Clorazepate and lorazepam:
clinical improvement and rebound anxiety

by
Rickels K, Fox IL, Greenblatt DJ,
Sandler KR, Schless A.
Department of Psychiatry,
University of Pennsylvania, Philadelphia.
Am J Psychiatry 1988 Mar;145(3):312-7


ABSTRACT

Sixty-two anxious patients were treated under double-blind conditions for 4 weeks with either clorazepate or lorazepam. Two-thirds of each treatment group were then switched abruptly to placebo for 2 weeks, while one-third continued to receive active medication. Two major findings were obtained. About 70% of the patients maintained improvement during the 2-week placebo period. Some patients, however, experienced rebound anxiety, which appeared to be more intense and occurred earlier when placebo was substituted for a benzodiazepine with a short half-life (lorazepam) than for one with a long half-life (clorazepate). The clinical relevance of these findings is discussed.
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