招聘講演 Selective Serotonin Reuptake Inhibitors (SSRIs) in Panic Disorder

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タイトル別名
  • Selective Serotonin Reuptake Inhibitors(SSRIs) in Panic Disorder
  • ショウヘイ コウエン Selective Serotonin Reuptake Inhibitors SSRIs in Panic Disorder

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Initial evidence of the effectiveness of imipramine and the monoamine oxidase inhibitors(MAOI), phenelzine and tranylcypromine, was first observed in Europe and the United States in the early to mid-60s. By the late 80s, the high potency benzodiazepines(BZs), alprazolam and clonazepam, were demonstrated to be effective in trials around the world. Clomipramine, altough not an SSRI, was the first predominantly serotonergic drug shown to be quite effective in panic disorder(PD). However, the SSRIs have become the treatment of first choice at this point first because of how well tolerated they are as a class, particularly the absence of weight gain, overdose danger, or abuse liability. Recent well-designed, double-blind, placebo-controlled trials- first with paroxetine and then sertraline, fluoxetine and citalopram- have demonstrated their clear effectiveness in the treatment of PD. Recommendations for length of treatment generally suggest, continuation of effective pharmacotherapy for 12-24 months, generally averaging 18 months before consideration of taper and discontinuation. Dosage is generally begum at the lowest level and then raised to levels effective in depression. The only established target dose in 40 mg for paroxetine but generally accepted dosage ranges for other SSRIs are sertraline (100-150 mg/day), fluoxetine (20-40 mg/day), citalopram (20-60 mg/day), and fluvoxamine (150-300mg/day).

収録刊行物

  • 心身医学

    心身医学 40 (4), 275-281, 2000

    一般社団法人 日本心身医学会

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