human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Alprazolam is the first of the triazolobenzodiazepines to be studied in a large population of depressed patients . In a six-week , double-blind multicenter comparison of alprazolam , imipramine hydrochloride , and placebo in the treatment of 723 patients with depression , the two active drugs were statistically more effective than placebo . Alprazolam was at least as effective as imipramine in relieving depressive symptoms , significantly more effective in relieving somatic symptoms , and showed an earlier onset of activity in some measurements . Anticholinergic side effects were reported most often by patients receiving imipramine , while drowsiness was the only side effect reported most often in the alprazolam group . The Feighner Diagnostic Criteria and pre study and post study intercenter conferences with videotaped patient interviews ensured interrater reliability In a four-week double-blind study comparing alprazolam with oxazepam , 62 out patients suffering from anxiety with depressive symptoms were evaluated . The average daily doses of alprazolam and oxazepam were 1.48 mg and 44.4 mg , respectively . According to all rating scales applied , both alprazolam and oxazepam were effective in relieving anxiety associated with mild depression ( p less than 0.01 ) . Alprazolam proved somewhat more effective than oxazepam especially with regard to overall performance ( p less than 0.05 ) . Treatment-emergent adverse effects were few and mild for both compounds tested The purpose of this study was to compare the safety and efficacy of a relatively new antidepressant drug , alprazolam ( a triazolobenzodiazepine ) with imipramine in the treatment of 60 depressed symptomatic volunteers . Eligible patients were r and omly assigned after a 1-week washout to one of the medications and followed for 6 treatment weeks . Contrary to the earlier report of Feighner et al. ( 1983 ) , who found alprazolam superior to imipramine and placebo , but consistent with Rush et al. ( 1985 ) we find imipramine superior in efficacy to alprazolam on a variety of symptoms . Both the present study and Rush 's study employed patients with signs indicative of response to tricyclics . Feighner 's patients may have been the type who tend to be less responsive to tricyclics but may be more responsive to alprazolam .  Some of our data also show that alprazolam may have a more advantageous effect in the early weeks of treatment but is overtaken in subsequent treatment weeks by imipramine The therapeutic effect and safety of alprazolam and doxepin were studied in 126 out patients suffering from primary unipolar depression . The 6-week study was double-blind with a r and om allocation of treatment . Patients were treated with a flexible dose of 1.0 - 4.5 mg of alprazolam and 50 - 225 mg of doxepin per day . The mean final doses were 2.7 mg for alprazolam and 137.5 mg for doxepin . The results indicate that alprazolam and doxepin were equally efficacious . The incidence of side-effects was lower in the alprazolam treatment group This paper presents findings from a multisite study of 126 subjects meeting DSM-III-R criteria for Panic Disorder who also met criteria for a concurrent Major Depressive Episode , Dysthymia , or Depressive Disorder NOS . The study 's primary aim was to discern the influence of varying degrees of depression on the comparative efficacy of alprazolam , imipramine and placebo on anxiety outcomes . A placebo-controlled , double-blind , parallel r and om assignment design was utilized over a total of 16 weeks . There was no medication effect on panic outcomes . At endpoint , percent of anticipatory anxiety ( i.e. , time spent worrying about having an anxiety attack ) was significantly lower in the patients taking active medications vs. placebo .  Phobic measures were significantly improved by alprazolam , vs. both imipramine and placebo early in the study ; however , by week 8 both active medications were equally superior to placebo in the reduction of phobic symptoms . In addition , both active medications were significantly more effective than placebo in reducing depression . The same efficacy pattern ( i.e. , active medications superior to placebo ) was observed on measures of general functioning . Importantly , there were no significant interactions observed between medication and presence of major depression on the depression measures , indicating that both alprazolam and imipramine were equally efficacious in treating the depression in patients with panic disorder and major depression . Since the patients enrolled in this study