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阿普唑仑：修订间差异

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<!-- Clinical data -->
<!-- Clinical data -->
| pronounce = {{IPAc-en|æ|l|'|p|r|æ|z|ə|l|æ|m}} or {{IPAc-en|æ|l|'|p|r|eɪ|z|ə|l|æ|m}}
| pronounce = {{IPAc-en|æ|l|'|p|r|æ|z|ə|l|æ|m}} 或 {{IPAc-en|æ|l|'|p|r|eɪ|z|ə|l|æ|m}}
| tradename = Xanax, Xanor, Niravam, others
| tradename = Xanax, Xanor, Niravam, others
| Drugs.com = {{drugs.com|monograph|alprazolam}}
| Drugs.com = {{drugs.com|monograph|alprazolam}}
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| sol_units =
| sol_units =
| specific_rotation =
| specific_rotation =
|legal_CN=第二类精神药品}}
}}
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'''阿普唑仑'''（商品名：'''Xanax'''）是[[三唑并苯二氮卓类]]中的中效速效镇静剂，它是与[[三唑]]环融合的[[苯二氮䓬类|苯二氮卓类]] (BZD)。<ref>{{Cite book|edition=6th|title=Drugs across the spectrum|url=https://www.worldcat.org/oclc/429504239|publisher=Wadsworth, Cengage Learning|date=2010|location=Belmont, CA|isbn=978-0-495-55793-7|oclc=429504239|first=Ray|last=Goldberg}}</ref>它最常用于[[焦虑症]]的短期管理，特别是[[恐慌症]]或[[广泛性焦虑症]] (GAD)。<ref name="dailymed">{{Cite web |title=XANAX- alprazolam tablet |url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=388e249d-b9b6-44c3-9f8f-880eced0239f |website=DailyMed |access-date=2022-06-20}}</ref>其他用途包括治疗化疗引起的恶心，以及其他治疗方法。<ref name="drugs">{{Cite web |title=Alprazolam Monograph for Professionals |url=https://www.drugs.com/monograph/alprazolam.html |website=Drugs.com |language=en |access-date=2022-06-20}}</ref>GAD 改善一般在一周内发生。<ref name="wiley">{{Cite journal |last=Verster |first=Joris C. |last2=Volkerts |first2=Edmund R. |date=2004 |title=Clinical pharmacology, clinical efficacy, and behavioral toxicity of alprazolam: a review of the literature |url=https://onlinelibrary.wiley.com/doi/10.1111/j.1527-3458.2004.tb00003.x |journal=CNS drug reviews |volume=10 |issue=1 |doi=10.1111/j.1527-3458.2004.tb00003.x |issn=1080-563X |pmc=6741717 |pmid=14978513}}</ref><ref>{{Cite book|title=Comprehensive review of psychiatry|url=https://www.worldcat.org/oclc/191317979|publisher=Wolters Kluwer/Lippincott Williams & Wilkins Health|date=2008|location=Philadelphia, PA|isbn=978-0-7817-7176-4|oclc=191317979|first=Rajesh R.|last=Tampi}}</ref>阿普唑仑通常[[口服给药|口服]]。<ref name="drugs" />


