Dobrovolsky Alexander, Ichim Thomas E, Ma Daqing, Kesari Santosh, Bogin Vladimir
Pirogov Russian National Research Medical University, Moscow, Russia.
Institute of Mental Health and Addictology, Moscow, Russia.
J Transl Med. 2017 Jun 13;15(1):137. doi: 10.1186/s12967-017-1237-1.
Current treatments of panic disorder (PD) are limited by adverse effects, poor efficacy, and need for chronic administration. The established safety profile of subanesthetic concentrations of xenon gas, which is known to act as a glutamate subtype NMDA receptor antagonist, coupled with preclinical studies demonstrating its effects in other anxiety related conditions, prompted us to evaluate its feasibility and efficacy in treatment of patients with PD.
An open-label clinical trial of xenon-oxygen mixture was conducted in 81 patients with PD; group 1 consisting of patients only with PD (N = 42); and group 2 patients with PD and other comorbidities (N = 39).
Based on the analysis of the results of a number of psychometric scales used in this study (SAS, HADS, CGI), several conclusions can be made: (1) xenon is a potentially effective modality in acute treatment of PD; (2) an anti-panic effect of xenon administration persists for at least 6 months after the completion of the active phase of treatment; (3) xenon inhalation is well tolerated, with the drop-out rates being much lower than that of conventional pharmacotherapy (5.8% vs. 15%); (4) the severity of depressive disorders that frequently accompany PD can be significantly reduced with the use of xenon; (5) xenon may be considered as an alternative to benzodiazepines in conjunction with cognitive-behavioral therapy as a safe modality in treatment of anxiety disorder.
These data support the need for randomized double-blind clinical trials to further study xenon-based interventions. Trial registration This clinical trial was retrospectively registered on April 14th, 2017 as ISRCTN15184285 in the ISRCTN database.
惊恐障碍（PD）的现有治疗方法受到不良反应、疗效不佳以及需要长期用药的限制。已知氙气在亚麻醉浓度下具有安全的特性，它可作为谷氨酸亚型NMDA受体拮抗剂，并且临床前研究表明其对其他焦虑相关病症有作用，这促使我们评估其在治疗PD患者中的可行性和疗效。
对81例PD患者进行了一项关于氙氧混合气体的开放标签临床试验；第1组仅由PD患者组成（N = 42）；第2组为患有PD和其他合并症的患者（N = 39）。
基于对本研究中使用的一些心理测量量表（SAS、HADS、CGI）结果的分析，可以得出以下几个结论：（1）氙气是PD急性治疗中一种潜在有效的方式；（2）在治疗的活跃期结束后，氙气给药的抗惊恐作用至少持续6个月；（3）氙气吸入耐受性良好，脱落率远低于传统药物治疗（5.8%对15%）；（4）使用氙气可显著降低PD常伴发的抑郁症的严重程度；（5）在结合认知行为疗法时，氙气可被视为苯二氮䓬类药物的替代品，作为治疗焦虑症的一种安全方式。
这些数据支持需要进行随机双盲临床试验以进一步研究基于氙气的干预措施。试验注册 本临床试验于2017年4月14日在ISRCTN数据库中作为ISRCTN15184285进行了回顾性注册。
