J Med Assoc Thai 1997; 80 (3):183

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Alprazolam and Standard Antidepressants in the Treatment of Depression: A Meta-analysis of the Antidepressant Effect
Srisurapanont M Mail, Boonyanaruthee V

Alprazolam differs from other benzodiazepines by the incorporation of a triazolo ring in
the basic chemical structure. Several lines of evidence have supported that alprazolam and standard
antidepressants have some similar actions, such as beta-adrenergic receptor down-regulation,
antipanic effect. Because of the difference in opinions pertaining to the antidepressant effect of
alprazolam, this issue could not reach a firm conclusion. In the present analysis, we carried out a
meta-analysis of 11 random controlled studies that compared the antidepressant effect of alprazolam
and standard antidepressants in depressed patients. The results showed that the weighted mean
effect size d (dw) is equal to 0.06. In conclusion, the antidepressant effect of alprazolam is comparable
to that of low-dose tricyclic antidepressants. Very few studies have investigated severely
depressed patients. Also, in long-term administration, the lack of a long-term treatment study makes
the isssue of alprazolam's benefits and disadvantages still undetermined.

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