Näytönastekatsaukset

Masennuslääke ahdistuneisuushäiriöön

Näytönastekatsaukset
8.1.2020
Sami Pirkola

Näytön aste: A

Masennuslääkkeistä ainakin SSRI -lääkkeet ja venlafaksiini ovat tehokkaita yksittäisten ahdistuneisuushäiriöiden hoidossa.

Lukuisissa lumekontrolloiduissa tutkimuksissa on osoitettu SSRI-lääkkeiden (selektiivinen serotoniinin takaisinoton estäjä) teho eri ahdistuneisuushäiriöissä, kuten sosiaalisessa fobiassa «Baldwin D, Bobes J, Stein DJ ym. Paroxetine in social phobia/social anxiety disorder. Randomised, double-blind, placebo-controlled study. Paroxetine Study Group. Br J Psychiatry 1999;175:120-6 »1, «Katzelnick DJ, Kobak KA, Greist JH ym. Sertraline for social phobia: a double-blind, placebo-controlled crossover study. Am J Psychiatry 1995;152:1368-71 »2, «Schneier FR, Goetz D, Campeas R ym. Placebo-controlled trial of moclobemide in social phobia. Br J Psychiatry 1998;172:70-7 »3, «Stein MB, Liebowitz MR, Lydiard RB ym. Paroxetine treatment of generalized social phobia (social anxiety disorder): a randomized controlled trial. JAMA 1998;280:708-13 »4, «Stein MB, Fyer AJ, Davidson JR ym. Fluvoxamine treatment of social phobia (social anxiety disorder): a double-blind, placebo-controlled study. Am J Psychiatry 1999;156:756-60 »5, paniikkihäiriössä «Pollack MH, Rapaport MH, Clary CM ym. Sertraline treatment of panic disorder: response in patients at risk for poor outcome. J Clin Psychiatry 2000;61:922-7 »6, «Boyer W. Serotonin uptake inhibitors are superior to imipramine and alprazolam in alleviating panic attacks: a meta-analysis. Int Clin Psychopharmacol 1995;10:45-9 »7, «Clum GA, Clum GA, Surls R. A meta-analysis of treatments for panic disorder. J Consult Clin Psychol 1993;61:317-26 »8, «Lepola UM, Wade AG, Leinonen EV ym. A controlled, prospective, 1-year trial of citalopram in the treatment of panic disorder. J Clin Psychiatry 1998;59:528-34 »9, «Loerch B, Graf-Morgenstern M, Hautzinger M ym. Randomised placebo-controlled trial of moclobemide, cognitive-behavioural therapy and their combination in panic disorder with agoraphobia. Br J Psychiat»11, «Londborg PD, Wolkow R, Smith WT ym. Sertraline in the treatment of panic disorder. A multi-site, double-blind, placebo-controlled, fixed-dose investigation. Br J Psychiatry 1998;173:54-60 »12, «Michelson D, Lydiard RB, Pollack MH ym. Outcome assessment and clinical improvement in panic disorder: evidence from a randomized controlled trial of fluoxetine and placebo. The Fluoxetine Panic Disor»13 , «Oehrberg S, Christiansen PE, Behnke K ym. Paroxetine in the treatment of panic disorder. A randomised, double-blind, placebo-controlled study. Br J Psychiatry 1995;167:374-9 »14, «Wade AG, Lepola U, Koponen HJ ym. The effect of citalopram in panic disorder. Br J Psychiatry 1997;170:549-53 »15, «Michelson D, Allgulander C, Dantendorfer K ym. Efficacy of usual antidepressant dosing regimens of fluoxetine in panic disorder: randomised, placebo-controlled trial. Br J Psychiatry 2001;179:514-8 »18 ja yleistyneessä ahdistuneisuushäiriössä (GAD) «Allgulander C, Hackett D, Salinas E. Venlafaxine extended release (ER) in the treatment of generalised anxiety disorder: twenty-four-week placebo-controlled dose-ranging study. Br J Psychiatry 2001;17»10, «Rickels K, Downing R, Schweizer E ym. Antidepressants for the treatment of generalized anxiety disorder. A placebo-controlled comparison of imipramine, trazodone, and diazepam. Arch Gen Psychiatry 199»16, «Rickels K, Pollack MH, Sheehan DV ym. Efficacy of extended-release venlafaxine in nondepressed outpatients with generalized anxiety disorder. Am J Psychiatry 2000;157:968-74 »17.

  • Tutkimuksen laatu: tasokas
  • Sovellettavuus suomalaiseen väestöön: kohtalainen

Perusterveydenhuollon ja psykiatrisen avohoidon potilailla tehdyssä, 541 potilaan 24 viikon lumekontrolloidussa tutkimuksessa «Allgulander C, Hackett D, Salinas E. Venlafaxine extended release (ER) in the treatment of generalised anxiety disorder: twenty-four-week placebo-controlled dose-ranging study. Br J Psychiatry 2001;17»10 venlafaksiini oli tehokas yleistyneen ahdistuneisuushäiriön oireisiin. Hitaasti liukeneva venlafaksiini annoksella 150 mg/vrk vähensi Hamiltonin ahdistuneisuusasteikolla (HRSA total) mitattuna ahdistuneisuutta 24 viikon seurannassa lumetta merkittävästi enemmän (-16,4 vs -11,0, p < 0,017).

