Tricyclic treatment of generalized anxiety disorder.
Tricyclic treatment of generalized anxiety disorder.
复制标题
三环治疗广泛性焦虑症。
DOI：
10.1016/0165-0327(87)90019-x
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发表时间：
1987
影响因子：
6.6
通讯作者：
Frankenthaler,LM
中科院分区：
文献类型：
--
作者：
Kahn,RJ;McNair,DM;Frankenthaler,LM
虽然三环类抗抑郁药(TCAs)已长期用于治疗抑郁症和恐慌症，但我们回顾并报道了它们在广泛性焦虑状态下的疗效。这些定义不清的状态通常夹杂着焦虑和抑郁。虽然还没有一个简洁的诊断分类来适应这片尚未定义的疾病的荒原，但它们对丙咪嗪表现出令人惊讶的反应。疗效似乎在大约2周或更晚开始，可能至少优于至少一种著名的苯二氮卓类药物，氯氮卓酮，远远超过这一时间。不可能将这些观察到的抗焦虑作用视为抗抑郁作用的次要作用，或者归因于意外地纳入了特殊敏感的个体子集，如恐慌症患者。这些发现表明，TCAs的情感调节适用于所谓的广泛性焦虑，以及抑郁症和恐慌症。对于TCA可能在焦虑症中的临床应用，简要的提醒和指南被概述，但仍然有更多的问题而不是答案。关于这里审查的结果的几项重复研究目前正在进行中。
While tricyclic antidepressants (TCAs) have now long been used in treatment for depressive and panic-phobic disorders, we reviewed and reported on their efficacy in generalized anxiety states. These ill-defined states usually have admixtures of anxiety and depression. While there is no neat diagnostic categorization to fit this wasteland of yet-to-be-defined disorders, they show surprising responsiveness to imipramine. The onset of efficacy appears to begin at about 2 weeks or later and is probably superior to at least one well-known benzodiazepine, chlordiazepoxide, well beyond that time. It is not possible to dismiss these observed antianxiety effects as secondary to antidepressant effects or as attributable to the unintended inclusion of a peculiarly sensitive subset of individuals such as panic-phobic patients. These findings indicate that affect regulation by TCAs applies to so-called generalized anxiety as well as to depression and panic-phobic disorder. Brief reminders and guidelines are outlined for the possible clinical use of TCAs in anxiety disorders, but there remain more questions than answers. Several replication studies concerning the results reviewed here are now under way.