阿普唑仑可降低惊恐障碍患者对大声响的反应，但对创伤后应激障碍患者无效。
Alprazolam reduces response to loud tones in panic disorder but not in posttraumatic stress disorder.
作者信息
Shalev A Y, Bloch M, Peri T, Bonne O
机构信息
Department of Psychiatry, Hadassah University Hospital, Jerusalem, Israel.
出版信息
Biol Psychiatry. 1998 Jul 1;44(1):64-8. doi: 10.1016/s0006-3223(98)80008-5.
BACKGROUND
Posttraumatic stress disorder (PTSD) and panic disorder (PD) share several clinical features, and theory postulates that phasic arousal is similarly dysregulated in both. The modulation of phasic arousal can be probed by measuring the effect of pharmacologic agents on auditory startle.
METHODS
Eyeblink electromyogram, heart rate, and skin conductance (SC) responses to 15 consecutive presentations of 1000-Hz, 95-dB, zero rise-time pure tones were measured, before and during treatment with alprazolam, in 9 PTSD and 9 PD patients. Concurrent anxiety was assessed by the Hamilton Anxiety Rating Scale.
RESULTS
The groups did not differ in initial psychometric and physiological measures. Significant decrease in anxiety was observed in both groups during treatment. A decrease in response probability and a decrease in the SC responses were observed in PD, but not in PTSD.
CONCLUSIONS
The results may reflect a difference in the modulation of phasic arousal between the disorders. They may also express an impaired between-session habituation or contextual sensitization in PTSD.
背景
创伤后应激障碍（PTSD）和惊恐障碍（PD）有若干共同的临床特征，理论推测二者的阶段性觉醒调节均存在类似失调。可通过测量药物制剂对听觉惊跳反应的影响来探究阶段性觉醒的调节情况。
方法
对9例创伤后应激障碍患者和9例惊恐障碍患者在接受阿普唑仑治疗前及治疗期间，测量其对1000赫兹、95分贝、零上升时间纯音连续15次呈现的眨眼肌电图、心率和皮肤电传导（SC）反应。同时采用汉密尔顿焦虑量表评估焦虑程度。
结果
两组在初始心理测量和生理指标上无差异。治疗期间两组焦虑均显著降低。惊恐障碍患者的反应概率降低，皮肤电传导反应降低，但创伤后应激障碍患者未出现此情况。
结论
结果可能反映了这两种障碍在阶段性觉醒调节方面的差异。结果也可能表明创伤后应激障碍患者在不同疗程间存在习惯化受损或情境敏感化受损。
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