Curtis G C, Massana J, Udina C, Ayuso J L, Cassano G B, Perugi G
University of Michigan, Ann Arbor.
J Psychiatr Res. 1993;27 Suppl 1:127-42. doi: 10.1016/0022-3956(93)90023-u.
The efficacy of tricyclics and benzodiazepines in the short term (approximately 2-4 months) treatment of panic disorder is well demonstrated, but efficacy over the longer term is not considered established. The present study provided systematic data from a double blind comparison of maintenance therapy (up to 8 months) of panic disorder with or without agoraphobia with alprazolam, imipramine, or placebo in 181 patients who had responded to the same regimen in a randomized 8-week treatment trial. All three groups had improved during the first 2 months (active treatments more than placebo and about equal to each other), and all maintained or extended their improvement over the next 6 months without any significant change in dose. More than twice as many alprazolam and imipramine than placebo patients (15%) remained in treatment for the full 8 months and did slightly better on symptom measures than the remaining placebo patients. Both medications were well tolerated during the maintenance period. The data suggest sustained efficacy and safety of imipramine and alprazolam over an extended period. More specifically, they suggest that tolerance does not develop to the therapeutic effects of either drug.
三环类药物和苯二氮䓬类药物在短期（约2 - 4个月）治疗惊恐障碍方面的疗效已得到充分证实，但长期疗效尚未确立。本研究提供了系统数据，该数据来自于对181名在为期8周的随机治疗试验中对相同治疗方案有反应的患者进行的双盲比较，这些患者患有或不患有广场恐惧症，分别接受阿普唑仑、丙咪嗪或安慰剂进行惊恐障碍维持治疗（长达8个月）。在最初的2个月里，所有三组患者的病情都有所改善（积极治疗组比安慰剂组改善更明显，且两组积极治疗组之间改善程度大致相同），并且在接下来的6个月里，所有患者都维持或扩大了改善程度，且剂量没有任何显著变化。在整个8个月的治疗期内，坚持治疗的阿普唑仑和丙咪嗪组患者数量是安慰剂组患者数量的两倍多（15%），且在症状测量方面比其余安慰剂组患者略好。在维持治疗期间，两种药物的耐受性都良好。数据表明丙咪嗪和阿普唑仑在较长时期内具有持续的疗效和安全性。更具体地说，数据表明两种药物的治疗效果均不会产生耐受性。
