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惊恐障碍的药物治疗

Author
Peter P Roy-Byrne, MD
Section Editor
Murray B Stein, MD, MPH
Deputy Editor
Richard Hermann, MD
Translators
曹庆久, 副主任医师

引言

惊恐障碍是一种慢性疾病，其特征为反复的惊恐发作，至少部分惊恐发作是意想不到的，伴对以后的发作或者对可能的发作结果(例如，未发现的躯体疾病、可能的猝死或者精神错乱)的焦虑或者伴发作导致的行为改变(如，回避某些场境和反复要求进行医学检查)[1]。

随着对第Ⅳ版《精神障碍诊断与统计手册》(Diagnostic and Statistical Manual of Mental Disorders, DSM)的修订形成DSM-Ⅴ，场所恐惧症的诊断已独立于惊恐障碍[1]。场所恐惧症通常(但并不总是)伴有惊恐障碍。

虽然在人群中有1/3的人在其一生中有惊恐发作，但是这些人中只有大约10%(人群中大约为3%)的人将会继续发展至发生惊恐障碍[2]。临床试验已发现，药物治疗和心理治疗方法对惊恐障碍的治疗均有效。

对惊恐障碍的药物治疗将在此讨论。惊恐障碍的流行病学、发病机制、临床表现、病程和诊断以及其心理治疗将单独讨论。 (参见“惊恐障碍：流行病学、发病机制、临床表现、病程、评估与诊断”和“惊恐障碍的心理治疗”)

药物治疗

几类药物已被显示对治疗惊恐障碍具有相当的疗效，这些药物包括：选择性5-羟色胺再摄取抑制剂(selective serotonin reuptake inhibitor, SSRI)、5-羟色胺和去甲肾上腺素再摄取抑制剂(serotonin-norepinephrine reuptake inhibitor, SNRI)、三环类抗抑郁剂(tricyclic antidepressant, TCAD)、单胺氧化酶抑制剂(monoamine oxidase inhibitor, MAOI)和苯二氮卓类药物。然而这些药物在证据支持的程度、副作用特征方面存在差异，且就苯二氮卓类来说，其具有滥用的可能性。这些问题将在下文讨论[3-6]。

                       

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Literature review current through: 2017-07 . | This topic last updated: 2017-05-15.
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