Wald, T.G., Roger, R.G., Noyes, R., Carroll, B.T., & Clamon, G.H. (1993). Rapid relief of anxiety in cancer patients with both alprazolam and placebo. Psychosomatics, 34, 324–332.

This randomized trial had two arms: alprazolam (0.5 mg) versus placebo. Dose increased over one week to 4 mg/day. Enrollment lasted four weeks.

The study reported on a sample of 36 inpatients and outpatients with cancer receiving treatment and/or follow-up.

• Single site
• Midwest teaching hospital

A randomized, controlled, double-blinded trial design was used.

• Hospital Anxiety and Depression Scale (HADS)
• Score > 7 on HADS and DSM-III criteria for anxiety, panic disorder, or adjustment disorder
• Hamilton Anxiety Rating Scale (HAM-A) (interviewer), Symptom Checklist–90-R (SCL-90-R) (self-rated)
• Hamilton Depression Rating Scale (HAM-D) (interviewer), Beck Depression Inventory (BDI) (self-rated)
• Global Rating Scale (GRS) (self-rated)

There was significant decrease in anxiety in both groups during week 1. There was no significant difference between alprazolam and placebo on anxiety for both self-rated and interviewer-rated scales.

• The study had a small sample size.
• The study points out that participation in a clinical trial may make one more susceptible to the placebo response.
• The average dose was only 1.2 mg/day; patients in study were unwilling to increase dose to therapeutic dosages.