Sheehan David V, Mao C Gloria
College of Medicine, University of South Florida, Tampa, FL 33613-4788, USA.
Psychopharmacol Bull. 2003 Spring;37 Suppl 1:64-75.
Generalized anxiety disorder (GAD) is a prevalent and disabling anxiety disorder, conservatively believed to affect at least 5% of the general population. Cardinal symptoms of GAD include chronic and uncontrollable worry, anxiety, and tension, which result in difficulty fulfilling social, professional, and family roles. Treatment options include benzodiazepines, tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and the serotonin-norepinephrine reuptake inhibitor (SNRI) venlafaxine XR. Because of the high comorbidity of GAD with other psychiatric disorders, pharmacologic therapy should possess both anxiolytic and antidepressive properties for best outcomes. The SSRIs are a good treatment option, and paroxetine is the best studied SSRI for GAD and the only SSRI to date approved by the US Food and Drug Administration for this indication. Results of randomized, controlled studies of paroxetine have demonstrated its efficacy in the short-term treatment of GAD, in achieving and sustaining full remission, and in preventing relapse. This article provides an overview of GAD and a discussion of studies of paroxetine treatment in this anxiety disorder.
广泛性焦虑症（GAD）是一种常见且使人致残的焦虑症，保守估计至少影响5%的普通人群。GAD的主要症状包括慢性且无法控制的担忧、焦虑和紧张，这些症状导致难以履行社会、职业和家庭角色。治疗选择包括苯二氮䓬类药物、三环类抗抑郁药（TCAs）、选择性5-羟色胺再摄取抑制剂（SSRIs）以及5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRI）文拉法辛缓释剂。由于GAD与其他精神障碍的高共病性，药物治疗应兼具抗焦虑和抗抑郁特性以获得最佳疗效。SSRIs是一种不错的治疗选择，而帕罗西汀是针对GAD研究得最充分的SSRI，也是迄今为止美国食品药品监督管理局批准用于该适应症的唯一一种SSRI。帕罗西汀的随机对照研究结果表明，它在GAD的短期治疗、实现并维持完全缓解以及预防复发方面均有效。本文概述了GAD，并讨论了帕罗西汀治疗这种焦虑症的研究情况。