suffered from major depressive disorder in the mild to moderate severity range , these results may not be transferrable to patients with panic disorder and severe major depression This study examines clinical predictors of outcome for patients with panic disorder and depression in a 16 week , placebo-controlled trial of alprazolam and imipramine  ( n = 126 ) . Baseline global severity of illness and phobic avoidance were differentially predictive of acute response to treatment . Patients in the mild to moderate range of global distress experienced smaller degrees of improvement on alprazolam than on imipramine at week 4 . At endpoint , the relative effectiveness of the active medication versus placebo was diminished in patients with higher levels of phobic avoidance . This relationship was not evident for completers , suggesting that the adverse effects of avoidance on outcome after sustained treatment was reduced The efficacy and safety of alprazolam as compared to imipramine or a placebo added to weekly interpersonal psychotherapy was compared in a 6-week double-blind r and omized clinical trial of 35 ambulatory elderly patients with major depression . The average maximum dosage of alprazolam was 2.2 mg and the average maximum dosage of imipramine was 97.5 mg . The findings showed a rapid onset of action of alprazolam within 1 week on symptoms of depression and anxiety . The effects for imipramine were seen later in the study . There were no serious side effects that interfered with treatment . The anticholinergic effects of imipramine were the ones that most commonly interfered with treatment . Alprazolam produced the greatest number of symptoms with discontinuation , most of which were alleviated within a week . We conclude that alprazolam may be useful as an antidepressant for the elderly . More clinical trials are needed to test its efficacy in the depressed elderly with concomitant medical problems , using plasma levels . A double-blind discontinuation study of alprazolam is needed to determine the degree of symptom return This study was design ed to compare the antidepressant effects of alprazolam and amitriptyline in a group of 30 in patients suffering from a severe major endogenous depression , diagnosed by Research Diagnostic Criteria and the Newcastle Rating scale , and to examine the effects of alprazolam and amitriptyline on two biological markers of depression , the dexamethasone suppression test and sleep EEG parameters . The 6-week study was double-blind with a r and om allocation of treatment . Patients were treated with flexible doses of 4 - 9 mg of alprazolam and 100 - 225 mg of amitriptyline . After 4 weeks of treatment the antidepressant effects of amitriptyline significantly exceeded those of alprazolam , as measured on the Hamilton Rating Scale for Depression . There was a high drop-out rate in the alprazolam group because of ineffectiveness of treatment . Alprazolam showed similar effects on sleep parameters as amitriptyline : lengthening of the REM latency and a tendency to shorten stages 3 and 4 and stage REM . These negative clinical results should be interpreted with caution , because of the severity of our selection criteria , and should not be extended to all depressive disorders One hundred patients with mixed symptoms of anxiety and depression were enrolled into a prospect i ve , multi-centre , r and omized , double-blind study comparing the response to , and the side-effects of , alprazolam and dothiepin hydrochloride over 4 weeks of treatment . Mean daily doses were 2.33 mg alprazolam and 115 mg dothiepin . Data on 96 patients were evaluated for tolerance , and data for 85 patients were analyzed for therapeutic response . In each case , the groups were similar in numbers , mean ages and sex ratios . Both groups experienced satisfactory responses to therapy , with highly statistically significant changes ( p less than 0.001 ) in the means of all efficacy measures within each group . No statistical difference was demonstrated in favour of either treatment group . Both dothiepin and alprazolam exhibited a similar profile of mild minor side-effects , but more patients suffered moderate to severe reactions to dothiepin , leading to a greater drop-out rate in the dothiepin-treated group . It is concluded that , as both treatments produced equally satisfactory responses in this study , alprazolam should be considered for the treatment of  anxiety associated with depression in patients for whom tricyclic antidepressant drugs are either contra-indicated or poorly tolerated SUMMARY This report describes the results of a multicentre collaborative study