Effects of gradual discontinuation of selective serotonin reuptake inhibitors in panic disorder with agoraphobia
Effects of gradual discontinuation of selective serotonin reuptake inhibitors in panic disorder with agoraphobia
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DOI：
10.1017/s1461145706007462
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发表时间：
2007-12-01
影响因子：
4.8
通讯作者：
Rafanelli, Chiara
中科院分区：
文献类型：
--
作者：
Fava, Giovanni A.;Bernardi, Manuela;Rafanelli, Chiara
本研究的目的是探讨惊恐障碍和广场恐怖症患者在最佳临床条件下，选择性5-羟色胺再摄取抑制剂（SSRIs）逐渐减量后停药综合征的患病率和特征。26名连续门诊患者在服用SSRIs时符合DSM-IV的惊恐障碍和广场恐怖症标准。20例经行为治疗后缓解。然后以尽可能慢的速度逐渐减少抗抑郁药，并对患者进行适当的教育。在停药后2周、1个月和1年，采用停药后出现的体征和症状（DESS）自评量表对患者进行评估。20名患者中有9名（45%）出现停药综合征，除3名长期服用帕罗西汀的患者外，其余患者均在一个月内消退。停药综合征似乎相当常见，即使在缓慢减量和临床缓解期间。在某些情况下，中断治疗后，干扰持续数月。
The aim of this investigation was to explore the prevalence and features of discontinuation syndromes ensuing with gradual tapering of selective serotonin reuptake inhibitors (SSRIs), in optimal clinical conditions in patients with panic disorder and agoraphobia. Twenty-six consecutive outpatients met the DSM-IV criteria for panic disorder and agoraphobia while taking SSRIs. Twenty remitted upon behavioural treatment. Antidepressant drugs were then tapered at the slowest possible pace and with appropriate patient education. Patients were assessed with the Discontinuation-Emergent Signs and Symptoms (DESS) checklist 2 wk, 1 month and 1 yr after discontinuation. Nine of the 20 patients (45%) experienced a discontinuation syndrome, which subsided within a month in all but three patients who had been taking paroxetine for a long time. Discontinuation syndromes appeared to be fairly common even when performed with slow tapering and during clinical remission. In some cases disturbances persisted for months after discontinuation.