Nardi A E, Valença A M, Zin W, Nascimento I
Laboratory of Panic and Respiration, Anxiety and Depression Research Program, Federal University of Rio de Janeiro, Brazil.
Arq Neuropsiquiatr. 1999 Jun;57(2B):361-5. doi: 10.1590/s0004-282x1999000300003.
We randomly selected six panic disorder subjects, using the Structured Clinical Interview for DSM-IV. All subjects went double-blindly through an inhalation of 35% CO2 and compressed gas (atmospheric air) on two occasions. First, at baseline, when they were drug free. Second, after a 10 days clonazepam treatment.
Neither at baseline nor after treatment any patient had a panic attack during compressed gas inhalation. At the first test five patients (83.3%) had a severe panic attack with high levels of subjective anxiety during carbon dioxide inhalation. After 9.6 (+/- 3.4) days of clonazepam treatment, only two (33.3%) patients experienced a mild panic attack.
This pilot study suggests the efficacy of the short term clonazepam therapy in attenuating panic attacks and supports the usefulness of the 35% carbon dioxide challenge test as an analogue method for study the efficacy of anti-panic drugs. Further placebo-controlled studies to pharmacological treatment are warranted.
我们使用《精神疾病诊断与统计手册》第四版的结构化临床访谈，随机选取了六名惊恐障碍患者。所有受试者均进行双盲试验，分两次吸入35%二氧化碳和压缩气体（大气空气）。第一次是在基线期，此时他们未服用药物。第二次是在氯硝西泮治疗10天后。
在吸入压缩气体期间，无论是基线期还是治疗后，均无患者出现惊恐发作。在第一次测试中，五名患者（83.3%）在吸入二氧化碳期间出现严重惊恐发作，并伴有高度主观焦虑。氯硝西泮治疗9.6（±3.4）天后，只有两名患者（33.3%）经历了轻度惊恐发作。
这项初步研究表明短期氯硝西泮治疗在减轻惊恐发作方面具有疗效，并支持35%二氧化碳激发试验作为研究抗惊恐药物疗效的类似方法的有效性。有必要进一步开展针对药物治疗的安慰剂对照研究。
