social isolation on buspirone  efficacy in male mice and rats as assessed by the elevated plus-maze . In addition , the impact of social support on buspirone  efficacy was assessed in male patients . When administered 30 min before testing and irrespective of housing conditions , buspirone significantly suppressed locomotor activity both in mice ( 6 mg/kg ) and rats ( 10 mg/kg ) and , as such , other behavioral changes observed at this time point must be seen as behaviorally nonselective . However , these locomotor disruptive effects of buspirone were not evident in either species at longer injection-test intervals ( 2 and 4 h ) . When given 2 h prior to testing , a low ( 3 mg/kg ) but not high ( 10 mg/kg ) dose of buspirone increased the frequency of open arm exploration in rats ( but not mice ) irrespective of housing conditions . At the longest injection-test interval used ( 4 h ) , buspirone increased the duration of open arm exploration in individually housed , but not group-housed , rats . Similar , though somewhat less robust , effects were observed in male mice at this time . In a double-blind placebo-controlled study with male patients , chronic buspirone treatment ( 3 x 10 mg daily for 6 weeks ) produced a highly significant reduction in scores on the Hamilton Rating Scale for Anxiety ( HAM-A ) . Multiple regression analysis of social support received by patients indicated that the support of nonrelatives ( but not of family or other relatives ) was a strong positive predictor of buspirone efficacy . Taken together , our data support the hypothesis that social conditions affect the anxiolytic efficacy of buspirone . Results are discussed in relation to differences in the social organization of the three species investigated BACKGROUND This study was design ed to evaluate the anxiolytic efficacy of buspirone in patients with a diagnosis of generalized anxiety disorder ( GAD ) with coexisting mild depressive symptoms . METHOD Patients who participated in this multicenter study scored > /= 18 on the Hamilton Rating Scale for Anxiety ( HAM-A ) and between 12 and 17 on the Hamilton Rating Scale for Depression ( HAM-D ) . Following a 7- to 10-day placebo lead-in phase , patients who continued to qualify were r and omly assigned to receive either buspirone titrated from 15 to 45 mg/day ( N = 80 ) or placebo ( N = 82 ) for the next 6 weeks . 121 patients completed 6 weeks of treatment . The primary efficacy measure was the HAM-A , taken weekly during the study . RESULTS Buspirone-treated patients averaged a 12.4-point reduction from their baseline total HAM-A score of 24.9 , while their counterparts on placebo averaged a 9.5-point reduction from their mean baseline total HAM-A score of 25.6 . This 2.9-point difference in HAM-A reductions between treatment groups was significantly different ( p < .03 ) . Buspirone patients decreased their HAM-D scores by an average 5.7 points from their mean baseline total HAM-D score of 15.8 , while placebo patients decreased their HAM-D scores by an average 3.5 points from their mean baseline score of 16.3 ( p < .05 ) . Overall , the incidence of adverse events was similar for both treatment groups , but buspirone-treated patients reported significantly more nausea , dizziness , somnolence , and sweating than placebo patients . CONCLUSION Buspirone is superior to placebo in improving anxiety and depressive symptoms in GAD patients who have coexisting depressive symptoms Lesopitron , a 5-hydroxytryptamine 1A agonist , is a new potential anxiolytic of the azapirone class . It has greater potency in animal models of anxiety than buspirone , gepirone , or ipsapirone , and it lacks the antidopaminergic effects associated with buspirone . Lesopitron has been tolerated at single doses up to 50 mg and repeated dosages of 45 mg/day in healthy volunteers . Forty-two patients with generalized anxiety disorder ( GAD ) were enrolled in this double-blind bridging study to determine the safety and tolerability of fixed doses of lesopitron ( 20 , 25 , 30 , 40 , 45 , 50 , and 60 mg two times a day ) over a 6 1/2-day inpatient administration period . Each of the seven panels included six patients ( four drug/two placebo ) . One patient in the 25-mg , two-times-a-day panel voluntarily withdrew because of increased anxiety symptoms . One patient experienced severe orthostatic hypotension at 60 mg two times a day , and moderate to severe adverse events ( dizziness , lightheadedness , nausea , headache ) occurred in two other patients at this dosage . The most commonly reported adverse events in all the panels were headache , dizziness , and nausea .  