普奈洛尔对失眠病人苯二氮类药物撤药症状的影响

目的:观察普奈洛尔对失眠症病人苯二氮(?)类药物撤药症状的作用和撤药成功率的影响。方法:69例因失眠症服用苯二氮(?)类药物且失眠症状消失的病人随机分为2组(普奈洛尔组33例和常规撤药组36例),撤药方法为1 wk减少原剂量的1/4,4 wk停用苯二氮(?)类药物。普奈洛尔组在撤药时加用普奈洛尔30 mg·d~(-1),分3次服用,常规撤药组按规定撤药,为期6 wk,观察撤药症状、脱落率和撤药成功率的差异。结果:普奈洛尔组撤药症状中的静坐不能、心悸和震颤明显少于常规撤药组(P<0.05),其余撤药症状无显著差异(P>0.05)。撤药成功率普奈洛尔组(61%)高于常规撤药组(36%,P<0.05)。结论:普奈洛尔用于苯二氮(?)类药物撤药的失眠症病人可减轻部分撤药症状,并提高撤药成功率。

Effects of propranolol in patients with insomnia during withdrawal of benzodiazepines

AIM:To observe the effects of propranolol on the withdrawal symptoms and successful rate during the withdrawal of benzodiazepines in patients with insomnia treated with benzodiazepines.METHODS: Sixty-nine patients with insomnia treated with benzodiazepines were randomly assigned to two groups:one group (propranolol withdrawal group,n=33) was added with propranolol 30 mg·d~(-1) while patients were gradually withdrew from benzodiazepines and the other group was natural withdrawal group.A quarter of daily dose was reduced each week,the time from full dosage to total discontinuation was 4 wk.At 0,1,2,4,and 6 wk, the patients were assessed by Athens insomnia scale,and the withdrawal symptoms were recorded.RESULTS: Compared with natural withdrawal group,the frequency of withdrawal symptoms of akathisia,palpitation,and tremors decreased significantly in propranolol withdrawal group (P<0.05).Other withdrawal symptoms such as insomnia,dizziness,headache,loss of appetite,nausea,etc,were no significant difference (P>0.05).The discontinuation rate of benzodiazepines was higher in propranolol withdrawal group (61%) than that in natural withdrawal group (36%,P<0.05).CONCLUSION:Propranolol can be used during the time of benzodiazepines withdrawal to reduce some withdrawal symptoms and enhance the discontinuation rate of benzodiazepines.