艾斯基塔洛普拉姆 (escitalopram) 用于患有泛性焦虑症的老年人:一项随机对照试验
Eric J Lenze1, Bruce L Rollman, M Katherine Shear
1Department of Psychiatry, Washington University School of Medicine, 660 S Euclid, Box 8134, St Louis, MO 63110, USA. lenzee@wustl.edu
JAMA
|January 22, 2009
概括
选择性血清素再吸收抑制剂 (SSRI),如埃斯基塔洛普拉姆,可以改善老年人普遍焦虑障碍 (GAD). 然而,需要进一步的研究来证实这种人群的长期疗效和安全性.
科学领域:
- 老年精神病学是一门精神病学专业.
- 临床药理学 临床药理学
- 心理药理学 心理药理学
背景情况:
- 一般焦虑症 (GAD) 在老年人中很普遍,但治疗指南仍然有限.
- 选择性血清素再吸收抑制剂 (SSRI) 在年轻人中对GAD有效,但它们在老年人群中的有效性和安全性需要特别研究.
研究的目的:
- 评估60岁及以上成年人治疗泛性焦虑障碍 (GAD) 的埃斯基塔洛普拉姆的疗效,安全性和耐受性.
- 为了比较埃斯基塔洛普拉姆与安慰剂对老年GAD患者焦虑症状和功能结果的影响.
主要方法:
- 一项为期12周的随机化,安慰剂对照试验,涉及177名被诊断患有GAD的参与者 (年龄≥60岁).
- 参与者接受了埃斯基塔洛普拉姆 (10-20 mg/d) 或与之匹配的安慰剂.
- 结果包括累积反应率,反应时间,焦虑症状严重程度 (汉密尔顿焦虑评分表),担忧 (宾夕法尼亚州焦虑问卷) 和功能障碍 (生命后期功能和残疾仪器,SF-36).
主要成果:
- 主要分析显示,与安慰剂 (51%) (P = .03) 相比,埃斯基塔洛普拉姆 (69%) 的累积反应率显著更高.
- 与安慰剂相比,埃斯基塔洛普拉姆治疗导致焦虑症状和角色功能得到更大的改善 (CGI-I的P<0.001).
- 与埃斯基塔洛普拉姆相关的不良反应包括疲劳/昏昏欲睡 (41.1%),睡眠障碍 (14.1%) 和尿路症状 (9.4%).
结论:
- 与安慰剂相比,埃斯基塔洛普拉姆在12周内显示,老年人患有GAD的累积反应率高于安慰剂.
- 对治疗意图的分析没有显示出响应率的统计学上显著差异.
- 需要进行进一步的研究,以确定埃斯基塔洛普拉姆在这个人群中的长期疗效和安全性.
相关概念视频
Anxiolytic Drugs: Overview
1.5K
Anxiolytic drugs are vital in managing anxiety disorders by effectively alleviating symptoms such as excessive fear, tachycardia, and tremors. There are several classes of anxiolytic medications, each with unique mechanisms of action and potential side effects.
Primary Types of Anxiolytic Drugs
1. Benzodiazepines:
Benzodiazepines bind to the GABA-A receptor in the brain, enhancing GABA's interaction. This action reduces neurotransmission, effectively blocking anxiety-associated limbic...
Primary Types of Anxiolytic Drugs
1. Benzodiazepines:
Benzodiazepines bind to the GABA-A receptor in the brain, enhancing GABA's interaction. This action reduces neurotransmission, effectively blocking anxiety-associated limbic...
1.5K
Anxiolytic Drugs: Benzodiazepines and Buspirone
3.1K
Benzodiazepines are a class of anxiolytic drugs known for their rapid efficacy and high therapeutic-to-lethal dose ratio, but with a potential risk of drug dependence. These drugs are lipophilic, allowing for rapid absorption after oral administration, eventually reaching the central nervous system (CNS). Once in the CNS, benzodiazepines bind to the allosteric site of the GABAA receptor. This binding enhances the inhibitory effects of the neurotransmitter GABA. By doing so, they prevent...
3.1K
Drug Dosing: Geriatric Patients
395
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
395
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
400
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
400
Pharmacodynamics in Geriatric Patients: Effects of Age
367
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
367
Generalized Anxiety Disorder
1.3K
Generalized Anxiety Disorder (GAD) is a chronic condition characterized by excessive and uncontrollable worry that persists for at least six months, significantly interfering with daily functioning. Unlike situational anxiety, which arises in response to specific stressors, GAD often occurs without a clear cause. Individuals may experience disproportionate worry about work, health, or relationships. For instance, a person might continuously fear poor health despite normal medical evaluations or...
1.3K


