Wilhelm F H, Roth W T
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, CA, USA.
Behav Res Ther. 1997 Sep;35(9):831-41. doi: 10.1016/s0005-7967(97)00033-8.
In order to test if a benzodiazepine would enhance or hinder the therapeutic effects of exposure, immediate and delayed effects of alprazolam on flight phobics were assessed by questionnaires and ambulatory physiological recording. Physiological measures included heart rate, skin conductance level and fluctuations, finger temperature, respiratory sinus arrhythmia, and various respiratory measures derived from two bands calibrated for each subject. Twenty-eight women with flying phobia flew twice at a 1-week interval. One and a half hours before flight 1, 14 randomly assigned phobics received double-blind 1 mg of alprazolam and 14 received placebo. On flight 1, alprazolam reduced self-reported anxiety (5.0 vs 7.4) and symptoms (5.3 vs 3.6) more than placebo, but induced an increase in heart rate (114 vs 105 bpm) and respiratory rate (22.7 vs 18.3 breaths/min). Before flight 2, the alprazolam group did not expect to be more anxious than the placebo group (6.7 vs 6.5), but in fact indicated more anxiety during flight (8.5 vs 5.6), and a substantial increase in panic attacks from flight 1 to flight 2 (7% vs 71%). Heart rates in the alprazolam group increased further (123 bpm). Results indicate that alprazolam increases physiological activation under acute stress conditions and hinders therapeutic effects of exposure in flying phobia.
为了测试苯二氮䓬类药物是否会增强或阻碍暴露疗法的治疗效果，通过问卷调查和动态生理记录评估了阿普唑仑对飞行恐惧症患者的即时和延迟效应。生理指标包括心率、皮肤电导率水平及波动、手指温度、呼吸性窦性心律不齐，以及根据每个受试者校准的两个频段得出的各种呼吸指标。28名患有飞行恐惧症的女性每隔1周飞行两次。在第一次飞行前1.5小时，14名随机分配的恐惧症患者接受双盲给予的1毫克阿普唑仑，14名接受安慰剂。在第一次飞行中，阿普唑仑比安慰剂更能降低自我报告的焦虑（5.0对7.4）和症状（5.3对3.6），但会导致心率（114对105次/分钟）和呼吸频率（22.7对18.3次/分钟）增加。在第二次飞行前，阿普唑仑组预计不会比安慰剂组更焦虑（6.7对6.5），但实际上在飞行期间表现出更多焦虑（8.5对5.6），并且从第一次飞行到第二次飞行惊恐发作大幅增加（7%对71%）。阿普唑仑组的心率进一步升高（123次/分钟）。结果表明，阿普唑仑在急性应激条件下会增加生理激活，并阻碍飞行恐惧症暴露疗法的治疗效果。