comparing the safety and efficacy of alprazolam with imipramine in patients suffering from major depressive disorder . Two hundred and eight patients diagnosed as major depression as per DSM-III criteria were r and omly allocated to alprazolam ( N= 105 ) or imipramine ( N = 103 ) in a double-blind fashion . Detailed assessment s were carried out for a period of six weeks . Results revealed that alprazolam was as effective as imipramine as an antidepressant . Side effects were less frequently reported with alprazolam Forty-three out- patients with depression of a moderate degree were enrolled in a r and omized , double-blind parallel group study comparing amitriptyline and alprazolam for 6 weeks of treatment . Patients were evaluated at the end of placebo washout and at Weeks 1 , 2 , 3 and 6 of drug therapy using the Hamilton Depression Rating Scale ( HAM-D ) , Hamilton Anxiety Rating Scale ( HAM-A ) , Beck Depression Inventory ( BDI ) and Clinical Global Impression ( CGI ) . Drug dosage was determined in a fixed-flexible design result ing in mean final doses of alprozalam 3.2 mg/day and of amitriptyline 115 mg/day . Although both drug groups improved there were statistically significant differences in favour of amitriptyline at the end of the study on the HAM-D , BDI and HAM-A scales .  Patients on amitriptyline reported more side effects overall than patients taking alprazolam with significantly more reports of dry mouth in the amitriptyline group The usefulness of the  Zung Self-Rating Depression Scale  as a screening instrument to uncover masked depression , and the benefits of early identification and treatment with alprazolam , were evaluated in a general medical practice population . There was a 95 % scale acceptance by patients and a 12 % overall prevalence of depression based on SDS results . Patients who scored in the depressed range on the SDS were , on a r and omized basis , either identified immediately to their physicians and treated with alprazolam ( N = 21 ) or identified after 4 weeks ( natural history controls , N = 20 ) . Treatment result ed in improvement in 66 % of the identified group versus a 35 % spontaneous improvement in the control group ( p less than .05 ) The objectives of this prospect i ve study were to calculate incidence rates for fall-related hospitalization , to compare the effect of risk factors among  benzodiazepine ( BZD ) users and unexposed controls , and to examine variations in risks according to length of time following a BZD prescription . Data were derived from Saskatchewan Health linked data bases , leading to information on 468 hospitalizations for injury due to falls among a study population of 321422 .  Incidence rates per 10000 within 28 days of the prescription fill date were 26.2 , 12.1 and 9.0 for BZD sedative users , BZD tranquillizer users and for unexposed controls , respectively . Incidence rates increased with age , and were higher for women than for men . Results from multivariate logistic regression models also showed a greater risk of falling for BZD users but the odds ratio was higher for men than for women . A history of treatment for alcohol abuse was a very strong risk factor for falls among both men ( odds ratio , 10.7 ) and women ( odds ratio , 4.3 ) . The highest risk of serious injury due to falls was within 15 days of filling the prescription , with an odds ratio of 3.6 for BZD sedatives and 2.6 for BZD tranquillizers . Risk decreased with further increase of time after the BZD fill date . For the individual BZD , flurazepam and triazolam showed the highest increase in risk with odds ratios of 3.4 and 2.7 , respectively , while oxazepam , lorazepam and diazepam showed odds ratios of 2.2 , 2.0 and 1.8 ( all odds ratios mentioned are statistically significant at p < 0.05 ) ABSTRACT — In a double‐blind r and omized study the therapeutic effect and safety of alprazolam was compared with amitriptyline in 81 out patients suffering from major depression . Variable dosages of both drugs were used , the mean final dose of alprazolam being 3.05 and that of amitriptyline 130 mg . Both treatment groups improved steadily , assessed weekly with the use of the Hamilton Rating Scale for Depression , and no significant differences were found between the groups , either on 
    Output:
    
agent
When alprazolam was compared with placebo for reduction in symptoms all estimates indicated a positive effect for alprazolam .
The RD of all-cause withdrawals did not differ between alprazolam and placebo .
Alprazolam appears to reduce depressive symptoms more effectively than placebo and as effectively as tricyclic antidepressants .