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'''阿普唑仑'''（[[INN]]：alprazolam），商品名'''贊安諾'''（{{lang|en|Xanax}}），是[[三唑并苯二氮䓬类]]中的中效速效镇静剂，它是与[[三唑]]环融合的[[苯二氮䓬类|苯二氮䓬类]] (BZD)<ref>{{Cite book|edition=6th|title=Drugs across the spectrum|url=https://www.worldcat.org/oclc/429504239|publisher=Wadsworth, Cengage Learning|date=2010|location=Belmont, CA|isbn=978-0-495-55793-7|oclc=429504239|first=Ray|last=Goldberg}}</ref>。它最常用于[[焦虑症]]的短期管理，特别是[[恐慌症]]或[[广泛性焦虑症]] (GAD)<ref name="dailymed">{{Cite web |title=XANAX- alprazolam tablet |url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=388e249d-b9b6-44c3-9f8f-880eced0239f |website=DailyMed |access-date=2022-06-20 |archive-date=2021-01-17 |archive-url=https://web.archive.org/web/20210117223138/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=388e249d-b9b6-44c3-9f8f-880eced0239f }}</ref>。其他用途包括治疗化疗引起的恶心，以及其他治疗方法<ref name="drugs">{{Cite web |title=Alprazolam Monograph for Professionals |url=https://www.drugs.com/monograph/alprazolam.html |website=Drugs.com |language=en |access-date=2022-06-20 |archive-date=2010-12-07 |archive-url=https://web.archive.org/web/20101207030717/https://www.drugs.com/monograph/alprazolam.html }}</ref>。GAD 改善一般在一周内发生<ref name="wiley">{{Cite journal |last=Verster |first=Joris C. |last2=Volkerts |first2=Edmund R. |date=2004 |title=Clinical pharmacology, clinical efficacy, and behavioral toxicity of alprazolam: a review of the literature |url=https://onlinelibrary.wiley.com/doi/10.1111/j.1527-3458.2004.tb00003.x |journal=CNS drug reviews |volume=10 |issue=1 |doi=10.1111/j.1527-3458.2004.tb00003.x |issn=1080-563X |pmc=6741717 |pmid=14978513 |access-date=2022-06-20 |archive-date=2022-06-23 |archive-url=https://web.archive.org/web/20220623191620/https://onlinelibrary.wiley.com/doi/10.1111/j.1527-3458.2004.tb00003.x }}</ref><ref>{{Cite book|title=Comprehensive review of psychiatry|url=https://www.worldcat.org/oclc/191317979|publisher=Wolters Kluwer/Lippincott Williams & Wilkins Health|date=2008|location=Philadelphia, PA|isbn=978-0-7817-7176-4|oclc=191317979|first=Rajesh R.|last=Tampi}}</ref>。阿普唑仑通常[[口服给药|口服]]<ref name="drugs" />。
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常见的副作用包括嗜睡、抑郁、头痛、感觉疲倦、口干和[[失忆症|记忆力问题]]。<ref name="drugs" />一些镇静和疲倦可能会在几天内得到改善。<ref>{{Cite book|edition=5th|title=Principles and practice of psychopharmacotherapy|url=https://www.worldcat.org/oclc/703840461|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|date=2011|location=Philadelphia|isbn=1-4511-2502-X|oclc=703840461|first=Stephen R.|last=Marder|first2=Mani N.|last2=Pavuluri}}</ref>由于担心误用，一些人不推荐阿普唑仑作为恐慌症的初始治疗。<ref name="sagepub">{{Cite journal |last=Moylan |first=Steven |last2=Giorlando |first2=Francesco |last3=Nordfjærn |first3=Trond |last4=Berk |first4=Michael |date=2012-03 |title=The role of alprazolam for the treatment of panic disorder in Australia |url=https://journals.sagepub.com/doi/10.1177/0004867411432074 |journal=The Australian and New Zealand Journal of Psychiatry |volume=46 |issue=3 |doi=10.1177/0004867411432074 |issn=1440-1614 |pmid=22391278}}</ref>如果突然减少使用，可能会出现[[药物戒断|戒断]]或反弹症状；<ref name="drugs" />可能需要在数周或数月内逐渐减少[[剂量 (生物化学)|剂量]]。<ref name="wiley" />其他罕见的风险包括[[自杀]]<ref>{{Cite journal |last=Dodds |first=Tyler J. |date=2017-03-02 |title=Prescribed Benzodiazepines and Suicide Risk: A Review of the Literature |url=https://www.psychiatrist.com/pcc/depression/suicide/prescribed-benzodiazepines-and-suicide-risk/ |journal=The primary care companion for CNS disorders |volume=19 |issue=2 |doi=10.4088/PCC.16r02037 |issn=2155-7780 |pmid=28257172}}</ref><ref>{{Cite journal |last=McCall |first=W. Vaughn |last2=Benca |first2=Ruth M. |last3=Rosenquist |first3=Peter B. |last4=Riley |first4=Mary Anne |last5=McCloud |first5=Laryssa |last6=Newman |first6=Jill C. |last7=Case |first7=Doug |last8=Rumble |first8=Meredith |last9=Krystal |first9=Andrew D. |date=2017-01-01 |title=Hypnotic Medications and Suicide: Risk, Mechanisms, Mitigation, and the FDA |url=https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2016.16030336 |journal=The American Journal of Psychiatry |volume=174 |issue=1 |doi=10.1176/appi.ajp.2016.16030336 |issn=1535-7228 |pmc=5205566 |pmid=27609243}}</ref>和全因死亡风险增加两倍。<ref>{{Cite journal |last=Xu |first=Kevin Y. |last2=Hartz |first2=Sarah M. |last3=Borodovsky |first3=Jacob T. |last4=Bierut |first4=Laura J. |last5=Grucza |first5=Richard A. |date=2020-12-01 |title=Association Between Benzodiazepine Use With or Without Opioid Use and All-Cause Mortality in the United States, 1999-2015 |url=https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2773826 |journal=JAMA network open |volume=3 |issue=12 |doi=10.1001/jamanetworkopen.2020.28557 |issn=2574-3805 |pmc=7726637 |pmid=33295972}}</ref>阿普唑仑与其他苯二氮卓类药物一样，通过[[γ-氨基丁酸A型受体|GABA<sub>A</sub>受体]]起作用。<ref name="drugs" />