Lesopitron is rapidly absorbed in patients , having a time to maximum concentration ( Tmax ) ranging from 0.5 to 1 hour , and its elimination half-life ranged from 1.1 to 5.6 hours . Peak plasma concentrations showed high interindividual variability for lesopitron , but increased linearly with dose for the main metabolite , 5-hydroxylesopitron . We defined the maximum tolerated dose in GAD patients as 50 mg two times a day , twice as high as the highest dose tested in healthy volunteers Risk of withdrawal was investigated in a prospect i ve , double-blind comparison of clorazepate dipotassium , a benzodiazepine with a long half-life , and the nonbenzodiazepine buspirone hydrochloride in the long-term treatment of anxious out patients . Patients were treated with therapeutic doses of clorazepate dipotassium ( 15 to 60 mg/d ) or buspirone hydrochloride ( 10 to 40 mg/d ) for six continuous months before their tranquilizer therapy was blindly and abruptly stopped . There was a significant increase in symptom severity consistent with a withdrawal reaction for the clorazepate group but not the buspirone group . For the clorazepate group , there was a suggestion that previous discontinuous exposure to benzodiazepines might sensitize patients to subsequent withdrawal effects . For the buspirone group , a higher dropout rate raised questions about patient satisfaction with therapy in this rather chronically anxious population BACKGROUND Very few studies have examined the combination of drug and psychological treatment in generalised anxiety disorder ( GAD ) . Theoretically , buspirone should be a useful drug to combine with a learning-based therapy . METHODS Sixty patients with GAD were r and omly assigned to treatment with buspirone or placebo , combined with anxiety management training or non-directive therapy for a period of 8 weeks . RESULTS Forty-four patients with a mean Hamilton Anxiety Scale score of 28 completed treatment . There were no significant differences between treatment groups . All groups showed significant improvement after 8 weeks compared to baseline . There were no baseline differences between those who completed the trial and those who did not but patients given buspirone were more likely to drop out . CONCLUSIONS A short course of psychological therapy , whether or not accompanied by active medication , was an effective treatment for patients diagnosed as having quite severe symptoms of GAD . CLINICAL IMPLICATION S AND LIMITATIONS : Dropouts led to a sample size which may have been too small to detect group differences . Cognitive therapy may have been more effective We report the findings of a r and omized , double-blind , placebo-controlled , parallel , generalized anxiety disorder ( GAD ) outpatient study . The purpose of the study was to compare the efficacy , safety , and tolerability of ipsapirone , an azapirone and 5-HT1A agonist , given at a total daily dose of 10 mg to 30 mg , with a total daily dose of 2 mg to 6 mg of lorazepam or placebo in 90 out patients with GAD of moderate or greater severity . At baseline , all patients had a Hamilton Anxiety Scale ( HAM-A ) score of > or = 18 and Covi anxiety score of > or = 8 . After a 1-week single-blind washout , patients entered a 4-week double-blind period with an optional extension for another 4 weeks , followed by a 2-week single-blind placebo washout .  Ipsapirone and lorazepam ratings on the HAM-A and Clinical Global Impressions ( CGI ) were significantly ( p < .05 ) superior to placebo at the end of the acute and maintenance periods of the trial , with a 50 percent HAM-A reduction on active drugs vs. 20 percent on placebo . The anxiety of patients receiving lorazepam , but not ipsapirone , rebounded during the final placebo washout This r and omized , double-blind clinical trial involving 198 generalized anxiety disorder ( GAD ) patients was conducted to more clearly define gepirone 's role for the treatment of anxiety in daily dosages of 10 to 45 mg compared with diazepam and placebo . A secondary goal was to test for possible discontinuation symptoms after abrupt discontinuation of therapy . After a 1-week washout period , patients were treated for 8 weeks and then abruptly shifted under single-blind conditions for 2 weeks on placebo . The highest attrition rate occurred with patients on gepirone ( 58 % ) and the lowest on diazepam ( 34 % ) . Medication intake for week 4 was 19.5 + /- 12.5 mg/day diazepam and 19.0 + /- 11.5 mg/day gepirone and was similar at week 8 . The major adverse events were light-headedness , nausea , and insomnia for gepirone and drowsiness and fatigue for diazepam . Clinical improvement data showed gepirone 's anxiolytic response to be delayed , being significant from placebo beginning at week 6 , whereas diazepam caused significantly more relief than placebo from week 1 onward . Taper results showed that only diazepam , but not gepirone , caused a temporary worsening of anxiety symptoms or rebound Abstract In this double-blind , placebo-controlled 10-week trial , the anxiolytic properties of the nonbenzodiazepine buspirone were compared with the benzo diazepine lorazepam and placebo in 125 out patients with generalized anxiety