RESULTS(2)

In both tables, the rates of dizziness or vertigo, respiratory symptoms, esophagus and stomach disorders other than peptic ulceration and gastrointestinal hemorrhage, female genital organ disorders, inflammatory skin conditions, injuries, and ill-defined signs and symptoms were significantly greater in the first 30-day period after the initial prescription than in the following six. In addition, significantly higher rates of infectious diseases, endocrine disorders, migraine, dysrhythmias, upper respiratory diseases, pneumonia and influenza, peptic ulceration or gastrointestinal hemorrhage, pregnancy, noninflammatory skin conditions and musculoskeletal disorders occurred in the first 30 days in the lorazepam patients.

Similar analyses were performed on the data divided by sex and by age group. The diagnostic categories, excluding neurotic, depressive and sleep disorders, in the physician service claims data with a significantly greater rate in the first 30 days after starting treatment are shown in Tables 3 and 4. Dizziness or vertigo was the only category in which there was a significant excess of events in the first period in both sexes in both alprazolam and lorazepam patients. In female patients, inflammatory skin conditions and genital organ disorders were significantly more common in the first 30 days of treatment in both drug groups, while there were significantly higher rates of respiratory symptoms, musculoskeletal disorders and injuries in the first 30 days in male patients in both groups.

Dizziness or vertigo occurred significantly more often after starting treatment in all age groups in the lorazepam patients and in the oldest age group of the alprazolam patients (Table 4). Inflammatory skin conditions were similarly significant in all age groups except the 45 to 54 years group in the lorazepam patients. Other disorders, such as those of the endocrine, cardiovascular, respiratory and musculoskeletal systems, where significance was achieved, are most likely linked with increasing age.

There were much fewer hospitalizations than physician service claims. The only consistent significant difference in both patient groups was a higher rate of mental disorder discharges in the first 30 days after the initial prescription. Injuries and poisonings were also significant in the lorazepam group.

TABLE 3 Diagnostic events recorded in the physician service claims datafile occurring at a significantly greater rate during the first period, by sex

Sex Alprazolam Lorazepam
Female Infectious or parasitic diseases Endocrine disorders
Dizziness or vertigo Dizziness or vertigo MigraineUpper respiratory diseases Pneumonia and influenza Respiratory symptoms
Genital organ disorders Genital organ disorders Pregnancy or birth complications
Inflammatory skin conditions Inflammatory and other skin conditions Musculoskeletal disorders Other signs and symptoms Injuries
Male Infectious or parasitic diseases
Dizziness or vertigo Dizziness or vertigo Upper respiratory diseases Pneumonia and influenza
Respiratorysymptoms Respiratory symptomsPeptic ulceration orgastrointestinal hemorrhage Other esophagus or stomach disorders
Musculoskeletal Musculoskeletal disorders
disorders Other signs and symptoms
Injuries Injuries

TABLE 4 Diagnostic events recorded in the physician service claims datafile occurring at a significantly greater rate during the first period, by age group (years)

Age (years)<35 AlprazolamRespiratorysymptoms LorazepamDizziness or vertigo
Esophagus or stomach disorders other than peptic ulcer and gastrointestinal hemorrhage Inflammatory skin conditions Other signs and symptoms Injuries
35-44 Other nervous system disorders Dizziness or vertigo
MigrainePneumonia and influenza, and respiratory symptoms Inflammatory skin conditions Other signs and symptoms
45-54 Blood disorders Infectious or parasitic disorders
Endocrine disordersDizziness or vertigoChronic obstructivepulmonary disease and respiratory symptomsMusculoskeletal disordersOther signs and symptoms
55-64 Other signs and symptoms Dizziness or vertigo
Hypertension and dysrhythmias Pneumonia and influenza, and respiratory symptoms Inflammatory skin conditions Musculoskeletal disorders
65 Dizziness or vertigo Dizziness or vertigo
HypertensionPeptic ulceration or gastrointestinal hemorrhageInflammatory skin conditions Endocrine disordersHypertension and ischemic heart diseaseDysrhythmias and other circulatory disordersRespiratory symptomsEsophagus or stomach disorders other than peptic ulcer and gastrointestinal hemorrhageGenital organ disordersInflammatory skin conditionsMusculoskeletal disorders

Other signs and symptoms

Injuries