Randall P K, Bremner J D, Krystal J H, Nagy L M, Heninger G R, Nicolaou A L, Charney D S
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Biol Psychiatry. 1995 Sep 1;38(5):319-24. doi: 10.1016/0006-3223(94)00306-n.
Evidence from preclinical and clinical studies suggests a role for alterations in the benzodiazepine/GABAA receptor complex in stress and anxiety. Flumazenil is a relatively pure benzodiazepine/GABAA antagonist with limited intrinsic activity. In panic disorder patients, but not healthy controls, flumazenil has been demonstrated to provoke panic attacks.
Vietnam combat veterans with PTSD (n = 14) received 90-second intravenous infusions of flumazenil 2 mg or placebo in a double-blind, crossover study design. PTSD symptomology was assessed using the PTSD Symptom Scale, and anxiety symptoms were measured with visual analogue rating scales.
There was no significant difference in PTSD and anxiety symptoms between administration of flumazenil and placebo.
Flumazenil administration does not produce an increase in anxiety and PTSD symptoms in patients with PTSD. This suggests that PTSD and panic disorder are dissimilar in terms of benzodiazepine/GABAA system function.
临床前和临床研究证据表明，苯二氮䓬/GABAA受体复合物的改变在应激和焦虑中起作用。氟马西尼是一种相对纯的苯二氮䓬/GABAA拮抗剂，内在活性有限。在惊恐障碍患者中，而非健康对照者中，已证实氟马西尼可诱发惊恐发作。
在一项双盲、交叉研究设计中，14名患有创伤后应激障碍（PTSD）的越战退伍军人接受了2毫克氟马西尼或安慰剂的90秒静脉输注。使用PTSD症状量表评估PTSD症状，并通过视觉模拟评分量表测量焦虑症状。
给予氟马西尼和安慰剂后，PTSD和焦虑症状无显著差异。
给予氟马西尼不会使PTSD患者的焦虑和PTSD症状增加。这表明PTSD和惊恐障碍在苯二氮䓬/GABAA系统功能方面存在差异。
