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The 'Efficacy' of Alprazolam in Panic Disorder and Agoraphobia: A Critique of Recent Reports

Isaac M. Marks, MD; Alfonso De Albuquerque, MD; Jean Cottraux, MD; Valentim Gentil, MD, PhD; John Greist, MD; Iver Hand, MD; Robert L. Liberman, MD; Joao S. Relvas, MD; Adolf TobeÑa, MD; Peter Tyrer, MD; Hans-Ulrich Wittchen, PhD
Arch Gen Psychiatry. 1989;46(7):668-670. doi:10.1001/archpsyc.1989.01810070094015.
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To the Editor.—  Psychiatrists and psychologists in several countries have helped to compose this letter, which critiques recent reports (in the May 1988 Archives, pp 407-443) by Klerman,1 Ballenger et al,2 Noyes et al,3 Pecknold et al,4 and Lesser et al.5The evaluation of treatment outcome is a complex process, and the same data can lead different observers to contrasting conclusions, as is highlighted by this large trial reported by respected researchers. All five articles claim that alprazolam is "effective," a claim made without qualification in the abstract of Klerman's article.1 Pecknold et al4 even recommend in their abstract that the administration of medication should last at least 6 months, with subsequent taper of at least 8 weeks. This claim of "efficacy" is misleading given the arguable interpretation of the data presented and that busy clinicians often have to rely on abstracts more


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