Noyes R, Garvey M J, Cook B, Suelzer M
Department of Psychiatry, University of Iowa College of Medicine, Iowa City.
Am J Psychiatry. 1991 Apr;148(4):517-23. doi: 10.1176/ajp.148.4.517.
The purpose of this study was to compare the effects of discontinuing treatment with intermediate- and long-acting benzodiazepines.
Fifty patients with panic disorder who had taken part in a double-blind treatment study and had responded to alprazolam, diazepam, or placebo for 8 months were asked to stop taking these medications gradually.
After a relatively rapid dose reduction, the majority of patients relapsed. Rebound anxiety and withdrawal symptoms were identified in a substantial minority of patients. Those who were taking alprazolam showed earlier and more intense rebound anxiety and withdrawal symptoms than did the patients who received diazepam. Both the level of pretreatment anxiety and the drug the patient was taking predicted the level of anxiety when drug treatment was discontinued.
The findings indicate that withdrawal phenomena commonly occur after patients stop taking benzodiazepines and that they are more frequent after discontinuation of treatment with shorter-acting drugs.
本研究旨在比较停用中长效苯二氮䓬类药物的效果。
五十名曾参与双盲治疗研究且对阿普唑仑、地西泮或安慰剂有8个月反应的惊恐障碍患者被要求逐渐停止服用这些药物。
在相对快速减药后，大多数患者复发。相当一部分少数患者出现了反跳性焦虑和戒断症状。服用阿普唑仑的患者比接受地西泮的患者出现反跳性焦虑和戒断症状更早且更强烈。治疗前焦虑水平和患者所服用的药物都能预测停药时的焦虑水平。
研究结果表明，患者停用苯二氮䓬类药物后通常会出现戒断现象，且短效药物停药后更频繁出现。
