Chouinard G, Labonte A, Fontaine R, Annable L
Prog Neuropsychopharmacol Biol Psychiatry. 1983;7(4-6):669-73. doi: 10.1016/0278-5846(83)90043-x.
Abrupt withdrawal of benzodiazepine treatment in generalized anxiety patients was found to induce a rebound anxiety state in addition to minor physical symptoms. Controlled clinical trials suggest that the newer high potency benzodiazepines (alprazolam, clonazepam and bromazepam) have novel psychiatric indications and greater anxiolytic effect than the classical benzodiazepines. Alprazolam, a triazolobenzodiazepine, was superior to placebo in the treatment of panic disorder, for which medium or low potency benzodiazepines are generally inefficacious. Clonazepam, an anticonvulsant which increases 5HT synthesis, was more efficacious than lithium in reducing manic symptoms. Bromazepam, a new potent benzodiazepine, was superior to diazepam in the treatment of generalized anxiety disorder.
研究发现，广泛性焦虑症患者突然停用苯二氮䓬类药物治疗，除了会出现轻微身体症状外，还会引发反弹性焦虑状态。对照临床试验表明，新型高效苯二氮䓬类药物（阿普唑仑、氯硝西泮和溴西泮）具有新的精神科适应证，且抗焦虑作用比传统苯二氮䓬类药物更强。三氮唑苯二氮䓬类药物阿普唑仑在治疗惊恐障碍方面优于安慰剂，而中效或低效苯二氮䓬类药物对此通常无效。氯硝西泮是一种能增加5-羟色胺合成的抗惊厥药，在减轻躁狂症状方面比锂盐更有效。新型高效苯二氮䓬类药物溴西泮在治疗广泛性焦虑症方面优于地西泮。
