ANTIDEPRESSANTS IN THE TREATMENT OF ANXIETY

三环类药物和其他抗抑郁药的成功使用 治疗恐慌症和三环类药物的可能成功 在主要焦虑的门诊患者中诱导症状缓解是有贡献的 人们对其抗焦虑特性的兴趣与日俱增 抗抑郁药。滥用苯二氮类药物的趋势，以及它们的 以令人上瘾的特性和产生宽容的名声， 增加了寻找特殊化学物质的焦虑剂的重要性 组成。 建议进行一项研究，以比较：a)广泛使用的和 有效的苯二氮卓类(安定)；b)有效的三环 被确定为可能有效的抗焦虑药(丙咪嗪)； C)一种已建立的非三环第二代抗抑郁剂 有效，但未作为抗焦虑药物(曲唑酮)使用；以及d)惰性安慰剂 在广泛性焦虑症(GAD)的治疗中 家庭医生给病人开诊。除了满足以下标准外 诊断为广泛性阿尔茨海默病，患者一定患有AT焦虑 至少3个月的中等严重程度，以符合研究资格 参与。拟议的研究包括：a)为期一周的安慰剂洗涤 在此之前至少一周内不服用精神药物 服药；b)为期8周的双盲治疗期 第1、2、3、4、6和8周后的评估；c)第9周的评估 在安慰剂治疗的最后一周后；以及d)在 改善患者2个月的随访期结束。频密 在试验的早期评估被包括在内，以增加 在症状的时间进程中检测不同治疗方法的差异 如释重负。伴随者对治疗结果的可能影响 抑郁、恐惧症和恐慌症、强迫症 倾向、自卑感和怨恨导致人际关系 困难，以及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.