Hoehn-Saric R, McLeod D R, Hipsley P A
Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287-7144.
J Clin Psychopharmacol. 1993 Oct;13(5):321-6.
Several reports suggest that selective serotonin reuptake blockers are helpful in the treatment of panic disorder. The aim of the study was to compare fluvoxamine with placebo in 50 panic disorder patients by using an 8-week, double-blind, parallel-groups design. Weekly assessment included a panic attack diary (frequency and severity), the Montgomery-Asberg Depression Scale, the Clinical Anxiety Scale, and the Sheehan Disability Scale. Although both groups improved on all measures, the fluvoxamine group experienced significantly less frequent major panic attacks from the third week on and significantly lower ratings on anxiety, depression, and disability from the sixth week on. Mean ratings of the severity of major and the severity and frequency of minor attacks were not affected differently by fluvoxamine and placebo. At the end of the study, significantly more patients on fluvoxamine were free of major and minor panic attacks. The results indicate that: (1) the administration of fluvoxamine, as compared with placebo, led to a significant reduction in the number of panic attacks. (2) The severity of panic attacks was not affected by fluvoxamine. (3) The effect of fluvoxamine on anxiety, depressive mood, and disability differed from placebo only after 6 weeks of treatment, after which the placebo group showed either no further improvement or a reversal of symptoms. (4) Participation in a drug study, even without additional psychotherapy, led to significant improvement in all patients.
多项报告表明，选择性5-羟色胺再摄取阻滞剂有助于治疗惊恐障碍。本研究的目的是采用为期8周的双盲平行组设计，对50名惊恐障碍患者使用氟伏沙明与安慰剂进行比较。每周评估包括惊恐发作日记（发作频率和严重程度）、蒙哥马利-阿斯伯格抑郁量表、临床焦虑量表和希恩残疾量表。虽然两组在所有测量指标上均有改善，但氟伏沙明组从第三周起严重惊恐发作的频率显著降低，从第六周起焦虑、抑郁和残疾评分显著降低。氟伏沙明和安慰剂对严重惊恐发作的严重程度以及轻微发作的严重程度和频率的平均评分影响无差异。在研究结束时，服用氟伏沙明的患者中无严重和轻微惊恐发作的人数显著更多。结果表明：（1）与安慰剂相比，服用氟伏沙明可显著减少惊恐发作的次数。（2）氟伏沙明对惊恐发作的严重程度无影响。（3）氟伏沙明对焦虑、抑郁情绪和残疾的影响仅在治疗6周后与安慰剂不同，此后安慰剂组要么没有进一步改善，要么症状出现逆转。（4）参与药物研究，即使没有额外的心理治疗，也会使所有患者有显著改善。
