Gladsjo J A, Rapaport M H, McKinney R, Auerbach M, Hahn T, Rabin A, Oliver T, Haze A, Judd L L
Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla 92037, USA.
J Clin Psychopharmacol. 2001 Apr;21(2):131-8. doi: 10.1097/00004714-200104000-00003.
Studies to date on the effects of benzodiazepines on neuropsychologic function have yielded conflicting data with respect to the type, severity, and duration of deficits that may be induced by these agents. As part of a placebo-controlled trial of alprazolam-XR (extended release) administered in combination with cognitive-behavioral therapy in patients with panic disorder, a battery of tests was used to measure neuropsychologic function. Thirty-eight outpatients were randomly assigned to receive either alprazolam-XR or placebo. Dosages were titrated up so that the alprazolam group (N = 18) received a mean dose of 4 mg/day (reduced in two patients because of sedative side effects). Neuropsychologic function after 6 weeks of therapy at the target dosage was compared with baseline assessments in each group. Both groups showed a statistically significant improvement from baseline to repeated assessments on measures of attention, executive functioning, psychomotor speed, and visual memory (p < 0.001); these gains were attributed to a practice effect. No significant changes were noted in measures of learning, verbal memory, or reaction time, and neither group showed any deterioration from baseline to retesting in any aspect of neuropsychologic function. These findings call into question the assumption that long-term benzodiazepine therapy produces significant neuropsychologic deficit in patients with diagnosed anxiety disorders.
迄今为止，关于苯二氮䓬类药物对神经心理功能影响的研究，在这些药物可能诱发的缺陷类型、严重程度和持续时间方面得出了相互矛盾的数据。作为一项在惊恐障碍患者中进行的阿普唑仑缓释剂（长效）联合认知行为疗法的安慰剂对照试验的一部分，使用了一系列测试来测量神经心理功能。38名门诊患者被随机分配接受阿普唑仑缓释剂或安慰剂。剂量逐步增加，以便阿普唑仑组（N = 18）平均每日剂量为4毫克（两名患者因镇静副作用而减量）。将目标剂量治疗6周后的神经心理功能与每组的基线评估进行比较。两组在注意力、执行功能、精神运动速度和视觉记忆测量方面从基线到重复评估均显示出统计学上的显著改善（p < 0.001）；这些改善归因于练习效应。在学习、言语记忆或反应时间测量方面未发现显著变化，两组在神经心理功能的任何方面从基线到重新测试均未显示出任何恶化。这些发现对长期苯二氮䓬类药物治疗会在已确诊的焦虑症患者中产生显著神经心理缺陷这一假设提出了质疑。
