Alprazolam and standard antidepressants in the treatment of depression: a meta-analysis of the antidepressant effect.

Alprazolam differs from other benzodiazepines by the incorporation of a triazolo ring in the basic chemical structure. Several lines of evidence have supported that alprazolam and standard antidepressants have some similar actions, such as beta-adrenergic receptor down-regulation, antipanic effect. Because of the difference in opinions pertaining to the antidepressant effect of alprazolam, this issue could not reach a firm conclusion. In the present analysis, we carried out a meta-analysis of 11 random controlled studies that compared the antidepressant effect of alprazolam and standard antidepressants in depressed patients. The results showed that the weighted mean effect size d (dw) is equal to 0.06. In conclusion, the antidepressant effect of alprazolam is comparable to that of low-dose tricyclic antidepressants. Very few studies have investigated severely depressed patients. Also, in long-term administration, the lack of a long-term treatment study makes the issue of alprazolam's benefits and disadvantages still undetermined.