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常见的副作用包括嗜睡、抑郁、头痛、感觉疲倦、口干和[[失忆症|记忆力问题]]。<ref name="drugs" />一些镇静和疲倦可能会在几天内得到改善。<ref>{{Cite book|edition=5th|title=Principles and practice of psychopharmacotherapy|url=https://www.worldcat.org/oclc/703840461|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|date=2011|location=Philadelphia|isbn=1-4511-2502-X|oclc=703840461|first=Stephen R.|last=Marder|first2=Mani N.|last2=Pavuluri}}</ref>由于担心误用，一些人不推荐阿普唑仑作为恐慌症的初始治疗。<ref name="sagepub">{{Cite journal |last=Moylan |first=Steven |last2=Giorlando |first2=Francesco |last3=Nordfjærn |first3=Trond |last4=Berk |first4=Michael |date=2012-03 |title=The role of alprazolam for the treatment of panic disorder in Australia |url=https://journals.sagepub.com/doi/10.1177/0004867411432074 |journal=The Australian and New Zealand Journal of Psychiatry |volume=46 |issue=3 |doi=10.1177/0004867411432074 |issn=1440-1614 |pmid=22391278 |access-date=2022-06-20 |archive-date=2022-04-21 |archive-url=https://web.archive.org/web/20220421160934/https://journals.sagepub.com/doi/10.1177/0004867411432074 }}</ref>如果突然减少使用，可能会出现[[药物戒断|戒断]]或反弹症状；<ref name="drugs" />可能需要在数周或数月内逐渐减少[[剂量 (生物化学)|剂量]]。<ref name="wiley" />其他罕见的风险包括[[自杀]]<ref>{{Cite journal |last=Dodds |first=Tyler J. |date=2017-03-02 |title=Prescribed Benzodiazepines and Suicide Risk: A Review of the Literature |url=https://www.psychiatrist.com/pcc/depression/suicide/prescribed-benzodiazepines-and-suicide-risk/ |journal=The primary care companion for CNS disorders |volume=19 |issue=2 |doi=10.4088/PCC.16r02037 |issn=2155-7780 |pmid=28257172 |access-date=2022-06-20 |archive-date=2022-02-16 |archive-url=https://web.archive.org/web/20220216092225/https://www.psychiatrist.com/pcc/depression/suicide/prescribed-benzodiazepines-and-suicide-risk/ }}</ref><ref>{{Cite journal |last=McCall |first=W. Vaughn |last2=Benca |first2=Ruth M. |last3=Rosenquist |first3=Peter B. |last4=Riley |first4=Mary Anne |last5=McCloud |first5=Laryssa |last6=Newman |first6=Jill C. |last7=Case |first7=Doug |last8=Rumble |first8=Meredith |last9=Krystal |first9=Andrew D. |date=2017-01-01 |title=Hypnotic Medications and Suicide: Risk, Mechanisms, Mitigation, and the FDA |url=https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2016.16030336 |journal=The American Journal of Psychiatry |volume=174 |issue=1 |doi=10.1176/appi.ajp.2016.16030336 |issn=1535-7228 |pmc=5205566 |pmid=27609243 |access-date=2022-06-20 |archive-date=2022-06-23 |archive-url=https://web.archive.org/web/20220623173603/https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2016.16030336 }}</ref>和全因死亡风险增加两倍。<ref>{{Cite journal |last=Xu |first=Kevin Y. |last2=Hartz |first2=Sarah M. |last3=Borodovsky |first3=Jacob T. |last4=Bierut |first4=Laura J. |last5=Grucza |first5=Richard A. |date=2020-12-01 |title=Association Between Benzodiazepine Use With or Without Opioid Use and All-Cause Mortality in the United States, 1999-2015 |url=https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2773826 |journal=JAMA network open |volume=3 |issue=12 |doi=10.1001/jamanetworkopen.2020.28557 |issn=2574-3805 |pmc=7726637 |pmid=33295972 |access-date=2022-06-20 |archive-date=2022-06-25 |archive-url=https://web.archive.org/web/20220625023625/https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2773826 }}</ref>阿普唑仑与其他苯二氮䓬类药物一样，通过[[γ-氨基丁酸A型受体|GABA<sub>A</sub>受体]]起作用。<ref name="drugs" />
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阿普唑仑于1971年获得专利，并于1981年在美国获准用于医疗用途。<ref name="drugs" /><ref>{{Cite book|title=Analogue-based drug discovery|url=https://www.worldcat.org/oclc/77601762|publisher=Wiley-VCH|date=2006|location=Weinheim|isbn=978-3-527-60749-5|oclc=77601762|page=536|first=János|last=Fischer|first2=C. R.|last2=Ganellin}}</ref>阿普唑仑是附表IV受控物质，是一种常见的滥用药物。<ref>{{Cite journal |last=Ait-Daoud |first=Nassima |last2=Hamby |first2=Allan Scott |last3=Sharma |first3=Sana |last4=Blevins |first4=Derek |date=2018 Jan/Feb |title=A Review of Alprazolam Use, Misuse, and Withdrawal |url=https://journals.lww.com/journaladdictionmedicine/Abstract/2018/02000/A_Review_of_Alprazolam_Use,_Misuse,_and_Withdrawal.2.aspx |journal=Journal of Addiction Medicine |volume=12 |issue=1 |doi=10.1097/ADM.0000000000000350 |issn=1935-3227 |pmc=5846112 |pmid=28777203}}</ref>它可作为[[通用名药物]]使用。<ref name="dailymed" />2019年，它是美国第41位最常用的处方药，有超过1700万张处方。<ref>{{Cite web |title=The Top 300 of 2019 |url=https://clincalc.com/DrugStats/Top300Drugs.aspx |website=ClinCalc |access-date=2022-06-20}}</ref><ref>{{Cite web |title=Alprazolam - Drug Usage Statistics, ClinCalc DrugStats Database |url=https://clincalc.com/DrugStats/Drugs/Alprazolam |website=ClinCalc |access-date=2022-06-20}}</ref>