Whilst the rate of all-cause withdrawals did not appear to differ between alprazolam and placebo , and withdrawals were less frequent in the alprazolam group than in any of the conventional antidepressants combined group , these findings should be interpreted with caution , given the dependency properties of benzodiazepines
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Alprazolam is the first of the triazolobenzodiazepines to be studied in a large population of depressed patients . In a six-week , double-blind multicenter comparison of alprazolam , imipramine hydrochloride , and placebo in the treatment of 723 patients with depression , the two active drugs were statistically more effective than placebo . Alprazolam was at least as effective as imipramine in relieving depressive symptoms , significantly more effective in relieving somatic symptoms , and showed an earlier onset of activity in some measurements . Anticholinergic side effects were reported most often by patients receiving imipramine , while drowsiness was the only side effect reported most often in the alprazolam group . The Feighner Diagnostic Criteria and pre study and post study intercenter conferences with videotaped patient interviews ensured interrater reliability In a four-week double-blind study comparing alprazolam with oxazepam , 62 out patients suffering from anxiety with depressive symptoms were evaluated . The average daily doses of alprazolam and oxazepam were 1.48 mg and 44.4 mg , respectively . According to all rating scales applied , both alprazolam and oxazepam were effective in relieving anxiety associated with mild depression ( p less than 0.01 ) . Alprazolam proved somewhat more effective than oxazepam especially with regard to overall performance ( p less than 0.05 ) . Treatment-emergent adverse effects were few and mild for both compounds tested The purpose of this study was to compare the safety and efficacy of a relatively new antidepressant drug , alprazolam ( a triazolobenzodiazepine ) with imipramine in the treatment of 60 depressed symptomatic volunteers . Eligible patients were r and omly assigned after a 1-week washout to one of the medications and followed for 6 treatment weeks . Contrary to the earlier report of Feighner et al. ( 1983 ) , who found alprazolam superior to imipramine and placebo , but consistent with Rush et al. ( 1985 ) we find imipramine superior in efficacy to alprazolam on a variety of symptoms . Both the present study and Rush 's study employed patients with signs indicative of response to tricyclics . Feighner 's patients may have been the type who tend to be less responsive to tricyclics but may be more responsive to alprazolam .  Some of our data also show that alprazolam may have a more advantageous effect in the early weeks of treatment but is overtaken in subsequent treatment weeks by imipramine The therapeutic effect and safety of alprazolam and doxepin were studied in 126 out patients suffering from primary unipolar depression . The 6-week study was double-blind with a r and om allocation of treatment . Patients were treated with a flexible dose of 1.0 - 4.5 mg of alprazolam and 50 - 225 mg of doxepin per day . The mean final doses were 2.7 mg for alprazolam and 137.5 mg for doxepin . The results indicate that alprazolam and doxepin were equally efficacious . The incidence of side-effects was lower in the alprazolam treatment group This paper presents findings from a multisite study of 126 subjects meeting DSM-III-R criteria for Panic Disorder who also met criteria for a concurrent Major Depressive Episode , Dysthymia , or Depressive Disorder NOS . The study 's primary aim was to discern the influence of varying degrees of depression on the comparative efficacy of alprazolam , imipramine and placebo on anxiety outcomes . A placebo-controlled , double-blind , parallel r and om assignment design was utilized over a total of 16 weeks . There was no medication effect on panic outcomes . At endpoint , percent of anticipatory anxiety ( i.e. , time spent worrying about having an anxiety attack ) was significantly lower in the patients taking active medications vs. placebo .  