广泛性焦虑障碍的药物治疗策略

[:20020751]:410011(GAD),,,GAD,,SSRIsSSRIsR74917+2A(generalanxietydis2order,GAD),,GAD,,Grennberg(1998)[1],GAD,GAD681,31%,54%,GAD1,,,,,Pollack[2],50%GAD,:,,;,,,,GAD(Hamiltonanxietyscale,HAMA),HAMA50%,,GAD,1/35(,),Ballenger,GAD[2]:,HAMA710HAMA70%;,(HAMD)7HAMD70%;;,812,3122GAD211GAD21111:,GABA-AGABA,,50%GAD[3],GAD,,,GAD,,,GAD[4],,,(),,21112:FDAGAD2060mg/d,GAD,,34,GAD,,,,,-,,[3,5]21113(TCAs):/,,,TCAsGAD[3],,211145-(SSRIs):,[6]SSRIsSSRIsGAD[7],Rocca4(DSM-IV)GAD,8GAD32GAD,2,629ChineseGeneralPractice,June2004,Vol17No112©1995-2004TsinghuaTongfangOpticalDiscCo.,Ltd.Allrightsreserved.4,,Bellew[3],8,20mg/d40mg/dGAD,4HAMD-A-,GADGAD,SSRIsTCAs,21115:5-,,,GADGAD[8]GAD,75225mg/dSheehan[9],GAD,70%DavidsonGAD,GAD,GAD,GAD,,GAD,1,GAD1-,,,,,,GAD212GAD:GAD,GAD3:,GAD;,;,,3GAD:(SSRIs),,,,,GAD,23,,30min,GAD,,,SSRIsGAD,GAD,GADGADGAD,GAD(SSRIs)213:,SSRITCAs(MAOIs)-,SSRIs-,,,TCAs-GAD(75375mg/d),,(1),,(34),SSRIsTACsMAOIs,,,,,GAD,GADHarvard&Brown164GAD[10],,2,25%;5,38%GAD,,GAD166%,220%,528%GAD,13GAD,,,,GAD,,,,,,GAD,72920046712©1995-2004TsinghuaTongfangOpticalDiscCo.,Ltd.Allrightsreserved.,GADSSRIs,GAD1NinanPT.Dissolvingtheburdenofgeneral2izedanxietydisorder[J].JournalofClinicalPsychiatry,2001,62(19):5-102BallengerJC.Clinicalguidelinesforestablish2ingremissioninpatientswithdepressionandanxiety[J].JournalofClinicalPsychiatry,1999,60(22):29-343PollackMH.Optimizingpharmacotherapyofgeneralizedanxietydisordertoachieveremis2sion[J].JournalofClinicalPsychiatry,2001,62(19):20-254,,1[J].,2004,7(10):738-73951[J]1,1999,11(2):70-726,,,1[J].,2002,5(4):272-27371[J]1,2001,9(2):119-12081[J].,2001,20(2):117-1199SheehanDV.Attainingremissioningeneral2izedanxietydisorder:Venlafaxineextendedreleasecomparativedata[J].JournalofClin2icalPsychiatry,2001,62(19):26-3110TrivediMH.Sensitizingcliniciansandpa2tientstothesocialandfunctionalaspectsofremission[J].JournalofClinicalPsychia2try,2001,62(19):32-35(:2003-12-15:2004-02-25)(:):102206,,;R318A,DNA(EST)GenBank,,,(invivoex2pressiontechnology,IVET)(differentialfluorescenceinduction,DFI)(signature-taggedmutagenesis,STM)(selectivecaptureoftranscribedsequences,SCOTS),,[1](cDNAmicroarray),DNA,()()mRNAcDNA,mRNAcDNA,;,poly-TmRNA[2][3][4]C[5],[6,7]1,,111:,143/,121/,,Schut[8](100),,,Leichert[9]829ChineseGeneralPractice,June2004,Vol17No112©1995-2004TsinghuaTongfangOpticalDiscCo.,Ltd.Allrightsreserved.