度洛西汀治疗广泛性焦虑研究解读2012-8-26.ppt

PURPOSE OF THE SLIDE Provide information on dosing for GAD during the acute and maintenance phases. SPEAKER DIRECTION Dosing information for GAD The starting dose for the treatment of GAD in the acute phase is 60 mg/day.? The target dose for the treatment of GAD in the acute phase is 60 mg/day. The maximum dose for the treatment of GAD in the acute phase is 120 mg/day. For some patients, it may be desirable to start at 30 mg once daily for 1 week, to allow patients to adjust to the medication before increasing to 60 mg once daily. For patients started at a lower dose, the recommended dose of 60 mg/day should be achieved as soon as possible. Doses up to 120 mg/day are approved for the acute treatment of GAD. While a 120 mg/day dose was shown to be effective, there is no evidence that doses greater than 60 mg/day confer any additional benefits, and some adverse reactions were observed to be dose dependent. Nevertheless, if a decision is made to increase the dose beyond 60 mg/day, dose increases should be in increments of 30 mg/day. The safety of doses above 120 mg/day has not been adequately evaluated. The target dose for the treatment of GAD in the maintenance phase is 60 mg/day. The maximum dose for the treatment of GAD in the maintenance phase is 120 mg/day. Patients should be periodically reassessed to determine the need for maintenance treatment and the appropriate dose for such treatment. The physician who elects to use Cymbalta for extended periods should periodically evaluate the long-term usefulness of the drug for the individual patient. BACKGROUND For additional background information, please see the reference listed below. REFERENCE Cymbalta (duloxetine hydrochloride) Full Prescribing Information. Indianapolis, Indiana: Eli Lilly and Company; 2010. * * 关键点 汉密尔顿焦虑量表（HAMA）是一种14-项测试，用来测定焦虑症状的严重程度。它也被称作汉密尔顿焦虑评定量表（HARS）5。 HAMA 是Max Hamilton在1959年研发的，用来评定精神性焦虑和躯体性焦虑的总体情况。它被用作评定焦虑症状的严重程度、抗焦虑药物（包括心理治疗或药物治疗）的作用，以及评价精神药物对于焦虑的作用5。 HAMA有效率评定主要基于总分。有效被定义为自基线至终