disorder according to DSM-III . After a 3- to 7-day wash-out period , patients were allocated at r and om to receive orally 3 × 5 mg buspirone ( n = 58 ) , 3 × 1 mg lorazepam ( n = 57 ) , or placebo ( n = 10 ) over a 4-week period . The study also comprised a 2-week taper period and a 4-week placebo-control period to assess the stability of clinical improvement . The patient´s clinical state was estimated on entry and at weekly intervals by general practitioners using the Hamilton Rating Scale for Anxiety ( HAM-A ) and Clinical Global Impression ( CGI ) assessment and by a self-rating scale ( State Trait Anxiety Inventory X2 = STAI-X2 ) . Lorazepam treatment result ed in descriptively , but not significantly , greater improvement on the Hamilton Rating Scale for Anxiety during the whole treatment ( week 0–4 ) and taper period ( week 5 , 6 ) than did buspirone . After treatment with active drugs had been discontinued , the 4-week placebo control period showed buspirone-treated patients to display a stability of clinical improvement , while the symptoms of lorazepam-treated patients worsened at week 7–10 . Both buspirone and lorazepam were more efficacious in reducing anxiety symptoms  than placebo during the treatment and taper period ; however , in contrast to the active drugs ( buspirone , lorazepam ) , patients of the placebo group showed further clinical improvement during the control period , especially in the HAM-A score , so differences between placebo and active drugs became smaller at the end of the study OBJECTIVE The authors sought to observe the long-term clinical course of anxiety disorders over 12 years and to examine the influence of comorbid psychiatric disorders on recovery from or recurrence of panic disorder , generalized anxiety disorder , and social phobia . METHOD Data were drawn from the Harvard/Brown Anxiety Disorders Research Program , a prospect i ve , naturalistic , longitudinal , multicenter study of adults with a current or past history of anxiety disorders . Probabilities of recovery and recurrence were calculated by using st and ard survival analysis methods . Proportional hazards regression analyses with time-varying covariates were conducted to determine risk ratios for possible comorbid psychiatric predictors of recovery and recurrence . RESULTS Survival analyses revealed an overall chronic course for the majority of the anxiety disorders . Social phobia had the smallest probability of recovery after 12 years of follow-up . Moreover , patients who had prospect ively observed recovery from their intake anxiety disorder had a high probability of recurrence over the follow-up period . The overall clinical course was worsened by several comorbid psychiatric conditions , including major depression and alcohol and other substance use disorders , and by comorbidity of generalized anxiety disorder and panic disorder with agoraphobia . CONCLUSIONS These data depict the anxiety disorders as insidious , with a chronic clinical course , low rates of recovery , and relatively high probabilities of recurrence . The presence of particular comorbid psychiatric disorders significantly lowered the likelihood of recovery from anxiety disorders and increased the likelihood of their recurrence . The findings add to the underst and ing of the nosology and treatment of these disorders OBJECTIVE Patients with generalized anxiety disorder ( N=107 ) who had been long-term benzodiazepine users ( average duration of use=8.5 years ) were enrolled in a benzodiazepine discontinuation program that assessed the effectiveness of concomitant imipramine ( 180 mg/day ) and buspirone ( 38 mg/day ) compared to placebo in facilitating benzodiazepine discontinuation . METHOD After a benzodiazepine stabilization period taking either diazepam , lorazepam , or alprazolam , patients were treated for 4 weeks with imipramine , buspirone , or placebo under double-blind conditions while benzodiazepine intake was kept stable ( treatment phase ) . Patients then entered a 4 - 6 week benzodiazepine taper and a 5-week posttaper phase with imipramine , buspirone , and placebo treatment being continued until 3 weeks into the posttaper phase , at which time all patients were switched to placebo for 2 weeks .  Benzodiazepine plasma levels were assayed weekly . Benzodiazepine-free status was assessed 3 and 12 months posttaper . RESULTS Study subjects were long-term benzodiazepine users with an average of three unsuccessful prior taper attempts . The success rate of the taper in this study was significantly higher for patients who received imipramine ( 82.6 % ) , and nonsignificantly higher for patients who received buspirone ( 67.9 % ) , than for patients who received placebo ( 37.5 % ) . The imipramine effect remained highly significant even after the analysis adjusted for three other independent predictors of taper success : benzodiazepine dose , level of anxious symptoms at baseline , and duration of benzodiazepine therapy . CONCLUSIONS Management of benzodiazepine discontinuation can be facilitated significantly by co-prescribing imipramine before and during the benzodiazepine taper . Daily benzodiazepine dose , severity of baseline symptoms of anxiety and depression , and duration of benzodiazepine use were additional significant predictors of successful taper outcome This multicentre study was conducted to evaluate the efficacy and consequences of progressive or abrupt withdrawal of clobazam in the treatment of Generalized Anxiety Disorder in a double blind study in comparison to lorazepam and buspirone .  