The present study was designed to compare the efficacy of doxepin (a tricyclic antidepressant with antianxiety properties), chlordiazepoxide (a benzodiazepine antianxiety compound), and placebo in nonpsychiatric, moderately anxious depressed patients commonly seen by a family practitioner. Patients treated with doxepin improved significantly by a reduction in the severity of symptoms of anxiety and depression. Daytime drowsiness, a major complaint of middle class patients, was alleviated by prescribing the major portion of the daily dosage at bedtime, an important implication in the prescribing of psychotropic drugs. The inability to demonstrate significant improvement in patients treated with chlordiazepoxide as compared to placebo was unexpected, and alerts us to recognize nondrug factors and their influence on treatment outcome as well as the possible effects of previous medication on drug tolerance.
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