Recent Study Casts Doubt on the Effectiveness of Xanax

New research has raised questions about the effectiveness of the widely prescribed sedative, alprazolam, commonly known as Xanax XR. This study suggests that previous publications may have overstated its efficacy by more than 40%, potentially due to publication bias.

The research indicates that the most commonly prescribed type of sedative in the country may not be as effective as previously believed, based on information found in medical journals.

Published on October 19 in the journal Psychological Medicine, this study delved into both published and unpublished data from five randomized controlled clinical trials that had undergone review by the U.S. Food and Drug Administration (FDA) concerning alprazolam, which is marketed as Xanax XR. This medication belongs to the benzodiazepine class and has been widely used since the 1970s to address conditions like anxiety and insomnia.

Associated Risks and Implications in Clinical Practice

Recent years have seen a growing awareness of serious clinical risks associated with benzodiazepines, including issues such as dependence, withdrawal, falls, and cognitive impairment.

According to senior author Erick Turner, M.D., a professor of psychiatry at the Oregon Health & Science University School of Medicine and a former FDA reviewer, “Clinicians are well aware of these safety issues, but there’s been essentially no questioning of their effectiveness. Our study throws some cold water on the efficacy of this drug. It shows it may be less effective than people have assumed.”

Understanding Benzodiazepines

Benzodiazepines are a class of drugs primarily used to manage anxiety, insomnia, seizures, and muscle spasms. They operate by depressing the central nervous system, resulting in a calming effect on the brain. Some common types of benzodiazepines and their brand names include:

• Alprazolam (Xanax): Typically prescribed for anxiety and panic disorders.
• Diazepam (Valium): Used to treat anxiety, muscle spasms, and seizures.
• Lorazepam (Ativan): Commonly prescribed for anxiety disorders.
• Clonazepam (Klonopin): Used to address panic disorders and certain types of seizures.
• Temazepam (Restoril): Mainly prescribed for insomnia.

It is important to exercise caution when using benzodiazepines due to potential risks such as dependence and withdrawal.

Study Methodology and Key Findings

Turner and co-author Rosa Ahn-Horst, M.D., M.P.H., a psychiatry resident at Harvard University, examined publicly available FDA data from phase 2 and phase 3 clinical trials that investigated extended-release alprazolam for the treatment of panic disorder. While the extended-release version received FDA approval in 2003, the immediate-release formulation had been approved in 1981.

Their analysis revealed that although five trials were conducted, only three of them had been published in medical journals. Moreover, when the FDA assessed the trial results comparing the drug’s performance to a placebo, they determined that only one of the five trials had a clearly positive outcome.

Through a statistical method known as meta-analysis, which combines all study results, they found that while alprazolam extended-release was still superior to a placebo, its efficacy was not as pronounced as the published data had suggested. In particular, publication bias had inflated the drug’s effectiveness by more than 40%.

These findings may have significant implications, particularly for patients and clinicians who have not previously used benzodiazepines, as opposed to those who use the drug infrequently or have already developed physical dependence.

Reference: “Unpublished trials of alprazolam XR and their influence on its apparent efficacy for panic disorder” by Rosa Y. Ahn-Horst and Erick H. Turner, 19 October 2023, Psychological Medicine. DOI: 10.1017/S0033291723002830

Frequently Asked Questions (FAQs) about Xanax Efficacy

More about Xanax Efficacy

• Psychological Medicine Journal – The journal where the study was published.
• FDA – The U.S. Food and Drug Administration, which reviewed the clinical trials related to Xanax XR.
• Benzodiazepines Overview – Information about benzodiazepines and their common uses.
• Oregon Health & Science University School of Medicine – The institution affiliated with senior author Erick Turner, M.D.