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阿普唑仑于1971年获得专利，并于1981年在美国获准用于医疗用途。<ref name="drugs" /><ref>{{Cite book|title=Analogue-based drug discovery|url=https://www.worldcat.org/oclc/77601762|publisher=Wiley-VCH|date=2006|location=Weinheim|isbn=978-3-527-60749-5|oclc=77601762|page=536|first=János|last=Fischer|first2=C. R.|last2=Ganellin|access-date=2022-06-20|archive-date=2020-05-30|archive-url=https://web.archive.org/web/20200530080824/https://www.worldcat.org/title/analogue-based-drug-discovery/oclc/77601762}}</ref>阿普唑仑是附表IV受控物质，是一种常见的滥用药物。<ref>{{Cite journal |last=Ait-Daoud |first=Nassima |last2=Hamby |first2=Allan Scott |last3=Sharma |first3=Sana |last4=Blevins |first4=Derek |date=2018 Jan/Feb |title=A Review of Alprazolam Use, Misuse, and Withdrawal |url=https://journals.lww.com/journaladdictionmedicine/Abstract/2018/02000/A_Review_of_Alprazolam_Use,_Misuse,_and_Withdrawal.2.aspx |journal=Journal of Addiction Medicine |volume=12 |issue=1 |doi=10.1097/ADM.0000000000000350 |issn=1935-3227 |pmc=5846112 |pmid=28777203 |access-date=2022-06-20 |archive-date=2022-07-01 |archive-url=https://web.archive.org/web/20220701085037/https://journals.lww.com/journaladdictionmedicine/Abstract/2018/02000/A_Review_of_Alprazolam_Use,_Misuse,_and_Withdrawal.2.aspx }}</ref>它可作为[[通用名药物]]使用。<ref name="dailymed" />2019年，它是美国第41位最常用的处方药，有超过1700万张处方。<ref>{{Cite web |title=The Top 300 of 2019 |url=https://clincalc.com/DrugStats/Top300Drugs.aspx |website=ClinCalc |access-date=2022-06-20 |archive-date=2020-03-18 |archive-url=https://web.archive.org/web/20200318234059/https://clincalc.com/DrugStats/Top300Drugs.aspx }}</ref><ref>{{Cite web |title=Alprazolam - Drug Usage Statistics, ClinCalc DrugStats Database |url=https://clincalc.com/DrugStats/Drugs/Alprazolam |website=ClinCalc |access-date=2022-06-20 |archive-date=2020-04-12 |archive-url=https://web.archive.org/web/20200412004557/https://clincalc.com/DrugStats/Drugs/Alprazolam }}</ref>


== 医疗用途 ==
== 医疗用途 ==
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阿普唑仑可有效缓解中度至重度[[焦虑]]和[[恐慌发作|惊恐发作]]。<ref name="dailymed" />然而，自从开发出[[选择性5-羟色胺再摄取抑制剂]]以来，它并不是一线治疗。由于对耐受性、依赖性和滥用的担忧，澳大利亚不推荐阿普唑仑用于治疗恐慌症。<ref name="sagepub"/>大多数证据表明，阿普唑仑治疗恐慌症的益处仅持续四到十周。 然而，恐慌症患者已经接受了长达八个月的公开治疗，而没有明显的益处损失。<ref name="dailymed" />
阿普唑仑可有效缓解中度至重度[[焦虑]]和[[恐慌发作|惊恐发作]]。<ref name="dailymed" />然而，自从开发出[[选择性5-羟色胺再摄取抑制剂]]以来，它并不是一线治疗。由于对耐受性、依赖性和滥用的担忧，澳大利亚不推荐阿普唑仑用于治疗恐慌症。<ref name="sagepub"/>大多数证据表明，阿普唑仑治疗恐慌症的益处仅持续四到十周。 然而，恐慌症患者已经接受了长达八个月的公开治疗，而没有明显的益处损失。<ref name="dailymed" />


阿普唑仑被世界生物精神病学联合会 (WFSBP) 推荐用于没有[[药物耐受性|耐受]]或[[物质依赖|依赖史]]的恐慌症难治性病例。<ref>{{Cite journal |last=Bandelow |first=Borwin |last2=Zohar |first2=Josef |last3=Hollander |first3=Eric |last4=Kasper |first4=Siegfried |last5=Möller |first5=Hans-Jürgen |last6=World Federation of Societies of Biological Psychiatry Task Force on Treatment Guidelines for Anxiety, Obsessive-Compulsive and Posttraumatic Stress Disorders |date=2002-10 |title=World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders |url=https://www.tandfonline.com/doi/abs/10.3109/15622970209150621 |journal=The World Journal of Biological Psychiatry: The Official Journal of the World Federation of Societies of Biological Psychiatry |volume=3 |issue=4 |doi=10.3109/15622970209150621 |issn=1562-2975 |pmid=12516310}}</ref>
阿普唑仑被世界生物精神病学联合会 (WFSBP) 推荐用于没有[[药物耐受性|耐受]]或[[物质依赖|依赖史]]的恐慌症难治性病例。<ref>{{Cite journal |last=Bandelow |first=Borwin |last2=Zohar |first2=Josef |last3=Hollander |first3=Eric |last4=Kasper |first4=Siegfried |last5=Möller |first5=Hans-Jürgen |last6=World Federation of Societies of Biological Psychiatry Task Force on Treatment Guidelines for Anxiety, Obsessive-Compulsive and Posttraumatic Stress Disorders |date=2002-10 |title=World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders |url=https://www.tandfonline.com/doi/abs/10.3109/15622970209150621 |journal=The World Journal of Biological Psychiatry: The Official Journal of the World Federation of Societies of Biological Psychiatry |volume=3 |issue=4 |doi=10.3109/15622970209150621 |issn=1562-2975 |pmid=12516310 |access-date=2022-06-20 |archive-date=2022-06-21 |archive-url=https://web.archive.org/web/20220621221535/https://www.tandfonline.com/doi/abs/10.3109/15622970209150621 }}</ref>


