Trucco M
Hospital del Trabajador, Santiago de Chile.
Rev Med Chil. 1990 Nov;118(11):1262-70.
The purpose of this article is to review the risks of pharmacological treatments of anxiety, mainly those due to benzodiazepines. Many mildly anxious patients do not need pharmacotherapy and psychological support is always an important component of treatment. The risks of benzodiazepine treatment increase with the doses used and the length of treatment, especially the risk of dependence. However, people who abuse benzodiazepines are a minority. Usually they also abuse alcohol and other drugs, probably reflecting underlying personality disorders. There are several alternative pharmacological treatments for anxiety. Tricyclics and MAO inhibitors are effective in panic disorders. Buspirone is useful in generalized anxiety disorder and in patients who are prone to substance abuse. All these alternative treatments may have disadvantages that need to be considered.
本文的目的是回顾焦虑症药物治疗的风险，主要是苯二氮䓬类药物所致的风险。许多轻度焦虑患者不需要药物治疗，心理支持始终是治疗的重要组成部分。苯二氮䓬类药物治疗的风险随着用药剂量和治疗时间的延长而增加，尤其是依赖风险。然而，滥用苯二氮䓬类药物的人是少数。他们通常还滥用酒精和其他药物，这可能反映了潜在的人格障碍。焦虑症有几种替代药物治疗方法。三环类药物和单胺氧化酶抑制剂对惊恐障碍有效。丁螺环酮对广泛性焦虑症以及易发生药物滥用的患者有用。所有这些替代治疗方法可能都有需要考虑的缺点。
