Wang Sheng-Min, Kim Jung-Bum, Sakong Jeong Kyu, Suh Ho-Suk, Oh Kang Seob, Woo Jong-Min, Yoo Sang-Woo, Lee Sang Min, Lee Sang-Yeol, Lim Se-Won, Cho Seong Jin, Chee Ik-Seung, Chae Jeong-Ho, Hong Jin Pyo, Lee Kyoung-Uk
International Health Care Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Psychiatry, Keimyung University School of Medicine, Daegu, Korea.
Clin Psychopharmacol Neurosci. 2016 May 31;14(2):177-83. doi: 10.9758/cpn.2016.14.2.177.
This study compared the efficacy and tolerability of clonazepam with other benzodiazepines in patients with anxiety disorders.
Inclusion criteria were as follows: age >20 years, diagnosis of anxiety disorder according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision (DSM-IV-TR) criteria, taking only one type of antidepressant, and prescribed one of three oral benzodiazepines (alprazolam, clonazepam, or lorazepam). At baseline and week 6, clinical benefit was evaluated using the Clinical Global Impression-Severity Scale (CGI-S), Clinical Global Impression-Anxiety Scale (CGI-anxiety), and Clinical Global Impression-Sleep Scale (CGI-sleep).
Among 180 patients, no differences in demographic characteristics among the three benzodiazepine groups were noted. After six weeks of treatment, all benzodiazepine groups showed significant improvements in CGI-S, CGI-anxiety, and CGI-sleep scores (p<0.001). There were no differences in mean changes in CGI-S, CGI-anxiety and CGI-sleep among the three benzodiazepine groups. The incidence of side effects was significantly lower in the clonazepam group than with the other benzodiazepines. The incidences of adverse events for the clonazepam, alprazolam, and lorazepam groups were 26.7% (n=20), 48.4% (n=31), and 43.9% (n=18), respectively.
The present study suggests that clonazepam is as efficacious as other benzodiazepines for the treatment of various anxiety disorders. Furthermore, the safety profile of clonazepam was superior to the other benzodiazepines in this study.
本研究比较了氯硝西泮与其他苯二氮䓬类药物在焦虑症患者中的疗效和耐受性。
纳入标准如下:年龄>20岁,根据《精神疾病诊断与统计手册》第4版,文本修订版(DSM-IV-TR)标准诊断为焦虑症,仅服用一种类型的抗抑郁药,并开具三种口服苯二氮䓬类药物(阿普唑仑、氯硝西泮或劳拉西泮)中的一种。在基线和第6周时,使用临床总体印象-严重程度量表(CGI-S)、临床总体印象-焦虑量表(CGI-焦虑)和临床总体印象-睡眠量表(CGI-睡眠)评估临床获益。
在180例患者中,三个苯二氮䓬类药物组的人口统计学特征无差异。治疗六周后,所有苯二氮䓬类药物组的CGI-S、CGI-焦虑和CGI-睡眠评分均有显著改善(p<0.001)。三个苯二氮䓬类药物组在CGI-S、CGI-焦虑和CGI-睡眠的平均变化上无差异。氯硝西泮组的副作用发生率显著低于其他苯二氮䓬类药物。氯硝西泮、阿普唑仑和劳拉西泮组的不良事件发生率分别为26.7%(n = 20)、48.4%(n = 31)和43.9%(n = 18)。
本研究表明,氯硝西泮在治疗各种焦虑症方面与其他苯二氮䓬类药物一样有效。此外,在本研究中,氯硝西泮的安全性优于其他苯二氮䓬类药物。