PSYCHOSOCIAL THERAPY FOR BENZODIAZEPINE DISCONTINUATION

苯二氮卓类药物停药的心理社会治疗

• 批准号: 2668159
• 负责人: Michael W. Otto
• 金额: $ 21.26万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 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/2668159
• 关键词: alprazolam; antidepressants; behavior prediction; behavioral /social science research tag; blood chemistry; 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; psychosocial rehabilitation; questionnaires; relapse /recurrence; relaxation; telecommunications; urinalysis; videotape /videodisc

High potency benzodiazepines are effective anxiolytic agents that are frequently prescribed for a number of anxiety conditions, including panic disorder. Recent FDA indications for alprazolam for the treatment of panic disorder 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 drug associated adverse effects for a longer period of time, and also does not allow the clinician to assess whether the disorder has remitted. Although discontinuation is desirable for these reasons, no well-studied, effective discontinuation procedures 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. Due to the particular difficulties associated with discontinuing benzodiazepine treatment for panic disorder, we will target patients with this 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 Therapy (PCT), adapted to facilitate benzodiazepine discontinuation (PCT-BD), combined with a conservative taper as usual (TAU) protocol. This program will be compared to a conservative TAU protocol alone, and a progressive muscle relaxation treatment combined with TAU that engages and educates the patient in a manner similar to PCT-BD but without the specific therapeutic procedures. Pending further evaluation, 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焦虑药 经常用于治疗多种焦虑症，包括 恐慌症。 FDA 最近对阿普唑仑治疗的适应症 恐慌症和随后的公司营销应该会增加 处方频率。然而，停药的困难 使此类药物引起争议，并且带来负面影响 效果概况，导致了额外监管的提议 行动。无法停止苯二氮卓类药物治疗暴露了 患者在较长时间内承受药物相关的不良反应， 并且也不允许临床医生评估该疾病是否患有 汇了。尽管出于这些原因需要停止治疗，但不 存在经过充分研究、有效的停药程序。我们建议 研究心理社会计划对急性发作的有效性 短半衰期（阿普唑仑）和长半衰期的停药 （氯硝西泮）高效苯二氮卓治疗。由于 与停用苯二氮卓类药物相关的特殊困难 治疗恐慌症，我们将针对患有此症的患者 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 奥尔巴尼恐慌控制疗法（PCT）的改编，适应于 促进苯二氮卓类药物停药（PCT-BD），并结合 保守锥度照常 (TAU) 协议。该计划将 与单独保守的 TAU 方案和渐进式肌肉方案相比 放松治疗与 TAU 相结合，吸引并教育患者 患者的治疗方式与 PCT-BD 类似，但没有具体说明 治疗程序。有待进一步评估，结果可能 提出结合高效苯二氮卓治疗的最佳方法 和PCT；也就是说，最初使用苯二氮卓类药物治疗可以是 随后是专门设计用于协助的 PCT 课程 停药，防止复发。此外，本研究还有 提供有关新要素的重要信息的潜力 可能对以下情况很重要的治疗（例如内感受暴露） 最大限度地提高患者耐受戒断不适的能力 作用，从而最大限度地发挥停药的效果 努力。

项目成果

Attending to emotional cues for drug abuse: bridging the gap between clinic and home behaviors.

关注药物滥用的情绪线索：弥合诊所和家庭行为之间的差距。

• DOI: 10.1151/spp073248
• 发表时间: 2007
• 期刊: Science & practice perspectives
• 作者: Otto,MichaelW;O'Cleirigh,ConallM;Pollack,MarkH
• 通讯作者: Pollack,MarkH

Internal cue exposure and the treatment of substance use disorders: lessons from the treatment of panic disorder.

• DOI: 10.1016/j.janxdis.2003.07.007
• 发表时间: 2004
• 期刊: Journal of anxiety disorders
• 影响因子: 10.3
• 作者: M. Otto;S. Safren;M. Pollack