ANTIDEPRESSANT DRUGS IN TREATMENT OF ANXIETY DISORDERS

研究抗抑郁药物对广场恐惧症患者的影响 互补的方法，这两种方法都是药理学的改编 提出了解剖的新方法。这项主要研究是双盲安慰剂。 丙咪嗪治疗80例广场恐怖症对照多剂量试验 病人。只有没有严重抑郁/焦虑症的患者才会 参与这项研究并鼓励或指示进入恐惧症 情况不会与丙咪嗪同时提供，以便 评估特定的抗恐慌和抗恐惧性作用的程度 丙咪嗪，污染尽可能少。的主要目标是 本研究包括：1)对剂量-反应关系进行描述和分层 中枢广场恐惧症的关系，例如恐慌、恐惧症、 回避行为会表明具体的，可能的 不同的丙咪嗪效应，同时对血浆进行研究 丙咪嗪和地昔帕明水平和2)确定最佳剂量范围 丙咪嗪治疗广场恐惧症和恐慌症。 第二项研究是丙咪嗪和两种药物的试验性开放试验。 结构不同的新抗抑郁药共30种广场恐惧症 伴有抑郁/烦躁不安的患者。这是一种神经化学 丙咪嗪混合神经化学药物和丙咪嗪的药理剖析 选择性氟伏沙明和奥沙普林的临床疗效 5-羟色胺能作用和去甲肾上腺素能作用。的主要目的是 这项试点调查是为了探索 抗抑郁药物的抗抑郁、抗恐慌和抗恐怖作用 并评估差别化神经生化调节的可能性 它们对广场恐惧症患者的影响。 靶向广场恐惧症丙咪嗪最佳剂量的确定 症状和识别新的有效药物的可能性 可以更好地容忍，从而更容易为更多的 广场恐惧症患者具有重要的临床实践意义。这个 拟议中的研究也有望阐明 抗抑郁药物的抗恐慌、抗恐惧和抗抑郁作用， 阐明它们在广场恐惧症中的适应症和预期 最后开始提供生化基础和理论基础 用抗抑郁药治疗广场恐惧症和恐慌症。

To characterize the effects of antidepressant drugs in agoraphobia two complementary approaches, both of which are adaptations of pharmacological dissections, are proposed. The major study is a double-blind placebo controlled, multiple dose trial with imipramine in 80 agoraphobic patients. Only patients without significant depression/dysphoria will participate in this study and encouragement or instructions to enter phobic situations will not be provided concurrently with imipramine in order to assess the extent of specific antipanic and antiphobic effects of imipramine with as little contamination as possible. The major aims of this study include: 1) to delineate and stratify dose-response relationships for central agoraphobic symptoms, e.g., panic, phobia, avoidance behavior which would indicate specific, and possibly differential, imipramine effects, with concurrent investigation of plasma imipramine and desipramine levels and 2) to determine optimum dose ranges of imipramine in the treatment of agoraphobia and panic attacks. The second study is a pilot, open trial with imipramine and two structurally different new antidepressants in a total of thirty agoraphobic patients with associated depression/dysphoria. This is a neurochemically based pharmacological dissection of imipramine's mixed neurochemical and clinical effects using fluvoxamine and oxaprotiline which have selective serotonergic and noradrenergic effects, respectively. The primary aim of this pilot investigation is to explore the relationship of the antidepressant, antipanic and antiphobic effects of antidepressant drugs and to assess the possibility of differential neurobiochemical mediation of their effects in agoraphobic patients. The identification of optimum imipramine dosages for targeted agoraphobic symptoms and the possibility of identifying newer effective agents which may be better tolerated and thus more accessible to a greater number of agoraphobic patients have important clinical-practical implications. The proposed studies also promise to shed light on the relationship of the antipanic, antiphobic and antidepressant effects of antidepressant drugs, clarify the indications and expectations for their use in agoraphobia and finally begin to provide a biochemical basis and rationale for the treatment of agoraphobia and panic attacks with antidepressants.