Mexazolam: Clinical Efficacy and Tolerability in the Treatment of Anxiety

INTRODUCTION Mexazolam is indicated for the management of anxiety with or without psychoneurotic conditions. In adult patients, the recommended daily dosage of mexazolam is 1-3 mg, administered three times daily. The objective of this article is to review the available information on the benzodiazepine (BZD) mexazolam and its clinical utility in treating patients with anxiety. METHODS The PubMed database was searched using the keyword "mexazolam" with no date or language restrictions applied to the search. As only 11 papers were retrieved, some previously published manuscripts of interest known by the authors (not indexed on PubMed) have been added for completeness. Relevant information was selected for inclusion by the authors. RESULTS A number of early studies demonstrated the ability of mexazolam to reduce anxiety symptoms with few side effects in patients with disorders associated with anxiety. Following on from this preliminary evidence, controlled studies directly comparing mexazolam with other BZDs showed that the drug is more effective than bromazepam and oxazolam, and is at least as effective as alprazolam. A larger, multicenter, phase IV study also showed that mexazolam 2 or 3 mg/day rapidly improved Hamilton Anxiety Rating Scale scores and substantially reduced the frequency and severity of numerous somatic anxiety symptoms in patients with anxiety disorders. With regard to safety, the clinical evidence indicates that mexazolam is generally well tolerated, with a low incidence of drowsiness and sedation. Furthermore, the lack of psychomotor or cognitive performance impairment following mexazolam administration may lead to better treatment compliance. CONCLUSION The available clinical evidence suggests that mexazolam is an effective therapeutic option for the management of anxiety. However, larger, well-controlled clinical trials are needed to directly compare and contrast mexazolam's efficacy and safety with other BZDs.