Fyer A J, Liebowitz M R, Gorman J M, Campeas R, Levin A, Sandberg D, Fyer M, Hollander E, Papp L, Goetz D
Anxiety Disorders Clinic, New York State Psychiatric Institute, NY 10032.
J Clin Psychopharmacol. 1988 Aug;8(4):270-4.
Effects of adjunctive clonidine (0.15 to 0.7 mg/day) on symptoms experienced during and for 4 weeks after gradual alprazolam discontinuation were observed in panic disorder patients after 6 weeks of successful treatment. Twelve of 14 entered patients were considered to have had a sufficient period of discontinuation (2 weeks) and clonidine administration (1 week) for effects to be assessed adequately. Nine of these 12 patients reached zero dose of alprazolam in 3 to 4 weeks. However, 10 of 12 patients experienced new withdrawal symptoms and 11 of 12 experienced recurrent panic attacks during tapering. Although a greater proportion of patients were successfully discontinued in a shorter time than in a previous nonclonidine trial, clonidine did not appear to have a specific effect on relapse or withdrawal. A placebo-controlled trial is needed to discriminate between possible contributions of clonidine and other factors (e.g., physician attitude, placebo effect of pill taking) to this improved outcome.
在成功治疗6周后，观察了辅助使用可乐定（0.15至0.7毫克/天）对惊恐障碍患者在逐渐停用阿普唑仑期间及停药后4周所经历症状的影响。14名入组患者中有12名被认为有足够长的停药期（2周）和可乐定给药期（1周）以充分评估疗效。这12名患者中有9名在3至4周内达到了阿普唑仑零剂量。然而，12名患者中有10名在减药期间出现了新的戒断症状，12名患者中有11名出现了惊恐发作复发。尽管与之前未使用可乐定的试验相比，有更大比例的患者在更短时间内成功停药，但可乐定似乎对复发或戒断没有特定影响。需要进行一项安慰剂对照试验，以区分可乐定与其他因素（如医生态度、服药的安慰剂效应）对这一改善结果可能的贡献。
