Rickels Karl, Rynn Moira, Iyengar Malini, Duff David
Mood & Anxiety Disorders Section, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Philadelphia, PA 19104-3309, USA.
J Clin Psychiatry. 2006 Jan;67(1):41-7. doi: 10.4088/jcp.v67n0107.
Paroxetine is a potent selective serotonin reuptake inhibitor with antidepressant and anxiolytic activity that is effective in the treatment of generalized anxiety disorder (GAD), improving the core symptoms of anxiety, worry, and tension. The majority of patients with GAD have chronic symptomatology and significant comorbid mood and anxiety disorders that often require ongoing pharmacotherapy. This article reviews the efficacy and tolerability of paroxetine in the short- and long-term treatment of GAD including remission data.
Data from more than 1800 outpatients with DSM-IV-defined GAD were analyzed from 3 short-term (8-week) studies and a longer (6-month) relapse prevention study. These studies were all randomized, double-blind, placebo-controlled trials of paroxetine.
The results emphasize the benefit of paroxetine treatment in GAD, enabling a substantial proportion of patients to achieve clinical remission and preventing relapse. Long-term treatment with paroxetine also shows good tolerability with no evidence of weight gain.
Given the high comorbidity of psychiatric depression and anxiety, the long-term efficacy and tolerability of paroxetine are important considerations when selecting a first-line therapy for patients with GAD.
帕罗西汀是一种强效的选择性5-羟色胺再摄取抑制剂,具有抗抑郁和抗焦虑活性,对广泛性焦虑症(GAD)的治疗有效,可改善焦虑、担忧和紧张等核心症状。大多数GAD患者有慢性症状,且常伴有严重的共病性情绪和焦虑障碍,往往需要持续的药物治疗。本文综述了帕罗西汀在GAD短期和长期治疗中的疗效及耐受性,包括缓解数据。
对3项短期(8周)研究和1项较长时间(6个月)的预防复发研究中1800多名符合DSM-IV标准的GAD门诊患者的数据进行了分析。这些研究均为帕罗西汀的随机、双盲、安慰剂对照试验。
结果强调了帕罗西汀治疗GAD的益处,使相当一部分患者实现临床缓解并预防复发。帕罗西汀的长期治疗也显示出良好的耐受性,没有体重增加的证据。
鉴于精神抑郁和焦虑的高共病性,在为GAD患者选择一线治疗药物时,帕罗西汀的长期疗效和耐受性是重要的考虑因素。