Hostname: page-component-7c8c6479df-24hb2 Total loading time: 0 Render date: 2024-03-28T20:35:16.582Z Has data issue: false hasContentIssue false

Is Diazepam an Antidepressant?

Published online by Cambridge University Press:  02 January 2018

John Tiller*
Affiliation:
Department of Psychiatry, The University of Melbourne
Isaac Schweitzer
Affiliation:
Department of Psychiatry, The University of Melbourne
Kay Maguire
Affiliation:
Department of Psychiatry, The University of Melbourne
Brian Davies
Affiliation:
Department of Psychiatry, The University of Melbourne
*
c/o P.O. Royal Melbourne Hospital, Victoria 3050, Australia

Abstract

In double-blind sequential study, diazepam was compared with the proven antidepressant moclobemide, in patients with atypical depression. Both agents significantly improved depression ratings over eight weeks of treatment. Diazepam was a significantly better antidepressant than moclobemide at four weeks, although not at eight weeks. All patients ceased diazepam within one year and none reported withdrawal reactions. These data suggest the need to reconsider that benzodiazepines may be antidepressants and to study their possible antidepressant actions.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists 1989 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aden, G. C. & Thein, S. G. (1980) Alprazolam compared to diazepam and placebo in the treatment of anxiety. Journal of Clinical Psychiatry, 41, 245248.Google Scholar
Akiskal, H. S. (1984) The interface of chronic depression with personality and anxiety disorders. Psychopharmacology Bulletin, 20, 393398.Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn). Washington, DC: APA.Google Scholar
Armitage, P. (1975) Sequential Medical Trials. Oxford: Blackwell Scientific Publications.Google Scholar
Baldessarini, R. J. (1985) Drugs and the treatment of psychiatric disorders. In The Pharmacological Basis of Therapeutics (eds Goodman Gillman, A., Goodman, L. S., Rand, T. W. & Muriad, F.). New York: Macmillan.Google Scholar
Barbaccia, M. L., Costa, E., Ferrero, P., et al (1986) Diazepam-binding inhibitor. Archives of General Psychiatry, 43, 11431147.Google Scholar
Bartholini, G., Lloyd, K. G. & Morselli, P. L. (eds) (1986) GABA and Mood Disorders, Experimental and Clinical Research, LERS, vol. 4. New York: Raven Press.Google Scholar
British Medical Journal (1986) Neurosis: another tough old word (Editorial). British Medical Journal, 292, 972973.Google Scholar
Carroll, B. J., Feinberg, M., Smouse, P. E., et al (1981) The Carroll Rating Scale for Depression: development, reliability and validation. British Journal of Psychiatry, 138, 194200.CrossRefGoogle ScholarPubMed
Cassachia, M., Carolei, A., Barba, C., et al (1984) A placebo-controlled study of the antidepressant activity of moclobemide, a new MAOA-inhibitor. Pharmacopsychiatry, 17, 122125.Google Scholar
Cassano, G. B., Conti, L., Placidi, G. F., et al (1985) The overlap of the spectrum of antianxiety and antidepressant drugs: a multivariate approach. In Psychiatry – Vol. 1. Clinical Psychopathology: Nomenclature and Classification (ed. Pichot, P.). New York: Plenum Press.Google Scholar
Committee on the Review of Medicines (1980) Systematic review of the benzodiazepines. British Medical Journal, 280, 910912.Google Scholar
Davis, J. M. (1985) Antidepressant drugs. In Comprehensive Textbook of Psychiatry IV (eds Kaplan, H. I. & Sadock, B. J.). Baltimore: Williams & Wilkins.Google Scholar
Fabre, L. F. & McLendon, D. M. (1979) A double blind study comparing the efficacy and safety of alprazolam with diazepam and placebo in anxious outpatients. Current Therapeutics Research, 25, 519526.Google Scholar
Fairchild, C. J., Rush, J., Vasavada, N., et al (1986) Which depressions respond to placebo? Psychiatry Research, 18, 217226.Google Scholar
Feighner, J. P., Aden, G. C., Fabre, L. F., et al (1983) Comparison of alprazolam, imipramine, and placebo in the treatment of depression. Journal of the American Medical Association, 249, 30573064.Google Scholar
Goldberg, D. & Simpson, N. (1985) The diagnosis of anxiety in primary care settings. In Drug Treatment of Neurotic Disorders: Focus on Alprazolam (eds Lader, M. H. & Davies, H. C.). Edinburgh: Churchill Livingston.Google Scholar
Hamilton, M. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 5662.CrossRefGoogle ScholarPubMed
Higgitt, A. C., Lader, M. H. & Fonagy, P. (1985) Clinical management of benzodiazepine dependence. British Medical Journal, 291, 688690.CrossRefGoogle ScholarPubMed
Holden, N. L. (1983) Depression and the Newcastle scale: their relationship to the dexamethasone suppression test. British Journal of Psychiatry, 142, 505507.Google Scholar
Imlah, N. W. (1985) An evaluation of alprazolam in the treatment of reactive or neurotic (secondary) depression. British Journal of Psychiatry, 146, 515519.Google Scholar
Johnson, D. A. W. (1983) Benzodiazepines in depression. In Benzodiazepines Divided (ed. Trimble, M. R.), pp. 247259. Chichester: Wiley.Google Scholar
