Forum GGz Nijmegen, Department for Anxiety Disorders "Overwaal", Nijmegen, the Netherlands.
Acta Psychiatr Scand. 2010 Jul;122(1):11-9. doi: 10.1111/j.1600-0447.2009.01517.x. Epub 2009 Dec 3.
To examine the effectiveness of paroxetine and cognitive-behavioural therapy (CBT) in elderly patients suffering from panic disorder with or without agoraphobia (PD(A)).
Forty-nine patients aged 60+ years with confirmed PD(A) were randomly assigned to 40 mg paroxetine, individual CBT, or to a 14-week waiting list. Outcomes, with avoidance behaviour and agoraphobic cognitions being the primary measures, were assessed at baseline and at weeks 8, 14 (conclusion CBT/waiting list), and at week 26 (treated patients only) and analysed using mixed models.
All outcome measures showed that the patients having received CBT and those treated with paroxetine had significantly better improvement compared with those in the waiting-list condition. With one patient (1/20, 5%) in the CBT and three (3/14, 17.6%) in the paroxetine condition dropping out, attrition rates were low.
Patients with late-life panic disorder respond well to both paroxetine and CBT. Although promising, the outcomes warrant replication in larger study groups.
考察帕罗西汀和认知行为疗法（CBT）对伴有或不伴有广场恐怖症的老年惊恐障碍（PD（A））患者的疗效。
49 名 60 岁以上确诊为 PD（A）的患者被随机分配到 40mg 帕罗西汀组、个体 CBT 组或 14 周等待名单组。在基线时以及 8 周、14 周（CBT/等待名单组的结论）和 26 周（仅治疗患者）评估了以回避行为和广场恐怖认知作为主要测量指标的结果，并使用混合模型进行了分析。
所有的结果指标都表明，接受 CBT 的患者和接受帕罗西汀治疗的患者的改善情况明显优于等待名单组的患者。在 CBT 组中有 1 名患者（1/20，5%）和帕罗西汀组中有 3 名患者（3/14，17.6%）退出，失访率较低。
老年惊恐障碍患者对帕罗西汀和 CBT 均有良好的反应。尽管结果很有希望，但需要在更大的研究群体中进行复制。
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