Phobic measures were significantly improved by alprazolam , vs. both imipramine and placebo early in the study ; however , by week 8 both active medications were equally superior to placebo in the reduction of phobic symptoms . In addition , both active medications were significantly more effective than placebo in reducing depression . The same efficacy pattern ( i.e. , active medications superior to placebo ) was observed on measures of general functioning . Importantly , there were no significant interactions observed between medication and presence of major depression on the depression measures , indicating that both alprazolam and imipramine were equally efficacious in treating the depression in patients with panic disorder and major depression . Since the patients enrolled in this study suffered from major depressive disorder in the mild to moderate severity range , these results may not be transferrable to patients with panic disorder and severe major depression This study examines clinical predictors of outcome for patients with panic disorder and depression in a 16 week , placebo-controlled trial of alprazolam and imipramine  ( n = 126 ) . Baseline global severity of illness and phobic avoidance were differentially predictive of acute response to treatment . Patients in the mild to moderate range of global distress experienced smaller degrees of improvement on alprazolam than on imipramine at week 4 . At endpoint , the relative effectiveness of the active medication versus placebo was diminished in patients with higher levels of phobic avoidance . This relationship was not evident for completers , suggesting that the adverse effects of avoidance on outcome after sustained treatment was reduced The efficacy and safety of alprazolam as compared to imipramine or a placebo added to weekly interpersonal psychotherapy was compared in a 6-week double-blind r and omized clinical trial of 35 ambulatory elderly patients with major depression . The average maximum dosage of alprazolam was 2.2 mg and the average maximum dosage of imipramine was 97.5 mg . The findings showed a rapid onset of action of alprazolam within 1 week on symptoms of depression and anxiety . The effects for imipramine were seen later in the study . There were no serious side effects that interfered with treatment . The anticholinergic effects of imipramine were the ones that most commonly interfered with treatment . Alprazolam produced the greatest number of symptoms with discontinuation , most of which were alleviated within a week . We conclude that alprazolam may be useful as an antidepressant for the elderly . More clinical trials are needed to test its efficacy in the depressed elderly with concomitant medical problems , using plasma levels . A double-blind discontinuation study of alprazolam is needed to determine the degree of symptom return This study was design ed to compare the antidepressant effects of alprazolam and amitriptyline in a group of 30 in patients suffering from a severe major endogenous depression , diagnosed by Research Diagnostic Criteria and the Newcastle Rating scale , and to examine the effects of alprazolam and amitriptyline on two biological markers of depression , the dexamethasone suppression test and sleep EEG parameters . The 6-week study was double-blind with a r and om allocation of treatment . Patients were treated with flexible doses of 4 - 9 mg of alprazolam and 100 - 225 mg of amitriptyline . After 4 weeks of treatment the antidepressant effects of amitriptyline significantly exceeded those of alprazolam , as measured on the Hamilton Rating Scale for Depression . There was a high drop-out rate in the alprazolam group because of ineffectiveness of treatment . Alprazolam showed similar effects on sleep parameters as amitriptyline : lengthening of the REM latency and a tendency to shorten stages 3 and 4 and stage REM . These negative clinical results should be interpreted with caution , because of the severity of our selection criteria , and should not be extended to all depressive disorders One hundred patients with mixed symptoms of anxiety and depression were enrolled into a prospect i ve , multi-centre , r and omized , double-blind study comparing the response to , and the side-effects of , alprazolam and dothiepin hydrochloride over 4 weeks of treatment . Mean daily doses were 2.33 mg alprazolam and 115 mg dothiepin . Data on 96 patients were evaluated for tolerance , and data for 85 patients were analyzed for therapeutic response . In each case , the groups were similar in numbers , mean ages and sex ratios . Both groups experienced satisfactory responses to therapy , with highly statistically significant changes ( p less than 0.001 ) in the means of all efficacy measures within each group . No statistical difference was demonstrated in favour of either treatment group . Both dothiepin and alprazolam exhibited a similar profile of mild minor side-effects , but more patients suffered moderate to severe reactions to dothiepin , leading to a greater drop-out rate in the dothiepin-treated group . It is concluded that , as both