ANTIDEPRESSANTS IN THE TREATMENT OF ANXIETY

三环类药物和其他抗抑郁药的成功使用 治疗恐慌症和可能成功的三环类药物， 在主要焦虑的门诊患者中诱导症状缓解 对抗焦虑特性的兴趣增加， 抗抑郁药 滥用苯二氮卓类药物的倾向，沿着 以成瘾性和产生耐受性而闻名， 增加了寻找抗焦虑药的重要性， 混合物. 建议进行一项研究，以比较以下药物的疗效：a）广泛使用的 证明有效的苯二氮杂卓（地西泮）; B）有效的三环 抗抑郁药被确定为可能有效的抗焦虑药（丙咪嗪）; c）非三环的第二代抗抑郁药， 有效但未尝试作为抗焦虑药（曲唑酮）;和d）惰性安慰剂 在广泛性焦虑症（GAD）的治疗中， 家庭医生病人 除了满足以下标准外， 诊断为广泛性焦虑症，患者必须患有焦虑症， 严重程度至少为中度，持续至少3个月，才有资格参加研究 参与的 拟议的研究包括：a）为期一周的安慰剂洗脱期 在此之前至少有一周的时间， B）8周双盲治疗期， c）第9周评估 在安慰剂治疗的最后一周后;和d）在第17周评估， 改善患者的2个月随访结束。 频繁 在试验早期进行评估，以提高 检测症状时间进程中治疗间的差异 救灾 合并用药对治疗结局的可能影响 抑郁、恐惧和恐慌样症状、强迫症 倾向，自卑感和怨恨，导致人际关系 困难和焦虑的长期性将被检查。

The success with which tricyclics and other antidepressants have been used to treat panic disorders and the possible success of a tricyclic in inducing symptom relief in primarily anxious outpatients have contributed to the development of increased interest in the anxiolytic properties of antidepressants. A tendency to abuse the benzodiazepines, along with their reputation for addictive properties and engendering tolerance, has increased the importance of finding anxiolytics of distinctive chemical composition. A study is proposed to compare the efficacy of: a) a widely used and demonstrably effective benzodiazepine (diazepam); b) an effective tricyclic antidepressant established as a possibly effective anxiolytic (imipramine); c) a non-tricyclic, second generation antidepressant of established efficacy but untried as an anxiolytic (trazodone); and d) an inert placebo in the treatment of Generalized Anxiety Disorder (GAD) in a sample of family practice patients. In addition to meeting the criteria for diagnosis as GAD, patients must have been suffering from anxiety of at least moderate severity for at least 3 months to qualify for study participation. The proposed study involves: a) a one-week placebo washout period preceded by at least one week during which no psychotropic medications are taken; b) an 8-week double-blind treatment period with assessments after 1, 2, 3, 4, 6, and 8 weeks; c) an assessment at Week 9 after a final week of placebo treatment; and d) a 17-week assessment at the end of a 2-month follow-up period of improved patients. Frequent assessments early in the trial are included to enhance the likelihood of detecting differences across treatments in the temporal course of symptom relief. The possible impact upon treatment outcome of concomitant depression, phobic- and panic-like symptoms, obsessive-compulsive tendencies, feelings of inferiority and resentment leading to interpersonal difficulties, and the chronicity of anxiety will be examined.