=== 焦虑症 ===
=== 焦虑症 ===
与抑郁症相关的焦虑对阿普唑仑有反应。临床研究表明，对焦虑症的疗效仅限于 4 个月。<ref name="dailymed" />然而，对阿普唑仑抗抑郁特性的研究很差，只评估了它对抑郁症的短期影响。<ref>{{Cite journal |last=van Marwijk |first=Harm |last2=Allick |first2=Gideon |last3=Wegman |first3=Froukje |last4=Bax |first4=Arjan |last5=Riphagen |first5=Ingrid I. |date=2012-07-11 |title=Alprazolam for depression |url=https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007139.pub2/ |journal=The Cochrane Database of Systematic Reviews |issue=7 |doi=10.1002/14651858.CD007139.pub2 |issn=1469-493X |pmc=6769182 |pmid=22786504}}</ref>在一项研究中，一些长期高剂量服用阿普唑仑的人出现了可逆性抑郁症。<ref>{{Cite journal |last=Lydiard |first=R. B. |last2=Laraia |first2=M. T. |last3=Ballenger |first3=J. C. |last4=Howell |first4=E. F. |date=1987-05 |title=Emergence of depressive symptoms in patients receiving alprazolam for panic disorder |url=https://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.144.5.664 |journal=The American Journal of Psychiatry |volume=144 |issue=5 |doi=10.1176/ajp.144.5.664 |issn=0002-953X |pmid=3578580}}</ref>在美国，阿普唑仑被[[美国食品药品监督管理局|FDA]]批准用于治疗焦虑症（与APA诊断和统计手册[[精神疾病诊断与统计手册|DSM-IV-TR]] 诊断广泛性焦虑症最接近的病症）或短期缓解焦虑症状。在英国，阿普唑仑被推荐用于严重急性焦虑症的短期治疗（2-4周）。<ref name="dailymed" /><ref>{{Cite web |date=2015-03-11 |title=Xanax (alprazolam) |url=http://www.netdoctor.co.uk/medicines/depression/news/a7768/xanax-alprazolam/ |website=Netdoctor |language=en-GB |access-date=2022-06-20}}</ref><ref>{{Cite web |title=Alprazolam |url=https://about.medicinescomplete.com/ |website=MedicinesComplete |language=en-GB |access-date=2022-06-20}}</ref>
与抑郁症相关的焦虑对阿普唑仑有反应。临床研究表明，对焦虑症的疗效仅限于 4 个月。<ref name="dailymed" />然而，对阿普唑仑抗抑郁特性的研究很差，只评估了它对抑郁症的短期影响。<ref>{{Cite journal |last=van Marwijk |first=Harm |last2=Allick |first2=Gideon |last3=Wegman |first3=Froukje |last4=Bax |first4=Arjan |last5=Riphagen |first5=Ingrid I. |date=2012-07-11 |title=Alprazolam for depression |url=https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007139.pub2/ |journal=The Cochrane Database of Systematic Reviews |issue=7 |doi=10.1002/14651858.CD007139.pub2 |issn=1469-493X |pmc=6769182 |pmid=22786504}}</ref>在一项研究中，一些长期高剂量服用阿普唑仑的人出现了可逆性抑郁症。<ref>{{Cite journal |last=Lydiard |first=R. B. |last2=Laraia |first2=M. T. |last3=Ballenger |first3=J. C. |last4=Howell |first4=E. F. |date=1987-05 |title=Emergence of depressive symptoms in patients receiving alprazolam for panic disorder |url=https://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.144.5.664 |journal=The American Journal of Psychiatry |volume=144 |issue=5 |doi=10.1176/ajp.144.5.664 |issn=0002-953X |pmid=3578580 |access-date=2022-06-20 |archive-date=2021-03-04 |archive-url=https://web.archive.org/web/20210304150544/https://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.144.5.664 }}</ref>在美国，阿普唑仑被[[美国食品药品监督管理局|FDA]]批准用于治疗焦虑症（与APA诊断和统计手册[[精神疾病诊断与统计手册|DSM-IV-TR]] 诊断广泛性焦虑症最接近的病症）或短期缓解焦虑症状。在英国，阿普唑仑被推荐用于严重急性焦虑症的短期治疗（2-4周）。<ref name="dailymed" /><ref>{{Cite web |date=2015-03-11 |title=Xanax (alprazolam) |url=http://www.netdoctor.co.uk/medicines/depression/news/a7768/xanax-alprazolam/ |website=Netdoctor |language=en-GB |access-date=2022-06-20}}</ref><ref>{{Cite web |title=Alprazolam |url=https://about.medicinescomplete.com/ |website=MedicinesComplete |language=en-GB |access-date=2022-06-20 |archive-date=2020-05-06 |archive-url=https://web.archive.org/web/20200506070430/https://about.medicinescomplete.com/ }}</ref>


