Masand Prakash S, Gupta Sanjay
Program for Continuing Medical Education, Department of Psychiatry, Box 3391, Duke University Medical Center, Durham, NC 27710, USA.
Expert Opin Drug Saf. 2003 Sep;2(5):485-93. doi: 10.1517/14740338.2.5.485.
Generalised anxiety disorder (GAD) significantly impacts upon quality of life and has a chronic and persistent nature. GAD requires pharmacological therapies that are well-tolerated, lessen the mitigating effects of common comorbidities and do not pose a high risk for dependency or abuse. Selective serotonin and serotonin-noradrenaline re-uptake inhibitors have become more viable treatments for GAD than the traditionally used benzodiazepines due to greater efficacy and a more tolerable adverse event profile. Among these newer-generation antidepressants, only paroxetine and venlafaxine are currently FDA-approved for the treatment of GAD. Paroxetine was approved after three double-blind, placebo-controlled studies demonstrated its superior efficacy compared to placebo for short-term treatment of GAD. Venlafaxine was approved for both short- and long-term treatment of GAD after demonstrating efficacy in 8-week and 6-month double-blind, placebo-controlled trials. For both paroxetine and venlafaxine, the safety and tolerability profiles during treatment of GAD are consistent with those demonstrated during the short- and long-term treatment of patients with major depressive disorder.
广泛性焦虑症（GAD）对生活质量有显著影响，且具有慢性和持续性。GAD需要耐受性良好的药物治疗，能减轻常见共病的影响，且不存在高依赖性或滥用风险。与传统使用的苯二氮䓬类药物相比，选择性5-羟色胺再摄取抑制剂和5-羟色胺-去甲肾上腺素再摄取抑制剂因疗效更佳且不良事件耐受性更好，已成为更可行的GAD治疗方法。在这些新一代抗抑郁药中，目前只有帕罗西汀和文拉法辛获得美国食品药品监督管理局（FDA）批准用于治疗GAD。三项双盲、安慰剂对照研究证明帕罗西汀在GAD短期治疗中疗效优于安慰剂后，它获得了批准。文拉法辛在8周和6个月的双盲、安慰剂对照试验中证明疗效后，被批准用于GAD的短期和长期治疗。对于帕罗西汀和文拉法辛，GAD治疗期间的安全性和耐受性与重度抑郁症患者短期和长期治疗期间所显示的情况一致。
