Current use of benzodiazepines in anxiety disorders
Current use of benzodiazepines in anxiety disorders
复制标题
DOI：
10.1097/yco.0b013e32831a473d
复制
发表时间：
2009-01-01
影响因子：
6.9
通讯作者：
Ferreira, Valerie
中科院分区：
文献类型：
--
作者：
Clocis, Jean-Marc;Ferreira, Valerie
综述的目的本研究的目的是对 2007 年 7 月至 2008 年 8 月期间发表的关于苯二氮卓类药物治疗焦虑症的当前使用和原理的文章进行综述。最近的研究结果最近的综述文章证实选择性血清素再摄取抑制剂是治疗焦虑症的首选药物，与普瑞巴林或血清素-去甲肾上腺素再摄取抑制剂等新药物并列，并与认知行为药物相结合治疗。最近的调查显示，临床医生仍然广泛使用苯二氮卓类药物来治疗这些疾病，尽管其抗焦虑效果受到质疑。更新的药物正在开发中，将来可能会解决治疗困境。总结尽管有现行指南，但许多临床医生仍然认为苯二氮卓类药物在焦虑症治疗的急性和慢性阶段仍然是良好的治疗选择，部分原因是它们起效快、疗效好、副作用小，还因为有时只有不完全的治疗反应和替代药物的副作用的出现。在苯二氮卓类药物治疗初期症状得到良好缓解后，患者可能也不愿意逐渐减少剂量。然而，临床医生应记住与这些物质相关的频繁的生理依赖性，并在选择长期苯二氮卓类治疗之前建议药物和心理治疗替代方案，这在某些临床情况下可能仍然是必要的。
Purpose of reviewThe aim of this study is to provide a review of articles published between July 2007 and August 2008 on the current use and rationale of benzodiazepines in anxiety disorders.Recent findingsRecent review articles confirm selective serotonin reuptake inhibitors as first-choice drugs for treating anxiety disorders, alongside newer agents such as pregabalin or serotonin-norepinephrine reuptake inhibitors, and combined with cognitive-behavioural therapy. Benzodiazepines are still widely used by clinicians for these disorders, as shown by recent surveys, even though their anxiolytic effectiveness is questioned. Newer agents are in development and may in the future resolve the therapeutic dilemma.SummaryDespite current guidelines, benzodiazepines are still considered by many clinicians to remain good treatment options, in both the acute and the chronic phase of the treatment of anxiety disorders, partially because of their rapid onset of action and their efficacy with a favourable side effect profile, and also because of the sometimes only incomplete therapeutic response and the emergence of side effects of alternative medications. Having experienced good initial symptom relief with benzodiazepine treatment, patients may also be reluctant to taper it down. Clinicians should, however, bear in mind the frequent physiological dependence associated with these substances, and suggest both pharmacological and psychological treatment alternatives before opting for a long-term benzodiazepine treatment, which may remain necessary in certain clinical conditions.