RESUMO
Anxiety symptoms and plasma diazepam and desmethyldiazepam were assessed in 50 male outpatient veterans with primary chronic anxiety symptoms who had been taking an average of 17.7 mg of diazepam per day for a mean of 4.9 years. These subjects were moderately anxious (mean Hamilton Anxiety Scale score = 23) despite their chronic diazepam use. Although tolerance could explain this inadequate anxiolytic effect, the absence of a significant correlation between duration of use and either diazepam dose or any of the three anxiety measures argues against this hypothesis. The findings of modest diazepam dose and plasma concentration (mean=324 ng/ml) and of a trend toward a positive correlation between anxiety level and both dose and plasma level suggest inadequate dosage as a more likely explanation for the subjects' continued anxiety.
Assuntos
Transtornos de Ansiedade/tratamento farmacológico , Diazepam/administração & dosagem , Adulto , Idoso , Assistência Ambulatorial , Transtornos de Ansiedade/sangue , Transtornos de Ansiedade/psicologia , Doença Crônica , Diazepam/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Nordazepam/sangue , Escalas de Graduação PsiquiátricaRESUMO
Twenty-four middle-aged male chronically anxious outpatients who were taking diazepam at a mean dose of 17 mg/day for a mean duration of 5 years were assigned to maintenance (M), gradual withdrawal (GW) or abrupt withdrawal (AW) and followed weekly. No differences were seen in two self-report anxiety measures or in withdrawal symptoms between groups. Hamilton Anxiety Rating Scale scores were slightly elevated (F = 2.34, P less than 0.05) in the AW patients at a mean duration of 4 weeks off diazepam. Thus, withdrawal from chronic diazepam (10-30 mg/day) use produced no prominent withdrawal syndrome, but the suggestion of gradual anxiety recurrence indicates the need fro longer-term follow-up studies to adequately assess maintenance efficacy.
