Bandelow B, Sievert K, Röthemeyer M, Hajak G, Broocks A, Rüther E
Psychiatrische Klinik, Universität Göttingen.
Fortschr Neurol Psychiatr. 1995 Nov;63(11):451-64. doi: 10.1055/s-2007-996646.
The present survey of controlled studies on the treatment of panic disorder and agoraphobia (PDA) reveals that treatment with tricyclic antidepressants (e.g., imipramine and clomipramine), benzodiazepines (e.g., alprazolam), serotonin reuptake inhibitors (e.g., fluvoxamine) and the monoamine oxidase inhibitor phenelzine has been proven effective. Among psychological therapies, cognitive therapy and exposure therapy in agoraphobia have been shown to be effective. There is an insufficient number of comparisons between pharmacological and psychological treatments. From the existing studies it can be assumed that none of these treatment modalities is superior to the other. The few existing follow-up studies do not suffice to prove a longer lasting effect for the psychological therapies, compared with drug therapies. Because of the low number of investigations, it cannot be clearly stated whether it is useful or harmful do treat patients with psychopharmacological drugs during psychological therapy. It is more likely that this combination is advantageous.
目前针对惊恐障碍和广场恐惧症(PDA)的对照研究调查显示,使用三环类抗抑郁药(如丙咪嗪和氯米帕明)、苯二氮䓬类药物(如阿普唑仑)、5-羟色胺再摄取抑制剂(如氟伏沙明)以及单胺氧化酶抑制剂苯乙肼进行治疗已被证明是有效的。在心理治疗中,认知疗法和广场恐惧症的暴露疗法已被证明是有效的。药物治疗和心理治疗之间的比较数量不足。从现有研究可以推断,这些治疗方式中没有一种优于其他方式。现有的少数随访研究不足以证明与药物治疗相比,心理治疗具有更持久的效果。由于调查数量较少,无法明确说明在心理治疗期间使用精神药物治疗患者是有益还是有害。这种联合治疗更有可能是有利的。