The Value of Anti–Anxiety Drugs in the Management of Cardiac Disease

In 3 double-blind randomized trials, clorazepate was compared to placebo in post-infarction and pre-infarction patients, and diazepam was compared to placebo added to verapamil. There was a significant reduction in trinitrate requirement in the first clorazepate study but not in the second nor in the third, although this has not yet been completed. Taking all 3 trials together, there were 5 cases of myocardial infarction in 63 patients treated with placebo but no cases in 64 patients treated with the anti-anxiety drugs (p less than 0.05). Relief of anxiety was accompanied by reduction in the anginal attack rate with both active and placebo medications. In further similar studies in hypertension, relief of anxiety was also accompanied by reduction in blood pressure. However, in a 4-way comparison between lorazepam, bendrofluazide, lorazepam plus bendrofluazide and placebo, mean normotensive levels were only achieved in patients treated with the combination of anti-anxiety and antihypertensive medication.