==副作用==
==副作用==
第148行： 第149行：


=== 食品和藥物相互作用 ===
=== 食品和藥物相互作用 ===
阿普唑崙的代謝主要是通過[[CYP3A4|CYP<sub>3</sub>A<sub>4</sub>]]進行<ref name="Otani-2003">{{Cite journal | last1 = Otani | first1 = K. | title = Cytochrome P450 3A4 and Benzodiazepines | language = ja | journal = Seishin Shinkeigaku Zasshi | volume = 105 | issue = 5 | pages = 631–642 | year = 2003 | pmid = 12875231}}</ref>，結合[[CYP3A4|CYP<sub>3</sub>A<sub>4</sub>]]临床上，抑製劑諸如[[西咪替丁]]、[[紅黴素]]、[[氟西汀]]、[[氟伏沙明]]、[[伊曲康唑]]、[[酮康唑]]、[[奈法唑酮]]（Nefazodone）、[[丙氧芬]]（Propoxyphene）、[[利托那韋]]（Ritonavir）等可以延緩阿普唑崙的[[肝清除率]]，但是這可能導致阿普唑崙在人体内部的的過度積纍<ref>{{Cite journal | last1 = Dresser | first1 = G. K. | last2 = Spence | first2 = J. D. | last3 = Bailey | first3 = D. G. | title = Pharmacokinetic-Pharmacodynamic Consequences and Clinical Relevance of Cytochrome P450 3A4 Inhibition | journal = Clinical Pharmacokinetics | year = 2000 | volume = 38 | issue = 1 | pages = 41–57 | pmid = 10668858 | doi = 10.2165/00003088-200038010-00003}}</ref>，如此很有可能會導致其不良反應更加的惡化<ref name=cpoati>{{cite journal | last1 = Greenblatt | first1 = D. J. | last2 = Wright | first2 = C. E. | title = Clinical Pharmacokinetics of Alprazolam. Therapeutic Implications | journal = Clinical Pharmacokinetics | year = 1993 | volume = 24 | issue = 6 | pages = 453–471 | doi = 10.2165/00003088-199324060-00003 | pmid = 8513649}}</ref><ref>{{Cite journal | last1 = Wang | first1 = J. S. | last2 = Chase | first2 = C. L. | title = Pharmacokinetics and Drug Interactions of the Sedative Hypnotics | journal = Psychopharmacological Bulletin | year = 2003 | volume = 37 | issue = 1 | pages = 10–29 | pmid = 14561946 | doi = 10.1007/BF01990373 | url = http://www.medworksmedia.com/psychopharmbulletin/pdf/12/010-029_PB%20W03_Wang_final.pdf | archiveurl = https://web.archive.org/web/20070709230745/http://www.medworksmedia.com/psychopharmbulletin/pdf/12/010-029_PB%20W03_Wang_final.pdf | archivedate = 2007-07-09 | format = PDF}}</ref>。
阿普唑崙的代謝主要是通過[[CYP3A4|CYP<sub>3</sub>A<sub>4</sub>]]進行<ref name="Otani-2003">{{Cite journal | last1 = Otani | first1 = K. | title = Cytochrome P450 3A4 and Benzodiazepines | language = ja | journal = Seishin Shinkeigaku Zasshi | volume = 105 | issue = 5 | pages = 631–642 | year = 2003 | pmid = 12875231}}</ref>，結合[[CYP3A4|CYP<sub>3</sub>A<sub>4</sub>]]临床上，抑製劑諸如[[西咪替丁]]、[[紅黴素]]、[[氟西汀]]、[[氟伏沙明]]、[[伊曲康唑]]、[[酮康唑]]、[[奈法唑酮]]（Nefazodone）、[[丙氧芬]]（Propoxyphene）、[[利托那韋]]（Ritonavir）等可以延緩阿普唑崙的[[肝清除率]]，但是這可能導致阿普唑崙在人体内部的過度積纍<ref>{{Cite journal | last1 = Dresser | first1 = G. K. | last2 = Spence | first2 = J. D. | last3 = Bailey | first3 = D. G. | title = Pharmacokinetic-Pharmacodynamic Consequences and Clinical Relevance of Cytochrome P450 3A4 Inhibition | journal = Clinical Pharmacokinetics | year = 2000 | volume = 38 | issue = 1 | pages = 41–57 | pmid = 10668858 | doi = 10.2165/00003088-200038010-00003}}</ref>，如此很有可能會導致其不良反應更加的惡化<ref name=cpoati>{{cite journal | last1 = Greenblatt | first1 = D. J. | last2 = Wright | first2 = C. E. | title = Clinical Pharmacokinetics of Alprazolam. Therapeutic Implications | journal = Clinical Pharmacokinetics | year = 1993 | volume = 24 | issue = 6 | pages = 453–471 | doi = 10.2165/00003088-199324060-00003 | pmid = 8513649}}</ref><ref>{{Cite journal | last1 = Wang | first1 = J. S. | last2 = Chase | first2 = C. L. | title = Pharmacokinetics and Drug Interactions of the Sedative Hypnotics | journal = Psychopharmacological Bulletin | year = 2003 | volume = 37 | issue = 1 | pages = 10–29 | pmid = 14561946 | doi = 10.1007/BF01990373 | url = http://www.medworksmedia.com/psychopharmbulletin/pdf/12/010-029_PB%20W03_Wang_final.pdf | archiveurl = https://web.archive.org/web/20070709230745/http://www.medworksmedia.com/psychopharmbulletin/pdf/12/010-029_PB%20W03_Wang_final.pdf | archivedate = 2007-07-09 | format = PDF}}</ref>。


