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成人特定恐惧症的药物治疗

Authors
Richard Swinson, MD
Randi E McCabe, PhD
Section Editor
Murray B Stein, MD, MPH
Deputy Editor
Richard Hermann, MD
Translators
刘铁桥, 主任医师，教授

引言

特定恐惧症是一种焦虑障碍，其特点为对某种特定物体或情境产生有临床意义的恐惧，通常会引发回避行为。恐惧的对象包括：动物、昆虫、高处、水、密闭空间、开车、飞行、看见血液、进行注射，以及窒息或呕吐。

特定恐惧症是最常见的精神障碍之一，可具有较高的致失能性[1,2]。然而，这类精神障碍也属于最可治疗的精神障碍之一[3-6]。尽管已经有了有效的治疗方法，但大多数特定恐惧症患者对寻求治疗犹豫不决[7]。其原因可能包括：患者不知道恐惧症是可治疗的、对于向保健专业人士说出自己的恐惧感到尴尬、通过回避调节恐惧，或者害怕在治疗过程中焦虑或不适会加重[5]。

本文将讨论成人特定恐惧症的药物治疗。成人特定恐惧症的流行病学、发病机制、临床表现、病程和诊断将单独讨论。成人特定恐惧症的心理治疗将单独讨论。与临床操作相关的特定恐惧症(例如，血液-注射-损伤恐惧症)及急性诊疗性焦虑的其他表现，将单独讨论。儿童特定恐惧症及其他恐惧也将单独讨论。(参见“Specific phobia in adults: Epidemiology, clinical manifestations, course and diagnosis”和“成年人特定恐惧症的心理治疗”和“成人急性诊疗性焦虑的流行病学和临床表现”和“成人急性操作性焦虑的治疗”和“儿童和青少年恐惧和恐惧症的概述”).

治疗概述

特定恐惧症的一线治疗是认知行为治疗(cognitive-behavior therapy, CBT)，包括暴露治疗[8]。 (参见“成年人特定恐惧症的心理治疗”)

包括苯二氮卓类药物和5-羟色胺再摄取抑制剂在内的药物治疗，在特定恐惧症治疗中的作用有限。当不能进行CBT，或相较于CBT患者更愿意采用药物治疗时，则使用药物治疗，尽管目前缺乏相对充分的临床试验证据来支持这一做法。

             

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Literature review current through: 2017-07 . | This topic last updated: 2015-11-30.
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