An open label trial of alprazolam in comorbid irritable bowel syndrome and generalized anxiety disorder
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G D Tollefson1, M Luxenberg, R Valentine
1Department of Psychiatry, St. Paul-Ramsey Medical Center, Minn 55101.
Background:
The irritable bowel syndrome (IBS) is very prevalent and psychiatric comorbidity runs high. A significant proportion of generalized anxiety disorder (GAD) patients manifest concurrent IBS.
Method:
We conducted a 14-week, open-label trial of the triazolobenzodiazepine alprazolam in 32 patients with comorbid generalized anxiety and IBS. At the end of a 2-week placebo run-in, eligible subjects received 6 weeks of active drug therapy.
Results:
Ninety-four percent of subjects (N = 25) had a full or partial anxiolytic response at the 6th treatment week (p less than .001). Eighty-nine percent (N = 24) experienced a concomitant reduction in IBS severity. For the majority, these dual benefits were still evident at the conclusion of a 4-week drug taper (p = .05) and achieved a trend (p = .07) at a 4-week postdrug discontinuation visit.
Conclusion:
Alprazolam was safe, effective, and well tolerated during the acute treatment of comorbid GAD and IBS; only a limited posttreatment rebound was observed.