Alprazolam-reinforced medication use in outpatients with anxiety

The reinforcing effects of alprazolam were investigated in 14 patients who had generalized anxiety or panic disorder, but were not current users/abusers of other psychoactive substances. Using a double-blind outpatient choice procedure, color-coded alprazolam (0.5 mg) and placebo capsules were provi...

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Bibliographic Details
Published in:	Drug and alcohol dependence Vol. 45; no. 3; pp. 143 - 155
Main Authors:	Roache, J.D., Stanley, M.A., Creson, D.R., Shah, N.N., Meisch, R.A.
Format:	Journal Article
Language:	English
Published:	Shannon Elsevier Ireland Ltd 02-05-1997 Elsevier Science
Subjects:	Adult Alprazolam Alprazolam - therapeutic use Analysis of Variance Anti-Anxiety Agents - therapeutic use Anxiety Anxiety Disorders - drug therapy Behavior, Addictive Benzodiazepines Biological and medical sciences Choice Behavior Circadian Rhythm Double-Blind Method Female Follow-Up Studies Humans Individuality Longitudinal Studies Male Medical sciences Middle Aged Neuropharmacology Panic Panic Disorder - drug therapy Pharmacology. Drug treatments Placebos Psycholeptics: tranquillizer, neuroleptic Psychology. Psychoanalysis. Psychiatry Psychopharmacology Reinforcement Reinforcement (Psychology) Self Administration - psychology Self-administration Self-medication Treatment Outcome Alprazolam Self-administration Panic Reinforcement Anxiety Self-medication Benzodiazepines Human Chemotherapy Treatment Tranquillizer Generalized anxiety disorder Psychotropic Anxiety disorder Benzodiazepine derivatives Self administration
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Summary:	The reinforcing effects of alprazolam were investigated in 14 patients who had generalized anxiety or panic disorder, but were not current users/abusers of other psychoactive substances. Using a double-blind outpatient choice procedure, color-coded alprazolam (0.5 mg) and placebo capsules were provided to patients for use ‘as needed’ in the treatment of anxiety symptoms. Comparisons of alprazolam and placebo during a 2 week sampling period in which placebo and alprazolam were available sequentially revealed no significant differences on measures of medication usage or anxiety levels, although alprazolam did increase subjective ratings of drug effects/side effects. During a 4 week choice period, alprazolam was strongly preferred over placebo in 11 out of 14 patients indicating that alprazolam functioned as a reinforcer. Medication usage ranged from zero to 4.0 mg alprazolam in a day. Variations in daily medication-use were positively correlated with anxiety level fluctuations for a majority of patients. For a majority of patients, the results indicate that alprazolam functioned as a reinforcer without accompanying signs of abuse or addiction.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0376-8716 1879-0046
DOI:	10.1016/S0376-8716(97)01354-9