==參考資料==
==參考資料==
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{{致幻剂}}
{{致幻剂}}
{{苯二氮䓬类药物}}
{{苯二氮䓬类药物}}
{{Anxiolytics}}{{GABAA受体正向变构调节剂}}{{精神药品品种目录}}
{{Anxiolytics}}
{{精神药品品种目录}}


{{Authority control}}
{{Authority control}}
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[[Category:抗焦慮藥]]
[[Category:抗焦慮藥]]
[[Category:氯代芳烴]]
[[Category:氯代芳烴]]
[[Category:GABAA受体正向变构调节剂]]

2024年7月27日 (六) 12:17的最新版本

维基百科中的醫學内容仅供参考，並不能視作專業意見。如需獲取醫療幫助或意見，请咨询专业人士。詳見醫學聲明。
阿普唑仑
臨床資料
读音/ælˈpræzəlæm/ 或 /ælˈpreɪzəlæm/
商品名（英语：Drug nomenclature）Xanax, Xanor, Niravam, others
AHFS/Drugs.comMonograph
MedlinePlusa684001
核准狀況
懷孕分級
  • 澳: C
依賴性High
给药途径口服
藥物類別（英语：Drug class）Benzodiazepine
ATC碼
法律規範狀態
法律規範
藥物動力學數據
生物利用度80–90%
血漿蛋白結合率80%
药物代谢代谢，via cytochrome P450 3A4
代謝產物Alpha-hydroxyalprazolam, 4-hydroxyalprazolam, beta-hydroxyalprazolam
藥效起始時間（英语：Onset of action）20~60分钟
生物半衰期完全释放：11~13小时
缓释：11~16小时
作用時間完全释放：6小时
缓释：11.3小时
排泄途徑Kidney
识别信息
  • 8-Chloro-1-methyl-6-phenyl-4H-[1,2,4]triazolo[4,3-a] [1,4]benzodiazepine
CAS号28981-97-7  checkY
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard（英语：CompTox Chemicals Dashboard） (EPA)
ECHA InfoCard100.044.849 編輯維基數據鏈接
化学信息
化学式C17H13ClN4
摩尔质量308.77 g·mol−1
3D模型（JSmol（英语：JSmol））
  • Cc1nnc2n1-c1ccc(Cl)cc1C(c1ccccc1)=NC2
  • InChI=1S/C17H13ClN4/c1-11-20-21-16-10-19-17(12-5-3-2-4-6-12)14-9-13(18)7-8-15(14)22(11)16/h2-9H,10H2,1H3 checkY
  • Key:VREFGVBLTWBCJP-UHFFFAOYSA-N checkY

阿普唑仑（INN：alprazolam），商品名贊安諾（Xanax），是三唑并苯二氮䓬类中的中效速效镇静剂，它是与三唑环融合的苯二氮䓬类 (BZD)[1]。它最常用于焦虑症的短期管理，特别是恐慌症或广泛性焦虑症 (GAD)[2]。其他用途包括治疗化疗引起的恶心，以及其他治疗方法[3]。GAD 改善一般在一周内发生[4][5]。阿普唑仑通常口服[3]。

常见的副作用包括嗜睡、抑郁、头痛、感觉疲倦、口干和记忆力问题。[3]一些镇静和疲倦可能会在几天内得到改善。[6]由于担心误用，一些人不推荐阿普唑仑作为恐慌症的初始治疗。[7]如果突然减少使用，可能会出现戒断或反弹症状；[3]可能需要在数周或数月内逐渐减少剂量。[4]其他罕见的风险包括自杀[8][9]和全因死亡风险增加两倍。[10]阿普唑仑与其他苯二氮䓬类药物一样，通过GABAA受体起作用。[3]

阿普唑仑于1971年获得专利，并于1981年在美国获准用于医疗用途。[3][11]阿普唑仑是附表IV受控物质，是一种常见的滥用药物。[12]它可作为通用名药物使用。[2]2019年，它是美国第41位最常用的处方药，有超过1700万张处方。[13][14]

医疗用途

[编辑]

阿普唑仑主要用于短期治疗焦虑症、恐慌症和化疗引起的恶心。[4]阿普唑仑适用于治疗成人广泛性焦虑症和恐慌症伴或不伴广场恐惧症。[2]FDA标签建议医生应定期重新评估药物的有效性。[2]

恐慌症

[编辑]

阿普唑仑可有效缓解中度至重度焦虑和惊恐发作。[2]然而，自从开发出选择性5-羟色胺再摄取抑制剂以来，它并不是一线治疗。由于对耐受性、依赖性和滥用的担忧，澳大利亚不推荐阿普唑仑用于治疗恐慌症。[7]大多数证据表明，阿普唑仑治疗恐慌症的益处仅持续四到十周。 然而，恐慌症患者已经接受了长达八个月的公开治疗，而没有明显的益处损失。[2]

阿普唑仑被世界生物精神病学联合会 (WFSBP) 推荐用于没有耐受或依赖史的恐慌症难治性病例。[15]

焦虑症

[编辑]

与抑郁症相关的焦虑对阿普唑仑有反应。临床研究表明，对焦虑症的疗效仅限于 4 个月。[2]然而，对阿普唑仑抗抑郁特性的研究很差，只评估了它对抑郁症的短期影响。[16]在一项研究中，一些长期高剂量服用阿普唑仑的人出现了可逆性抑郁症。[17]在美国，阿普唑仑被FDA批准用于治疗焦虑症（与APA诊断和统计手册DSM-IV-TR 诊断广泛性焦虑症最接近的病症）或短期缓解焦虑症状。在英国，阿普唑仑被推荐用于严重急性焦虑症的短期治疗（2-4周）。[2][18][19]

副作用

[编辑]
Xanax（阿普唑崙）2毫克三片連狀錠劑

可能的副作用包括：

異常反應

[编辑]
阿普唑崙的副作用.

