Gorman J M
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
J Clin Psychiatry. 1997;58 Suppl 14:54-8; discussion 59.
Antidepressants are frequently prescribed to treat panic disorder. Although tricyclic antidepressants and monoamine oxidase inhibitors both block panic attacks, they have many adverse effects such as orthostatic hypotension and weight gain. High potency benzodiazepines such as alprazolam are also efficacious but carry the risk of physical dependency. Data from research trials as well as clinical experience are accumulating to indicate that the serotonin selective reuptake inhibitors (SSRIs)--fluoxetine, fluvoxamine, paroxetine, and sertraline--and perhaps venlafaxine, which inhibits both serotonergic and noradrenergic reuptake, are useful antipanic medications. The possibility also exists that these newer antidepressants such as SSRIs and venlafaxine are superior in effectiveness to the previously available drugs and, when combined with cognitive-behavioral therapy, might provide the best treatment outcome for patients with panic disorder.
抗抑郁药常用于治疗惊恐障碍。尽管三环类抗抑郁药和单胺氧化酶抑制剂都能阻止惊恐发作，但它们有许多副作用，如体位性低血压和体重增加。高效苯二氮䓬类药物如阿普唑仑也有效，但有身体依赖的风险。研究试验和临床经验的数据不断积累，表明5-羟色胺选择性再摄取抑制剂（SSRI）——氟西汀、氟伏沙明、帕罗西汀和舍曲林——以及可能还有抑制5-羟色胺能和去甲肾上腺素能再摄取的文拉法辛，都是有效的抗惊恐药物。还有可能这些新型抗抑郁药如SSRI和文拉法辛在疗效上优于先前可用的药物，并且与认知行为疗法联合使用时，可能为惊恐障碍患者提供最佳治疗效果。
