Bernik M A, Gorenstein C, Vieira Filho A H
Ambulatório de Ansiedade, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil.
J Psychopharmacol. 1998;12(2):146-50. doi: 10.1177/026988119801200205.
The acute effects of flumazenil, a benzodiazepine (BZD) receptor antagonist in long-term BZD users were used as a possible test to detect physiological dependence. Thirty-four subjects (20 females, 14 males) aged 26-48 years (mean + SD, 42.4+/-8.5 years), all chronic users of low doses of diazepam (5-20 mg/day, 14.2+/-4.8 mg/day) for 5 to 28 years (10.5+/-6 years), received a single 1-mg i.v. flumazenil dose or saline, infused slowly under double-blind conditions. Physiological dependence was suggested as all patients receiving flumazenil developed an anxiety reaction while the placebo group did not. Flumazenil triggered a qualitatively different reaction amounting to a panic attack during infusion in nine out of 15 patients. These patients had a diagnosis of panic disorder or a history of panic attacks. Caution should be exercised when giving flumazenil to panic patients who are taking BZDs as maintenance treatment.
氟马西尼是一种苯二氮䓬（BZD）受体拮抗剂，其对长期使用BZD的患者的急性效应被用作检测生理依赖性的一种可能测试。34名年龄在26至48岁（平均±标准差，42.4±8.5岁）的受试者（20名女性，14名男性），均长期低剂量使用地西泮（5至20毫克/天，14.2±4.8毫克/天）达5至28年（10.5±6年），在双盲条件下缓慢静脉注射单次1毫克氟马西尼剂量或生理盐水。由于所有接受氟马西尼的患者均出现焦虑反应，而安慰剂组未出现，提示存在生理依赖性。15名患者中有9名在输注氟马西尼期间引发了性质不同的反应，相当于惊恐发作。这些患者被诊断为惊恐障碍或有惊恐发作史。对于正在服用BZD进行维持治疗的惊恐患者给予氟马西尼时应谨慎。
