The Treatment of Mixed Anxiety and Depression with Loxapine: A Controlled Comparative Study

The therapeutic effects of loxapine (2 mg capsules) were compared with those of chlordiazepoxide (10 mg capsules) and placebo in 115 outpatients exhibiting mild to moderate symptoms of anxiety and depression. They were treated for 4 wk in a double blind fashion using a flexible dose range of 4 to 20 mg loxapine or 20 to 100 mg chlordiazepoxide. Average therapeutic dosages for loxapine and chlordiazepoxide were 7.4 mg and 39.4 mg, respectively. The data presented indicate that loxapine is significantly more effective than placebo in reducing the degree of pathology characterized by the Brief Psychiatric Rating Scale (BPRS) items, tension and depressive mood and the Hamilton Anxiety Scale (HAS) items, anxious mood, tension and depressed mood. Chlordiazepoxide is significantly more effective than placebo in ameliorating the HAS items, depressed mood and insomnia. The physician's global evaluation of improvement revealed that chlordiazepoxide and loxapine treated subjects were significantly more improved than those treated with placebo. Side effects were for the most part mild to moderate in severity. There were significantly more occurrences of side effects in the loxapine treated group. These were primarily related to the anticholinergic properties of loxapine. Loxapine and chlordiazepoxide are more effective than placebo in the symptomatic treatment of mixed anxiety and depression. There also appears to be differential activity in terms of symptom relief and production of side effects.