Baclofen treatment for chronic posttraumatic stress disorder
Baclofen treatment for chronic posttraumatic stress disorder
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DOI：
10.1345/aph.1c465
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发表时间：
2003-09-01
影响因子：
2.9
通讯作者：
Lowe, JS
中科院分区：
文献类型：
--
作者：
Drake, RG;Davis, LL;Lowe, JS
目的：已有研究表明，GABA(B)受体激动剂对治疗惊恐障碍患者的焦虑和治疗酒精中毒患者的抑郁和焦虑有疗效。我们假设，GABA(B)激动剂巴氯芬将是对患有慢性创伤后应激障碍(PTSD)的退伍军人进行对症治疗的有效治疗方法。方法：14名患有慢性战斗相关PTSD的男性退伍军人参加了一项为期8周的开放试验，巴氯芬分3个剂量滴定至最高80 mg/d。主要结果是临床医生应用创伤后应激障碍量表(CAPS)，次要结果测量包括汉密尔顿焦虑量表、汉密尔顿抑郁量表、全球功能评估量表和临床总体印象。结果：在完成8周试验的11名患者中，CAPS总分较基线显著下降(从82.9+/-16.1降至63.5+/-21.2)。回避和过度唤醒因子分显著下降(分别从36.2±6.2降至26.5±9.6和从31.9±6.5降至22.1+/-7.1)，而重体验因子无明显变化。还注意到所有次要结果衡量标准均有显著改善。治疗反应在治疗的前4周内被记录下来，并在整个试验过程中保持不变。巴氯芬治疗耐受性良好，仅1例患者因不良反应退出治疗。结论：巴氯芬治疗对战斗所致慢性创伤后应激障碍患者的创伤后应激障碍症状及伴随的抑郁、焦虑症状均有较好的疗效。需要更大规模的双盲安慰剂对照研究来证实巴氯芬治疗创伤后应激障碍的疗效。
OBJECTIVE: Previous studies have shown the efficacy of gamma-aminobutyric acid B (GABA(B)) receptor agonists in treating anxiety in patients with panic disorder and in treating depression and anxiety in alcoholic patients. We hypothesized that baclofen, a GABA(B) agonist, would be an effective treatment in the symptomatic management of veterans with chronic posttraumatic stress disorder (PTSD).METHODS: Fourteen male veterans with chronic, combat-related PTSD were enrolled in an open-label, 8-week, monotherapy trial of baclofen titrated to a maximum of 80 mg/d in 3 divided doses. The primary outcome measure was the Clinician-Administered PTSD Scale (CAPS), and secondary outcome measures included the Hamilton Rating Scale for Anxiety, the Hamilton Rating Scale for Depression, the Global Assessment of Functioning Scale, and the Clinical Global Impressions.RESULTS: In the 11 patients who completed the 8-week trial, the mean total CAPS score decreased significantly from baseline (from 82.9 +/- 16.1 to 63.5 +/- 21.2). The avoidance and hyperarousal subscales showed significant decreases (from 36.2 +/- 6.2 to 26.5 +/- 9.6 and from 31.9 +/- 6.5 to 22.1 +/- 7.1, respectively), whereas the re-experiencing subscale remained unchanged. Significant improvements were also noted on all secondary outcome measures. Treatment response was noted within the first 4 weeks of treatment and was maintained throughout the trial. Baclofen therapy was well tolerated, as only 1 patient dropped out due to adverse effects.CONCLUSIONS: Baclofen therapy was effective in treating both the PTSD symptoms and accompanying depression and anxiety in patients with chronic PTSD due to combat. Larger, double-blind, placebo-controlled studies are needed to confirm the efficacy of baclofen in the treatment of PTSD.