PSYCHOSOCIAL THERAPY FOR BENZODIAZEPINE DISCONTINUATION

苯二氮卓类药物停药的心理社会治疗

• 批准号: 2377420
• 负责人: David H. Barlow
• 金额: $ 32.63万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 1995
• 资助国家: 美国
• 起止时间: 1995-03-15 至 1999-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2377420
• 关键词: alprazolam; antidepressants; behavior prediction; behavioral /social science research tag; clinical trials; clonazepam; cognitive behavior therapy; combination chemotherapy; combination therapy; drug administration rate /duration; drug withdrawal; human subject; human therapy evaluation; interview; longitudinal human study; mental disorder chemotherapy; panic disorder; prognosis; psychosocial rehabilitation; questionnaires; relapse /recurrence

High potency benzodiazepines are effective anti-panic agents that are frequently prescribed for panic disorder. Recent FDA indications for panic disorder of alprazolam and subsequent company marketing should increase prescription frequency. However, difficulties with discontinuation have made this class of drugs controversial and, along with negative side effect profiles, have led to proposals for additional regulatory actions. Inability to discontinue benzodiazepine treatment exposes the patient to persisting drug associated adverse effects for a longer period of time and also does not allow the clinician to assess if the disorder has remitted. Although discontinuation is desirable for these reasons, no well studied effective discontinuation procedures yet exist. We propose to study the efficacy of a psychosocial program for the acute discontinuation of both short half life (alprazolam) and long half life (clonazepam) high potency benzodiazepine treatment of panic disorder. Successful discontinuation in the acute period and long-term maintenance of discontinuation will be examined after treatment with an adaptation of the Albany panic control treatment (PCT) adapted to facilitate benzodiazepine discontinuation (PCT-BD) combined with a conservative taper as usual (TAU) protocol. This program will be compared to a supportive group treatment that engages and educates the patient in a manner similar to PCT-BD, but without the specific therapeutic procedures, combined with TAU, and the TAU protocol alone. Pending further evaluations, the results may suggest an optimal way to combine high potency benzodiazepine treatment and PCT; that is, initial treatment with benzodiazepines could be followed by a course of PCT specifically designed to assist in discontinuation and prevent relapse. In addition, this study has the potential of providing important information on newer elements of treatment (e. g., interoceptive exposure) that may be important for maximizing the ability of patients to tolerate uncomfortable withdrawal effects, thereby maximizing the effectiveness of drug discontinuation efforts.

高效苯二氮卓类药物是有效的抗恐慌剂 经常用于治疗恐慌症。 FDA 最近的适应症 阿普唑仑恐慌症和随后的公司营销应该 增加处方频率。然而，困难 停药使此类药物引起争议，并且 具有负面副作用，导致提出了额外的建议 监管行动。无法停止苯二氮卓类药物治疗 使患者面临持续的药物相关不良反应 较长的一段时间，也不允许临床医生评估 如果疾病已经缓解。尽管停药是可取的 这些原因，尚未充分研究有效的停药程序 存在。我们建议研究心理社会计划的有效性 短半衰期（阿普唑仑）和长半衰期的急性终止 半衰期（氯硝西泮）高效苯二氮卓类药物治疗恐慌 紊乱。急性期和长期成功停药 治疗后将检查停药的维持情况 奥尔巴尼恐慌控制治疗（PCT）的改编适应于 促进苯二氮卓类药物停药（PCT-BD）与 保守锥度照常 (TAU) 协议。该计划将 与吸引和教育患者的支持性团体治疗相比 患者的治疗方式与 PCT-BD 类似，但没有具体说明 治疗程序与 TAU 相结合，以及单独的 TAU 方案。 在进一步评估之前，结果可能会提出一种最佳方法 结合高效苯二氮卓治疗和 PCT；即初始 苯二氮卓类药物治疗后可进行 PCT 疗程 专门设计用于协助停药和预防复发。 此外，这项研究有可能提供重要的 有关治疗新要素的信息（例如，内感受 暴露）这对于最大化患者的能力可能很重要 容忍不舒服的戒断效应，从而最大限度地 停药工作的有效性。