128 out patients suffering from Generalized Anxiety Disorder according to DMS III criteria were included in the study and treated for three weeks . They were r and omly divided into 4 groups : group 1 : 32 patients receiving  clobazam , abruptly withdrawn and replaced by a placebo ; group 2 : 29 patients receiving  clobazam with progressive withdrawal over 3 weeks , clobazam being replaced by a placebo ; group 3 : 33 patients receiving lorazepam with progressive withdrawal over 3 weeks , lorazepam being replaced by a placebo ; group 4 : 34 patients receiving buspirone , abruptly withdrawn and replaced by a placebo . The dosages were increased progressively during the first week of treatment . At the end of this time , the patients received either 30 mg clobazam or 30 mg buspirone or 3 mg lorazepam daily . After the first week , the Hamilton Anxiety Rating Scale ( HARS ) showed a significant improvement in clobazam and lorazepam groups but not in buspirone group . All the drugs were equally effective after three weeks of treatment . The anti-anxiety activity persisted after withdrawal of the studied drug in the 4 groups , without any signs of rebound anxiety or withdrawal syndrome . No clinical ly relevant differences were found between the 4 groups regarding safety . The side-effects reported were mainly drowsiness in clobazam and lorazepam groups , nausea and headache in buspirone group . In conclusion , clobazam like lorazepam improved anxiety more quickly than buspirone ; after 3 weeks of therapy , efficacy was comparable with the 3 drugs and persisted after treatment discontinuation In double-blind trials with hundreds of patients , buspirone has proven to be as effective an anxiolytic as the benzodiazepines . It causes less sedation and motor impairment than diazepam , and may be particularly useful in geriatric patients . We conducted a 4 week double-blind , r and omized trial of buspirone versus diazepam and placebo in thirty adult out patients with generalized anxiety disorder . Maximum doses were 40 mg of diazepam or buspirone or eight placebo tablets a day . There were no significant differences in outcome between the three groups on any physician or subject measures . Some implication s of this finding are discussed In a 8-week double-blind placebo controlled study , 48 out patients with generalized anxiety disorder were r and omized to diazepam , buspirone , a non-benzodiazepine anxiolytic , or placebo . During the treatment phase of 4 weeks duration diazepam was found to be significantly better than placebo and buspirone . Following abrupt withdrawal by placebo substitution the diazepam group showed a gradual relapse maximal after two weeks while the buspirone and the placebo groups did not differ . There were more cases of rebound anxiety with diazepam as compared to buspirone or placebo . In addition , there were three early terminations related to rebound anxiety in the diazepam group while there were none in the placebo and buspirone groups . There were significantly more new symptoms in the diazepam group than in the placebo or buspirone group Abstract The efficacy of hydroxyzine and buspirone , controlled by placebo , was investigated in a double-blind , parallel group , multicentre study conducted in France and the UK . A total of 244 patients with generalised anxiety disorder in primary care was allocated r and omly to treatments with hydroxyzine ( 12.5 mg morning and mid-day , 25 mg evening ) , buspirone ( 5 mg morning and mid-day , 10 mg evening ) or placebo ( three capsules/day ) for 4 weeks , preceded by a 1-week single-blind placebo run-in and followed by 1-week single-blind placebo administration . Rating scales were applied on days -7,0,7,14,12,28 and 35 . Seventy percent of the patients were female ; the average age was 41 ± 11 years , and the mean Hamilton Anxiety Score at day 0 was 26.5 ± 4.2 . Only 31 of the 244 patients dropped out , but equally in the three groups . Intention-to-treat LOCF analyses on the primary variable showed a significant difference only between hydroxyzine and placebo with respect to improvement on the Hamilton Anxiety Scale ( 10.75 versus 7.23 points , respectively ) . Secondary variables such as CGI and self-ratings ( HAD scale ) showed both hydroxyzine