Controlled comparison of bromazepam, amitriptyline, and placebo in anxiety-depressive neurosis

Abstract

Seventy-two private practice patients with moderate or severe anxiety-depressive neurosis received mean daily oral doses of 23.8 mg bromazepam, 94 mg amitriptyline, or 4.6 capsules of placebo in a double-blind four-week study. The patient's condition was assessed initially and at weekly intervals by using the Brief Psychiatric Rating Scale and the Hamilton Psychiatric Rating Scale for Depression. From the first through the fourth week evaluations, a larger proportion of patients improved on bromazepam than on amitriptyline. Bromazepam was also superior to amitriptyline and placebo in the degree of improvement made Statistical significance (p less than 0.05) of the changes noted after one week was even greater after four weeks, particularly in BPRS items of somatic concern, depressive mood, anxiety and tension and in nearly all representative psychic and somatic symptoms on the depression scale, confirmed by global evaluation. Compared to bromazepam patients, amitriptyline patients had significantly severer adverse reactions which were the major cause of the group's higher dropout rate (66% vs 33%). The prompt clinical response to bromazepam contributed to its superior safety and patient progress in that it was possible to carefully titrate dosage and thus help to control adverse reactions and allow patients to maintain alertness and productivity under therapy.