Rickels K, Fox I L, Greenblatt D J, Sandler K R, Schless A
Department of Psychiatry, University of Pennsylvania, Philadelphia.
Am J Psychiatry. 1988 Mar;145(3):312-7. doi: 10.1176/ajp.145.3.312.
Sixty-two anxious patients were treated under double-blind conditions for 4 weeks with either clorazepate or lorazepam. Two-thirds of each treatment group were then switched abruptly to placebo for 2 weeks, while one-third continued to receive active medication. Two major findings were obtained. About 70% of the patients maintained improvement during the 2-week placebo period. Some patients, however, experienced rebound anxiety, which appeared to be more intense and occurred earlier when placebo was substituted for a benzodiazepine with a short half-life (lorazepam) than for one with a long half-life (clorazepate). The clinical relevance of these findings is discussed.
62名焦虑症患者在双盲条件下接受了4周的氯氮䓬或劳拉西泮治疗。然后，每个治疗组的三分之二患者突然改用安慰剂治疗2周，而三分之一的患者继续接受活性药物治疗。获得了两项主要发现。约70%的患者在2周的安慰剂治疗期内保持病情改善。然而，一些患者出现了反弹性焦虑，当用安慰剂替代半衰期短的苯二氮䓬类药物（劳拉西泮）时，这种反弹性焦虑似乎更强烈且出现得更早，而替代半衰期长的苯二氮䓬类药物（氯氮䓬）时则不然。讨论了这些发现的临床意义。
