THE ANXIOLYSIS CONUNDRUM: BENZODIAZEPINE VS LOW DOSE ANTIPSYCHOTIC

Abstract

Background: The unprecedented and unaccounted use of benzodiazepines is running havoc in many countries in terms of substance abuse problems and is exponentially increasing. The prescription of benzodiazepines should be minimized and the search for and use of better alternatives be incorporated into clinical practice of Psychiatry.

Aim: The aim of this study is to compare the efficacy of low dose Risperidone and relatively higher dosage of Clonazepam in moderate to severe anxiety states when used in combination with an SSRI.

Method: A group of 60 patients having moderate to severe anxiety level, as measured by Hamilton Anxiety Rating Scale (HARS) were randomly divided into two groups. First group was given 1 mg of Risperidone with 50 mg Sertraline and the second group was given 2 mg of Clonazepam with 50 mg Sertraline. The anxiety levels of patients in both groups were again calculated on the 10th post treatment day and compared to each other. Moreover, the Side Effect profiling of Risperidone was also done in all the Patients by using the Glasgow Anti-psychotic Side-effect Scale (GASS)’. Result: The first group receiving sertraline and risperidone showed a significant decrease in the level of anxiety as measured by HARS with a mean score of 29.16 on day 0 to a mean score of 9.60 on day 10 (p=0.0125). The second group receiving sertraline and clonazepam also showed a significant decrease in the anxiety levels with a mean HARS score of 31.12 on day 0 to 12.36 on day 10(p=0.019). One way anova showed that there was no significant difference between the two groups (p=0.989).

Conclusion: The efficacy of low dose risperidone is comparable to that of relatively high dose of clonazepam in treating moderate to severe anxiety states. Use of risperidone for symptomatic relief from anxiety is a viable alternative to benzodiazapines