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Re: The Best Benzo for Depression? Experiences?

Posted by sdb on November 28, 2006, at 10:09:06

In reply to The Best Benzo for Depression? Experiences?, posted by blueberry on November 25, 2006, at 14:34:33

There are two good benzo's available in some countries (Prazepam, Ketazolam). Prazepam has antidepressive actions proven in some studies (clomipramine-prazepam). Ketazolam is probably one of the smoothest benzo pharmacodynamically. Ketazolam->n-desmethyl-metabolites and to some extend Ketazolam->diazepam->n-desmethyl-metabolites
Ketazolam is compared in studies to be more favorable mainly because of its pharmacodynamics.

When I took prazepam I thought it had antidepressive actions. Actually a benzo would be indicated for my peripheral spasticity problem of the under extremity but
nevertheless I avoid to take that longer because of some reasons.

Its very likely that these benzo's aren't available for most people here.

sdb

Compared efficacy of prazepam and clomipramine in major depression with anxiety: a multicenter controlled study.

* Lemoine P,
* Boulenger JP,
* Caillard V,
* Tanne N,
* Bonnet D.

Unite Clinique de Psychiatrie Biologique, C.H.S. Le Vinatier, Lyon Bron, France.

The efficacy of antidepressants is well established in major depressions, especially those with melancholic features. However, some anxiolytics also appear to have antidepressant properties at least for outpatients. 118 outpatients (25 males, 93 females, age: 18-60) with major depression according to DSM-III criteria, neither melancholic nor suicidal, reaching at least 27 on Montgomery and Asberg depression rating scale (MADRS) and 19 on Hamilton anxiety rating scale (HARS) accepted to participate this double blind study carried out by 15 G.P.s coordinated by 3 psychiatrists. After a one week placebo wash-out-single-blind period, they were randomly, double blind, assigned to one of the two following groups: PR treated with prazepam (30-60 mg), a benzodiazepine anxiolytic or CL treated clomipramine, an imipramine antidepressant (75-150 mg). Patients were evaluated at days 0, 7, 14, and 28, using MADRS, HARS, Clinical Global Impression and Hopkins symptoms check list 58. In addition, G.P.s had to meet monthly for a case discussion group. Results: groups were comparable at day 0. A highly significant improvement of MADRS and HARS scores (p less than 0.001) was observed in the total population. For the completer population evolution was also significantly positive in all the parameters studied but, considering MADRS and HSCL scores, a difference in favor of CL is observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID: 1775523 [PubMed - indexed for MEDLINE]

Comparison of the therapeutic effect, tolerance and safety of ketazolam and diazepam administered for six months to out-patients with chronic anxiety neurosis.

* Fabre LF,
* McLendon DM,
* Stephens AG.

Recently, it has been argued that benzodiazepines may not be safe or efficacious beyond 3 months continuous dosage. This study was designed to provide data regarding efficacy, safety, possible tolerance development, and possible withdrawal effects of administering ketazolam and diazepam for a 6-month period. Chronic anxiety patients were screened for participation according to specific inclusion and exclusion criteria. Of 139 patients, forty-four terminated prematurely for non-drug related reasons and are not included in the analysis. Of the ninety-five patients remaining, sixty-three were on ketazolam, and thirty-two on diazepam. Efficacy parameters included the Hamilton Anxiety Rating Scale, Physician's Global Impressions, Target Symptoms, Self-Rating Symptom Scale, and Patient's Global Impressions. Patients were evaluated weekly for the first month except for Week 3, and then seen bi-weekly and rated monthly. The results of the study showed that ketazolam was as efficacious as diazepam in treating anxiety and resulted in fewer side-effects. No adverse effects were noted in either group. Both benzodiazepines were safe and well-tolerated. No tolerance or withdrawal effects were noted. The average doses were ketazolam Week 4 (50.0 mg), Week 24 (66.14 mg) and diazepam Week 4 (26.33 mg) and Week 24 (33.0 mg). An increase in anxiety occurred in a significant number of patients after termination of either drug. By 2 weeks after the last dose many patients were free of anxiety and did not require further treatment. These results demonstrate that benzodiazepines are safe and efficacious for at least 6 months of continuous dosage.

PMID: 6113174 [PubMed - indexed for MEDLINE]


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