Burrows G D, Norman T R, Judd F K, Marriott P F
Department of Psychiatry, University of Melbourne, Victoria, Australia.
J Psychiatr Res. 1990;24 Suppl 2:65-72. doi: 10.1016/0022-3956(90)90037-q.
An increasing body of evidence suggests that benzodiazepines--which have long been considered the drugs of choice in the treatment of various anxiety disorders due to their relative lack of side effects, lack of adverse drug reaction, their safety, and increased efficacy over other agents--are effective in the treatment of panic disorders. Originally, the benzodiazepines were believed to be devoid of dependence-inducing properties, even at high doses. Recent evidence, however, suggests that discontinuation of both high and normal doses of both short- and long-acting benzodiazepines generally results in similar withdrawal symptoms, including anxiety and sleep and perceptual disturbances. This article presents a brief review of benzodiazepine withdrawal, with an emphasis on the discontinuation of these drugs following treatment of panic disorders. In particular, short-acting and long-acting drugs may present different features following long-term treatment and withdrawal. Preliminary results from a study comparing alprazolam and diazepam are presented to illustrate this point in contrast to expectations: the problems associated with withdrawal of both agents were comparable.
越来越多的证据表明，苯二氮䓬类药物——长期以来因其相对较少的副作用、缺乏药物不良反应、安全性以及相较于其他药物更高的疗效，一直被视为治疗各种焦虑症的首选药物——对惊恐障碍有效。最初，人们认为苯二氮䓬类药物即使在高剂量时也不会产生成瘾性。然而，最近的证据表明，停用高剂量和正常剂量的短效及长效苯二氮䓬类药物通常都会导致类似的戒断症状，包括焦虑、睡眠和感知障碍。本文简要回顾了苯二氮䓬类药物的戒断情况，重点是在惊恐障碍治疗后停用这些药物。特别是，短效和长效药物在长期治疗和停药后可能会呈现不同的特征。一项比较阿普唑仑和地西泮的研究的初步结果表明，与预期相反，两种药物戒断相关的问题相当，以此来说明这一点。