Johnstone, E. C., Cunningham Owens, D. G., Frith, C. D., et al (1980) Neurotic illness and its response to anxiolytic and antidepressant treatment. Psychological Medicine, 10, 321328.Google Scholar
Kahn, R. J., McNair, D. M., Lipman, R. S. et al (1986) Imipramine and chlordiazepoxide in depressive and anxiety disorders – II. Archives of General Psychiatry, 43, 7985.Google Scholar
Katz, M. M., Koslow, S. H., Maas, J. W., et al (1987) The timing, specificity and clinical prediction of tricyclic drug effects in depression. Psychological Medicine, 17, 297309.Google Scholar
Klein, D. F. (1974) Endomorphogenic depression. Archives of General Psychiatry, 36, 447454.Google Scholar
Klerman, G. L. (1980) Anxiety and depression. In Handbook of Studies on Anxiety (eds Burrows, G. D. & Davies, B.). Amsterdam: Elsevier/North-Holland Biomedical Press.Google Scholar
Larsen, J. K., Holm, P. & Mikkelson, P. L. (1984) Moclobemide and clomipramine in the treatment of depression. Acta Psychiatrica Scandanavica, 70, 254260.CrossRefGoogle ScholarPubMed
Liebowitz, M. R., Quitkin, F. M., Stewart, J. W., et al (1984) Phenelzine vs. imipramine in atypical depression. Archives of General Psychiatry, 41, 669677.Google Scholar
Lipman, R. S., Covi, L., Rickels, K., et al (1986) Imipramine and chlordiazepoxide in depressive and anxiety disorders – I. Archives of General Psychiatry, 43, 6877.Google Scholar
Medical Research Council (1965) Clinical trial of the treatment of depressive illness. British Medical Journal, i, 881886.Google Scholar
Morris, J. & Beck, A. (1974) The efficacy of antidepressant drugs. Archives of General Psychiatry, 30, 667674.Google Scholar
National Health and Medical Research Council (1983) Statement on Human Experimentation and Supplementary Notes. Canberra: NH&MRC.Google Scholar
Norman, T. R., Ames, D., Burrows, G. D., et al (1985) A controlled study of a specific MAO-A reversible inhibitor (Ro 11-1163) and amitriptyline in depressive illness. Journal of Affective Disorders, 8, 2935.Google Scholar
Pecknold, J. C., Swinson, R. P., Kuch, K., et al (1988) Alprazolam in panic disorder and agoraphobia: results from a multicentre trial – III. Discontinuation effects. Archives of General Psychiatry, 45, 429436.Google Scholar
Prien, R. F. & Levine, J. (1984) Research and methodological issues for evaluating the therapeutic effectiveness of antidepressant drugs. Psychopharmacology Bulletin, 20, 250257.Google Scholar
Prusoff, B. & Klerman, G. (1974) Differentiating depressed from anxious neurotic outpatients. Archives of General Psychiatry, 30, 302308.CrossRefGoogle ScholarPubMed
Raskin, A., Schulterbrandt, J. G., Reatig, N., et al (1974) Depression subtypes and response to phenelzine, diazepam, and a placebo. Archives of General Psychiatry, 30, 6675.Google Scholar
Rickels, K., Cohen, D. O., Csanalosi, I., et al (1982) Alprazolam and imipramine in depressed outpatients: a controlled study. Current Therapeutic Research, 32, 157164.Google Scholar
Rickels, K., Feighner, J. P. & Smith, W. T. (1985) Alprazolam, amitriptyline, doxepin, and placebo in the treatment of depression. Archives of General Psychiatry, 42, 134141.Google Scholar
Roth, M., Gurney, C., Garside, R., et al (1972) Studies in the classification of affective disorders. The relationship between anxiety states and depressive illness. British Journal of Psychiatry, 121, 147167.Google Scholar
Russell, G. F. M., Niaz, U., Wakeling, A., et al (1978) Comparative double-blind trial of mianserin hydrochloride (Organon GB94) and diazepam in patients with depressive illness. British Journal of Clinical Pharmacology, 5, 57S65S.Google Scholar
Schatzberg, A. F. & Cole, J. O. (1978) Benzodiazepines in depressive disorders. Archives of General Psychiatry, 35, 13591365.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773782.Google Scholar
Stefanis, C. N., Alevizos, B. & Papadimitriou, G. N. (1982) Antidepressant effect of Ro 11-1163, a new MAO inhibitor. International Pharmacopsychiatry, 17, 4348.Google Scholar
Stefanis, C. N., Alevizos, B. & Papadimitriou, G. N. (1984) Controlled clinical study of moclobemide (Ro 11-1163), a new MAO inhibitor and desipramine in depressive patients. In Monoamine Oxidase and Disease-Prospects for Therapy with Reversible Inhibitors (eds Dostert, P., Benedetti, M. S. & Tipton, K. F.). London: Academic Press.Google Scholar
Stern, S. L., Rush, A. J. & Mendels, J. (1980) Towards rational pharmacotherapy of depression. American Journal of Psychiatry, 137, 545552.Google Scholar
Thomson, R. (1982) Side effects and placebo amplification. British Journal of Psychiatry, 140, 6468.Google Scholar
Tiller, J., Schweitzer, I., Maguire, K., et al (1989) A sequential double blind controlled study of moclobemide and diazepam in patients with atypical depression. Journal of Affective Disorders (in press).Google Scholar
Tyrer, P. (1989) Risks of dependence on benzodiazepine drugs: the importance of patient selection. British Medical Journal, 290, 102104.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.