ANTIDEPRESSANTS IN ANXIETY DISORDERS--DISCONTINUATION/MAINTENANCE W/ IMIPRAMINE

本研究的主要目的是a）评估恶化的程度/在100名患有惊恐障碍和广场恐怖症的受试者的总实验样本中，检验在停用丙咪嗪后复发的假设，这些受试者在随机分配到12个月的前瞻性安慰剂对照组之前，对6个月的系统开放治疗表现出良好和稳定的反应。B）通过将双盲安慰剂替代条件的观察期延长至24个月来评估晚期复发/逆转; c）在停止1年维持治疗后12个月内复发的对照评估从研究完成者和重新接受治疗的复发者以及从双盲治疗的各个阶段脱落的受试者的初始随机化起长达3至4年，为了收集系统的纵向和临床相关数据，特别是与丙咪嗪维持不同时间后复发相关的数据，治疗 所采用的方法包括为期6个月的初始开放治疗期。对治疗表现出良好反应的患者被随机分配至安慰剂或持续用药12个月的双盲治疗。 然后进行第二次随机化;安慰剂组继续安慰剂，药物组再次随机分配至安慰剂组或继续药物组。

The main objectives of the study are a) to assess the extent of worsening/relapse upon discontinuation of imipramine and to test the hypothesis that maintenance on the drug protects from such reversal in a total experimental sample of 100 subjects with panic disorder and agoraphobia who have shown good and stable response to 6 months of systematic open treatment prior to randomization to the 12 month prospective placebo controlled discontinuation/maintenance phase of the study; b) An evaluation of late relapse/reversals achieved by extending the observation period of the double-blind placebo substitution condition to 24 months; c) A controlled assessment of relapse within the 12 month period following discontinuation of 1 year maintenance treatment d) A follow-up for 3 to 4 years from initial randomization of study completers and relapsers who are retreated as well as subjects who drop out from various stages of the double-blind protocol in order to gather systematic longitudinal and clinically relevant data specifically as they relate to relapse after varying lengths of imipramine maintenance treatment. The methods employed include an initial open treatment phase for 6 months. Patients who show a good response to treatment are randomized to double-blind treatment to either placebo or continuation of medication for 12 months. A second randomization then occurs; the placebo group continues on placebo and the medication group is randomized again to either placebo or continuation of the medication.