and buspirone to be more efficacious than placebo . Thus , hydroxyzine is a useful treatment for GAD One hundred and sixty patients ( mean age 39.8 years ; 67 % female ) diagnosed with generalized anxiety disorder ( GAD ) who had completed a prospect i ve , 8 week , double-blind comparison of lorazepam  ( mean daily dose 4.2 mg ) and  ipsapirone ( mean daily dose 19.5 mg ) were rapidly tapered by a substitution of half-strength medication for 3 days , then substitution of matched placebo for an additional 11 days . Patients treated with ipsapirone showed no rebound anxiety on discontinuation , nor any other significant increase in withdrawal symptomatology compared to patients who had been prospect ively treated with placebo . In contrast , patients treated with lorazepam showed significant emergent anxiety and /or withdrawal-related symptomatology by almost all clinical measures employed . Overall , 25 % of patients treated with lorazepam showed rebound anxiety , and 40 % of them utilized reserve medication because they found drug discontinuation to be intolerable . The clinical implication s for discontinuation of benzodiazepines after short-term therapy are discussed BACKGROUND The development of effective and well-tolerated anxiolytic agents is an area of critical clinical importance . Abecarnil , a beta carboline , is a partial benzodiazepine-receptor agonist that has demonstrated promise as an anxiolytic agent . In this study , we examine the efficacy , safety , and discontinuation-related effects of abecarnil , buspirone , and placebo in the acute and long-term treatment of patients who have generalized anxiety disorder . METHOD This is a double-blind , placebo-controlled study of two dosages of abecarnil and buspirone . In total , 464 patients were r and omized . After a placebo run-in week , patients entered a 6-week double-blind treatment period , followed by an optional 18-week maintenance period for treatment responders . After abrupt discontinuation of the acute or maintenance treatment , patients entered a 3-week placebo-substitution follow-up period . Treatment response was assessed with the Hamilton Rating Scale for Anxiety and the Clinical Global Impressions ( CGI ) Scale . RESULTS Compared with placebo , abecarnil showed significant anxiolytic activity early in the treatment period , particularly in the high-dosage group , though these differences did not maintain statistical significance at the end of the trial . Buspirone was associated with a slower onset of action and better symptom relief than placebo after 6 weeks of therapy . Withdrawal symptoms emerged in patients who abruptly discontinued abecarnil ( particularly at the higher dosage ) only in those receiving a longer duration of treatment . CONCLUSION The results of this study need to be understood in the context of a high placebo-response rate , which hampers the ability to demonstrate significant drug-placebo differences . This study suggests that abecarnil may be an effective anxiolytic agent ; further attention is warranted to assess its spectrum of clinical effectiveness OBJECTIVE An 8-week r and omized , reference-controlled , double-blind , multi-centre clinical trial investigated Kava-Kava LI 150 in Generalized Anxiety Disorder ( GAD ; ICD-10 : F41.1 ) . METHOD 129 out- patients received either 400 mg Kava LI 150 , 10 mg Buspirone or 100 mg Opipramol daily for 8 weeks . At week 9 , subjects were seen to check for symptoms of withdrawal or relapse . Primary outcome measures comprised the HAMA scale and the proportion of responders at week 8 . Secondary measures were the Boerner Anxiety Scale ( BOEAS ) , SAS , CGI , a self-rating scale for well-being ( Bf-S ) , a sleep question naire ( SF-B ) , a quality -of-life question naire ( AL ) and global judgements by investigator and patients . RESULTS In 127 patients ( ITT ) no significant differences could be observed regarding all efficacy and safety measures . About 75 % of patients were classified as responders ( 50 % reduction of HAMA score ) in each treatment group , about 60 % achieved full remission . CONCLUSION Kava-Kava LI150 is well tolerated and as effective as Buspirone and Opipramol in the acute treatment of out- patients suffering from GAD Buspirone is an antianxiety compound that has been extensively evaluated in clinical trials : it has proved superior to placebo and comparable to diazepam in the treatment of patients with generalized anxiety disorder . In this study , 33 out patients with generalized anxiety disorder were entered into a crossover study of 3 weeks each of placebo , buspirone 10 to 30 mg daily , and diazepam 10 to 30 mg daily . Psychiatrist and patient ratings were made , together with psychological tests and EEG and skin conductance measures before and after each treatment . Of the nine dropouts , six were on buspirone at the time of dropout . For the remaining 24 patients , the mean