  • Tutkimuksen laatu: tasokas
  • Sovellettavuus suomalaiseen väestöön: hyvä

Tämä teksti on linkitetty seuraaviin artikkeleihin:

  • Depressio 1

Kirjallisuutta

  1. Baldwin D, Bobes J, Stein DJ ym. Paroxetine in social phobia/social anxiety disorder. Randomised, double-blind, placebo-controlled study. Paroxetine Study Group. Br J Psychiatry 1999;175:120-6 «PMID: 10627793»PubMed
  2. Katzelnick DJ, Kobak KA, Greist JH ym. Sertraline for social phobia: a double-blind, placebo-controlled crossover study. Am J Psychiatry 1995;152:1368-71 «PMID: 7653696»PubMed
  3. Schneier FR, Goetz D, Campeas R ym. Placebo-controlled trial of moclobemide in social phobia. Br J Psychiatry 1998;172:70-7 «PMID: 9534836»PubMed
  4. Stein MB, Liebowitz MR, Lydiard RB ym. Paroxetine treatment of generalized social phobia (social anxiety disorder): a randomized controlled trial. JAMA 1998;280:708-13 «PMID: 9728642»PubMed
  5. Stein MB, Fyer AJ, Davidson JR ym. Fluvoxamine treatment of social phobia (social anxiety disorder): a double-blind, placebo-controlled study. Am J Psychiatry 1999;156:756-60 «PMID: 10327910»PubMed
  6. Pollack MH, Rapaport MH, Clary CM ym. Sertraline treatment of panic disorder: response in patients at risk for poor outcome. J Clin Psychiatry 2000;61:922-7 «PMID: 11206597»PubMed
  7. Boyer W. Serotonin uptake inhibitors are superior to imipramine and alprazolam in alleviating panic attacks: a meta-analysis. Int Clin Psychopharmacol 1995;10:45-9 «PMID: 7622804»PubMed
  8. Clum GA, Clum GA, Surls R. A meta-analysis of treatments for panic disorder. J Consult Clin Psychol 1993;61:317-26 «PMID: 8097212»PubMed
  9. Lepola UM, Wade AG, Leinonen EV ym. A controlled, prospective, 1-year trial of citalopram in the treatment of panic disorder. J Clin Psychiatry 1998;59:528-34 «PMID: 9818634»PubMed
  10. Allgulander C, Hackett D, Salinas E. Venlafaxine extended release (ER) in the treatment of generalised anxiety disorder: twenty-four-week placebo-controlled dose-ranging study. Br J Psychiatry 2001;179:15-22 «PMID: 11435263»PubMed
  11. Loerch B, Graf-Morgenstern M, Hautzinger M ym. Randomised placebo-controlled trial of moclobemide, cognitive-behavioural therapy and their combination in panic disorder with agoraphobia. Br J Psychiatry 1999;174:205-12 «PMID: 10448444»PubMed
  12. Londborg PD, Wolkow R, Smith WT ym. Sertraline in the treatment of panic disorder. A multi-site, double-blind, placebo-controlled, fixed-dose investigation. Br J Psychiatry 1998;173:54-60 «PMID: 9850204»PubMed
  13. Michelson D, Lydiard RB, Pollack MH ym. Outcome assessment and clinical improvement in panic disorder: evidence from a randomized controlled trial of fluoxetine and placebo. The Fluoxetine Panic Disorder Study Group. Am J Psychiatry 1998;155:1570-7 «PMID: 9812120»PubMed
  14. Oehrberg S, Christiansen PE, Behnke K ym. Paroxetine in the treatment of panic disorder. A randomised, double-blind, placebo-controlled study. Br J Psychiatry 1995;167:374-9 «PMID: 7496647»PubMed
  15. Wade AG, Lepola U, Koponen HJ ym. The effect of citalopram in panic disorder. Br J Psychiatry 1997;170:549-53 «PMID: 9330022»PubMed
  16. Rickels K, Downing R, Schweizer E ym. Antidepressants for the treatment of generalized anxiety disorder. A placebo-controlled comparison of imipramine, trazodone, and diazepam. Arch Gen Psychiatry 1993;50:884-95 «PMID: 8215814»PubMed
  17. Rickels K, Pollack MH, Sheehan DV ym. Efficacy of extended-release venlafaxine in nondepressed outpatients with generalized anxiety disorder. Am J Psychiatry 2000;157:968-74 «PMID: 10831478»PubMed
  18. Michelson D, Allgulander C, Dantendorfer K ym. Efficacy of usual antidepressant dosing regimens of fluoxetine in panic disorder: randomised, placebo-controlled trial. Br J Psychiatry 2001;179:514-8 «PMID: 11731354»PubMed