Fareed Minhas, Nusrat Ara Majeed, Mumtaz Naqvi, Ayesha Minhas, Jawed Rashid, Syed Shahid Hussain.
To assess the safety and efficacy of Alprazolam in hypertensive patients with generalized anxiety disorders.
Med Channel Jan ;11(1):40-5.

OBJECTIVE: To assess the safety and efficacy of Alprazolam in hypertensive patients with generalized anxiety disorder. INTRODUCTION: A six months study from September 2002 to March 2003 was conducted at the Institute of Psychiatry, Rawalpindi Medical College, Rawalpindi in 120 hypertensive patients of 18 to 65 years of age, with diagnosis of generalized anxiety state according to Hamilton Anxiety Rating Score (HARS). While the patients suffering from schizophrenia, bipolar or unipolar depression or dysrythmic disorder, major depression, pregnant women, history of alcoholism or drug abuse, or with acute suicidal ideation, and/or having history of serious disease pathology were excluded from the study. MATERIALS & METHODS: The selected patients were allocated to either Study or Control group by using Random Number Table; both groups were provided antihypertensive therapy in the form of ACE inhibitor or ACE inhibitor plus Diuretics. The patients in study group were given Alprazolam 0.5 mg three times a day & the dose was adjusted to suit individual patient needs while the control group was not given Alprazolam. Required lab investigations were done at the time of recruitment and at the end of trial. The primary end point was change in Anxiety Rating Scales, while the incidence of Adverse Events in hypertensive patients concomitantly treated with Alprazolam was the secondary end point. SPSS version 10 was used for data analysis. RESULTS: Out of 120 patients, I0I completed the trial, 52 in Alprazolam group and 49 in control group. 52 (51.48%) were males and 49 (48.52%) females with a mean age (± SD) of 45.36 ± 9.16 years. Systolic Blood Pressure (SBP) was 143.75 ± 12.2 mm Hg in Alprazolam group and 143.77 ± 14.67 in Control group. After 12 weeks of treatment, mean SBP was 117.88 ±4.00 mm Hg in Alprazolam group and 120.51 ±5.5 mm Hg in the Control group (P< 0.007). At the start of the study, all patients in both groups had a HARS of 18, while after 12 weeks, only one patient in Alprazolam group (1.9 %) had HARS 18 while 27 patients (55.1%) among control had HARS of - 18, (P<0.001), showing that Alprazolam had been effective in reducing the anxiety level. Conversion to normal status in Alprazolam group (94.2%) was significantly higher than the conversion (20.4%) in the Control group (P< 0.001). The adverse events in both the groups were mild and transitory and did not require discontinuation of the therapy. CONCLUSION: The results demonstrate that addition of Alprazolam to the antihypertensive therapy leads to significant reduction in both SBP, DBP, as well as in the anxiety score on HARS. These results may lead to new intervention trials specifically selecting hypertensive patients with anxiety or depression for treatment with stress reduction or other appropriate therapies & further contribute to the evaluation of anxiety and depression as risk factors for hypertension.

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