daily doses attained of buspirone and diazepam were both 20 mg . On most clinical ratings diazepam was superior to buspirone and placebo , which did not differ . Diazepam produced minor psychomotor changes and the expected major effects on the EEG . Buspirone was without effect . Side effects on buspirone were mainly nausea and giddiness and on diazepam , drowsiness . The lack of efficacy of buspirone is discussed in terms of the previous benzodiazepine exposure--23/24 patients had had previous exposure and only 10 were able to tolerate a pretrial placebo washout period . The implication s are considerable for the introduction of any new antianxiety agent not cross-tolerant with the benzodiazepines into a chronically anxious group of patients with previous long-term benzodiazepine therapy 1 . The purpose of this study was to compare the effects and abrupt discontinuation of buspirone 15 or 20 mg tid and lorazepam 3 or 4 mg tid following 8 weeks of treatment . A total of 43 out patients with generalized anxiety disorder were included in the study and 39 entered the withdrawal phase . 2 . Clinical assessment s were performed at baseline , 2 , 4 , 6 and 8 weeks ( active phase ) and after 9 and 10 weeks ( withdrawal phase ) . These included the Hamilton anxiety scale , the visual analogue scale , the CHESS 84 ( a check list for the evaluation of somatic symptoms ) and the Lader tranquilizer withdrawal scale ( translated in french ) . 3 . Results show similar efficacy for lorazepam and buspirone during the active phase with a higher significant difference for buspirone on the CHESS 84 in relation with neurovegetatives symptoms :  lorazepam D0 : 16.30 + /- 3.14 D56 : 5.10 + /- 0.93 ( p < or = 0.01 ) buspirone D0 : 18.82 + /- 3.4 D56 : 4.73 + /- 1.18 ( p < or = 0.001 ) No withdrawal phenomena was observed for both drugs using HAM-A lorazepam D63 : 12.59 + /- 2.26 D70 : 12.0 + /- 1.75 ( p = ns ) buspirone D63 : 10.05 + /- 1.28 D70 : 10.32 + /- 1.82 ( p = ns ) and the same significant difference using Lader scale : lorazepam D63 : 4.44 + /- 0.89 D70 : 6.96 + /- 1.28 ( p < or = 0.05 ) buspirone D63 : 2.95 + /- 0.66 D70 : 4.15 + /- 0.92 ( p < or = 0.05 ) . 4 . This study confirmed that buspirone was as effective as lorazepam at D56 in monitored out patients with generalized anxiety disorder . ( ABSTRACT TRUNCATED AT 250 WORDS This r and omized , double-masked , comparative study evaluated the efficacy and safety of buspirone 30 mg/d , administered twice a day ( BID ) or three times a day ( TID ) , in patients with generalized anxiety disorder ( GAD ) , commonly called persistent anxiety . Patients who participated had GAD according to criteria of the Diagnostic and Statistical Manual of Mental Disorders . Third Edition , Revised , modified to include patients for whom the symptom duration was at least 4 weeks and scored > or = 18 on the Hamilton Rating Scale for Anxiety ( HAM-A ) . After a 7-day placebo lead-in phase , patients who continued to qualify were r and omized to receive buspirone , titrated from 15 mg/d ( 5 mg TID ) to 30 mg/d , as either a BID or TID regimen , for 8 weeks . Of the 137 patients who began the study , 120 patients were included in the data evaluation . Both buspirone BID and TID treatment groups demonstrated significant reductions in mean HAM-A total scores and improvement on Clinical Global Impression measures , with no significant differences detected between the two treatment groups for either measure at any time point . The overall incidence of adverse events was similar for both treatment groups , except for a significantly greater incidence of amblyopia in patients receiving buspirone 15 mg BID . In summary , there was no appreciable difference in efficacy or safety between buspirone 15 mg BID or 10 mg TID in patients with persistent anxiety
target: Azapirones may be less effective than benzodiazepines and we were unable to conclude if azapirones were superior to antidepressants , kava kava or psychotherapy .
  Azapirones appeared to be well tolerated .
  Azapirones appeared to be useful in the treatment of GAD , particularly for those participants who had not been on a benzodiazepine .
  Azapirones may not be superior to benzodiazepines and do not appear as acceptable as benzodiazepines .
  Side effects appeared mild and non serious in the azapirone treated group .
  Longer term studies are needed to show that azapirones are effective in treating GAD , which is a chronic long-term illness
background: BACKGROUND Azapirones are a group of drugs that work at the 5-HT1A receptor and are used to treat patients suffering from generalized anxiety disorder ( GAD ) .
  However , several studies have shown conflicting results .
  Whether azapirones are useful as first line treatment in general anxiety disorders still needs to be answered .
  OBJECTIVES To assess the efficacy and the acceptability of azapirones for the treatment of GAD .