使用阿普唑仑有可能會發生下面的異常反應：

食品和藥物相互作用

[编辑]

阿普唑崙的代謝主要是通過CYP3A4進行[37]，結合CYP3A4临床上，抑製劑諸如西咪替丁、紅黴素、氟西汀、氟伏沙明、伊曲康唑、酮康唑、奈法唑酮（Nefazodone）、丙氧芬（Propoxyphene）、利托那韋（Ritonavir）等可以延緩阿普唑崙的肝清除率，但是這可能導致阿普唑崙在人体内部的過度積纍[38]，如此很有可能會導致其不良反應更加的惡化[39][40]。

參考資料

[编辑]
  1. ^ Goldberg, Ray. Drugs across the spectrum 6th. Belmont, CA: Wadsworth, Cengage Learning. 2010. ISBN 978-0-495-55793-7. OCLC 429504239. 
  2. ^ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 XANAX- alprazolam tablet. DailyMed. [2022-06-20]. （原始内容存档于2021-01-17）. 
  3. ^ 3.0 3.1 3.2 3.3 3.4 3.5 Alprazolam Monograph for Professionals. Drugs.com. [2022-06-20]. （原始内容存档于2010-12-07） （英语）. 
  4. ^ 4.0 4.1 4.2 Verster, Joris C.; Volkerts, Edmund R. Clinical pharmacology, clinical efficacy, and behavioral toxicity of alprazolam: a review of the literature. CNS drug reviews. 2004, 10 (1) [2022-06-20]. ISSN 1080-563X. PMC 6741717 可免费查阅. PMID 14978513. doi:10.1111/j.1527-3458.2004.tb00003.x. （原始内容存档于2022-06-23）. 
  5. ^ Tampi, Rajesh R. Comprehensive review of psychiatry. Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins Health. 2008. ISBN 978-0-7817-7176-4. OCLC 191317979. 
  6. ^ Marder, Stephen R.; Pavuluri, Mani N. Principles and practice of psychopharmacotherapy 5th. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 2011. ISBN 1-4511-2502-X. OCLC 703840461. 
  7. ^ 7.0 7.1 Moylan, Steven; Giorlando, Francesco; Nordfjærn, Trond; Berk, Michael. The role of alprazolam for the treatment of panic disorder in Australia. The Australian and New Zealand Journal of Psychiatry. 2012-03, 46 (3) [2022-06-20]. ISSN 1440-1614. PMID 22391278. doi:10.1177/0004867411432074. （原始内容存档于2022-04-21）. 
  8. ^ Dodds, Tyler J. Prescribed Benzodiazepines and Suicide Risk: A Review of the Literature. The primary care companion for CNS disorders. 2017-03-02, 19 (2) [2022-06-20]. ISSN 2155-7780. PMID 28257172. doi:10.4088/PCC.16r02037. （原始内容存档于2022-02-16）. 
  9. ^ McCall, W. Vaughn; Benca, Ruth M.; Rosenquist, Peter B.; Riley, Mary Anne; McCloud, Laryssa; Newman, Jill C.; Case, Doug; Rumble, Meredith; Krystal, Andrew D. Hypnotic Medications and Suicide: Risk, Mechanisms, Mitigation, and the FDA. The American Journal of Psychiatry. 2017-01-01, 174 (1) [2022-06-20]. ISSN 1535-7228. PMC 5205566 可免费查阅. PMID 27609243. doi:10.1176/appi.ajp.2016.16030336. （原始内容存档于2022-06-23）. 
  10. ^ Xu, Kevin Y.; Hartz, Sarah M.; Borodovsky, Jacob T.; Bierut, Laura J.; Grucza, Richard A. Association Between Benzodiazepine Use With or Without Opioid Use and All-Cause Mortality in the United States, 1999-2015. JAMA network open. 2020-12-01, 3 (12) [2022-06-20]. ISSN 2574-3805. PMC 7726637 可免费查阅. PMID 33295972. doi:10.1001/jamanetworkopen.2020.28557. （原始内容存档于2022-06-25）. 
  11. ^ Fischer, János; Ganellin, C. R. Analogue-based drug discovery. Weinheim: Wiley-VCH. 2006: 536 [2022-06-20]. ISBN 978-3-527-60749-5. OCLC 77601762. （原始内容存档于2020-05-30）. 
  12. ^ Ait-Daoud, Nassima; Hamby, Allan Scott; Sharma, Sana; Blevins, Derek. A Review of Alprazolam Use, Misuse, and Withdrawal. Journal of Addiction Medicine. 2018 Jan/Feb, 12 (1) [2022-06-20]. ISSN 1935-3227. PMC 5846112 可免费查阅. PMID 28777203. doi:10.1097/ADM.0000000000000350. （原始内容存档于2022-07-01）. 
  13. ^ The Top 300 of 2019. ClinCalc. [2022-06-20]. （原始内容存档于2020-03-18）. 
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外部連結

[编辑]
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