Roy-Byrne P P, Sullivan M D, Cowley D S, Ries R K
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle.
J Psychiatr Res. 1993;27 Suppl 1:143-53. doi: 10.1016/0022-3956(93)90024-v.
The variety of pharmacologic and psychotherapeutic approaches to facilitate benzodiazepine discontinuation are reviewed. Strategies to attenuate physiologic withdrawal with clonidine, propranolol and carbamazepine have been inconsistently effective. Strategies to prevent relapse by substituting medications that could later be discontinued more easily (i.e., antidepressants and azapirones) appear more useful but have been less well studied. Psychotherapeutic approaches appear to work, but specific therapeutic components are unclear and non-specific "placebo" effects may play an important role.
本文综述了促进苯二氮䓬类药物停药的各种药理和心理治疗方法。使用可乐定、普萘洛尔和卡马西平减轻生理戒断反应的策略效果并不一致。通过替代后续更易停药的药物(即抗抑郁药和阿扎哌隆)来预防复发的策略似乎更有用,但相关研究较少。心理治疗方法似乎有效,但具体的治疗成分尚不清楚,非特异性的“安慰剂”效应可能起重要作用。