Fairbanks J M, Pine D S, Tancer N K, Dummit E S, Kentgen L M, Martin J, Asche B K, Klein R G
Department of Child Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
J Child Adolesc Psychopharmacol. 1997 Spring;7(1):17-29. doi: 10.1089/cap.1997.7.17.
An open-label pilot study examined fluoxetine treatment in 16 outpatients (9-18 years old) with mixed anxiety disorders. Following nonresponse to psychotherapy, fluoxetine monotherapy was started at 5 mg daily and was increased weekly by 5 or 10 mg daily for 6-9 weeks until improvement occurred or to a maximum of 40 mg (children under 12) or 80 mg (adolescents). Among patients on fluoxetine, severity of illness ratings were "much improved" (mean final Clinical Global Impression scale score 2.8 +/- 0.7). Clinical improvement occurred in 10 of 10 patients with current separation anxiety disorder, 8 of 10 with social phobia, 4 of 6 with specific phobia, 3 of 5 with panic disorder, and 1 of 7 with generalized anxiety disorder. Mean time to improvement was 5 weeks. Mean doses were 24 mg (0.7 mg/kg) for children and 40 mg (0.71 mg/kg) for adolescents. Side effects were transient and included drowsiness (31% of patients), sleep problems (19%), decreased appetite (13%), nausea (13%), abdominal pain (13%), and excitement (13%). No patient developed disinhibition, akathisia, or suicidality. These preliminary findings suggest fluoxetine effectiveness in separation anxiety disorder and social phobia. Youths with only one anxiety disorder appeared to respond to lower doses of fluoxetine than patients with multiple anxiety disorders (0.49 +/- 0.14 versus 0.80 +/- 0.28 mg/kg, p < 0.05).
一项开放标签的试点研究对16名患有混合性焦虑症的门诊患者（9至18岁）进行了氟西汀治疗。在对心理治疗无反应后，开始氟西汀单药治疗，初始剂量为每日5毫克，每周增加5或10毫克，持续6至9周，直至病情改善或达到最大剂量，12岁以下儿童最大剂量为40毫克，青少年为80毫克。在接受氟西汀治疗的患者中，疾病严重程度评级为“显著改善”（临床总体印象量表最终平均得分为2.8±0.7）。10名患有当前分离焦虑症的患者中有10名病情改善，10名社交恐惧症患者中有8名，6名特定恐惧症患者中有4名，5名恐慌症患者中有3名，7名广泛性焦虑症患者中有1名。平均改善时间为5周。儿童的平均剂量为24毫克（0.7毫克/千克），青少年为40毫克（0.71毫克/千克）。副作用是短暂的，包括嗜睡（31%的患者）、睡眠问题（19%）、食欲下降（13%）、恶心（13%）、腹痛（13%）和兴奋（13%）。没有患者出现脱抑制、静坐不能或自杀行为。这些初步研究结果表明氟西汀对分离焦虑症和社交恐惧症有效。仅患有一种焦虑症的青少年似乎比患有多种焦虑症的患者对较低剂量的氟西汀有反应（0.49±0.14对0.80±0.28毫克/千克，p<0.05）。