treatments produced equally satisfactory responses in this study , alprazolam should be considered for the treatment of  anxiety associated with depression in patients for whom tricyclic antidepressant drugs are either contra-indicated or poorly tolerated SUMMARY This report describes the results of a multicentre collaborative study comparing the safety and efficacy of alprazolam with imipramine in patients suffering from major depressive disorder . Two hundred and eight patients diagnosed as major depression as per DSM-III criteria were r and omly allocated to alprazolam ( N= 105 ) or imipramine ( N = 103 ) in a double-blind fashion . Detailed assessment s were carried out for a period of six weeks . Results revealed that alprazolam was as effective as imipramine as an antidepressant . Side effects were less frequently reported with alprazolam Forty-three out- patients with depression of a moderate degree were enrolled in a r and omized , double-blind parallel group study comparing amitriptyline and alprazolam for 6 weeks of treatment . Patients were evaluated at the end of placebo washout and at Weeks 1 , 2 , 3 and 6 of drug therapy using the Hamilton Depression Rating Scale ( HAM-D ) , Hamilton Anxiety Rating Scale ( HAM-A ) , Beck Depression Inventory ( BDI ) and Clinical Global Impression ( CGI ) . Drug dosage was determined in a fixed-flexible design result ing in mean final doses of alprozalam 3.2 mg/day and of amitriptyline 115 mg/day . Although both drug groups improved there were statistically significant differences in favour of amitriptyline at the end of the study on the HAM-D , BDI and HAM-A scales .  Patients on amitriptyline reported more side effects overall than patients taking alprazolam with significantly more reports of dry mouth in the amitriptyline group The usefulness of the  Zung Self-Rating Depression Scale  as a screening instrument to uncover masked depression , and the benefits of early identification and treatment with alprazolam , were evaluated in a general medical practice population . There was a 95 % scale acceptance by patients and a 12 % overall prevalence of depression based on SDS results . Patients who scored in the depressed range on the SDS were , on a r and omized basis , either identified immediately to their physicians and treated with alprazolam ( N = 21 ) or identified after 4 weeks ( natural history controls , N = 20 ) . Treatment result ed in improvement in 66 % of the identified group versus a 35 % spontaneous improvement in the control group ( p less than .05 ) The objectives of this prospect i ve study were to calculate incidence rates for fall-related hospitalization , to compare the effect of risk factors among  benzodiazepine ( BZD ) users and unexposed controls , and to examine variations in risks according to length of time following a BZD prescription . Data were derived from Saskatchewan Health linked data bases , leading to information on 468 hospitalizations for injury due to falls among a study population of 321422 .  Incidence rates per 10000 within 28 days of the prescription fill date were 26.2 , 12.1 and 9.0 for BZD sedative users , BZD tranquillizer users and for unexposed controls , respectively . Incidence rates increased with age , and were higher for women than for men . Results from multivariate logistic regression models also showed a greater risk of falling for BZD users but the odds ratio was higher for men than for women . A history of treatment for alcohol abuse was a very strong risk factor for falls among both men ( odds ratio , 10.7 ) and women ( odds ratio , 4.3 ) . The highest risk of serious injury due to falls was within 15 days of filling the prescription , with an odds ratio of 3.6 for BZD sedatives and 2.6 for BZD tranquillizers . Risk decreased with further increase of time after the BZD fill date . For the individual BZD , flurazepam and triazolam showed the highest increase in risk with odds ratios of 3.4 and 2.7 , respectively , while oxazepam , lorazepam and diazepam showed odds ratios of 2.2 , 2.0 and 1.8 ( all odds ratios mentioned are statistically significant at p < 0.05 ) ABSTRACT — In a double‐blind r and omized study the therapeutic effect and safety of alprazolam was compared with amitriptyline in 81 out patients suffering from major depression . Variable dosages of both drugs were used , the mean final dose of alprazolam being 3.05 and that of amitriptyline 130 mg . Both treatment groups improved steadily , assessed weekly with the use of the Hamilton Rating Scale for Depression , and no significant differences were found between the groups , either on 
    Output:
    