Pecknold J C, Luthe L, Iny L, Ramdoyal D
Douglas Hospital Research Centre, Verdun, Quebec, Canada.
J Psychiatry Neurosci. 1995 May;20(3):193-8.
Serotonergic implication in panic disorder has been demonstrated by the efficacy of serotonin reuptake blockers in treatment. Fluoxetine, a potent 5-HT reuptake blocker, has been suggested to have anti-panic efficacy. This open study examines 30 patients (eight males and 22 females) with an average age of 36.9 years, ranging from 18 to 62, who were treated for eight weeks with fluoxetine (mean dose 20 mg per day). All patients fulfilled DSM-III-R criteria of panic disorder with agoraphobia as determined in a SCID interview schedule. Out of 28 patients who started medication, 64% of the patients completed the clinical trial and 36% of the patients dropped out of treatment because of increased anxiety or a lack of efficacy. Thirty-two percent of the patients had zero panic attacks by week 3. By the end of eight weeks of treatment, 48% of the patients had zero panic attacks. There was a significant reduction in anxiety and phobic avoidance and panic attacks. Tritiated platelet imipramine and paroxetine bindings revealed significantly lower maximal binding for patients with panic disorder in comparison with controls. Paroxetine Bmax showed a trend to increase in the direction of control values by the end of the trial.
血清素再摄取阻滞剂在治疗惊恐障碍中的疗效已证明了血清素能的影响。强效5-羟色胺再摄取阻滞剂氟西汀已被认为具有抗惊恐疗效。这项开放性研究对30名患者（8名男性和22名女性）进行了检查，他们的平均年龄为36.9岁，年龄范围在18至62岁之间，接受了为期8周的氟西汀治疗（平均剂量为每天20毫克）。所有患者均符合DSM-III-R中惊恐障碍伴广场恐惧症的标准，这是在SCID访谈表中确定的。在开始用药的28名患者中，64%的患者完成了临床试验，36%的患者因焦虑加剧或缺乏疗效而退出治疗。32%的患者在第3周时无惊恐发作。到治疗8周结束时，48%的患者无惊恐发作。焦虑、恐惧回避和惊恐发作均有显著减少。与对照组相比，惊恐障碍患者的氚标记血小板丙咪嗪和帕罗西汀结合显示出显著更低的最大结合力。到试验结束时，帕罗西汀的最大结合力（Bmax）显示出向对照值方向增加的趋势。
