得了焦虑症该怎样治疗

得了焦虑症该如何治疗配图，仅供参考

PHARMACOLOGICAL THERAPY
Numerous neurotransmitters play a role in normal states and in pathological anxiety states. Each of these systems is a potential target for pharmacological intervention,but relatively few classes of medications are used in clinical practice for the treatment of anxiety. These drug classes are briefly discussed next.
# Selective Serotonin Reuptake Inhibitors
SSRIs,usually indicated in depression,are considered to be the first line of therapy for anxiety disorders. This drug class includes fluoxetine (Prozac,Eli Lilly),sertraline (Zoloft,Pfizer),citalopram (Celexa,Forest),escitalopram (Lexapro,Forest),fluvoxamine (Luvox,Solvay),paroxetine (Paxil,GlaxoSmithKline),and vilazodone (Viibryd,Forest). The essential characteristic of the medications in this class is that they inhibit the serotonin transporter and appear to cause desensitization of postsynaptic serotonin receptors,thus normalizing the activity of serotonergic pathways.
The mechanism by which this leads to amelioration of anxiety symptoms is not fully understood. Vilazodone,the most recently approved medication in this class (although indicated for major depressive disorder),also acts as a partial agonist at the serotonin-1a receptor,which may contribute to anxiolysis. Buspirone (BuSpar,Bristol-Myers Squibb),which is not a serotonin reuptake inhibitor (SRI),is also a 5-HT1a agonist and is frequently used as a single agent or as augmentation to SSRI therapy.
# Serotonin–Norepinephrine Reuptake Inhibitors
SNRIs,which inhibit the serotonin and norepinephrine transporters,include venlafaxine,desvenlafaxine (Pristiq,Pfizer),and duloxetine. Milnacipran (Savella,Cypress/Forest) is rarely,if ever,used to treat anxiety because its only FDA-approved indication is for fibromyalgia. SNRIs are typically used after failure or inadequate response to an SSRI. They are used in place of augmentation to SSRIs because the combination of these two drug classes may result in serotonin syndrome.
Patient responses to SNRIs can vary widely; some patients may experience an exacerbation of the physiological symptoms of anxiety as a result of the increased norepinephrine-mediated signaling caused by inhibition of the norepinephrine transporter. For patients who do not experience this effect,the increased noradrenergic tonus may contribute to the anxiolytic efficacy of these medications.
# Benzodiazepines
Although benzodiazepines were widely used in the past to treat anxiety conditions,they are no longer considered to be first-line therapies because of the risks associated with their chronic use. They are very effective in reducing acute anxiety but are associated with problematic adverse effects when used for a long time in high doses,including:
physiological and psychological dependence.
potential fatalities upon withdrawal.
impaired cognition and coordination.
a potentially lethal overdose when they are mixed with alcohol or opioids.
inhibition of memory encoding,which can interfere with the efficacy of concomitant psychotherapy.
For these reasons,the use of benzodiazepines is often restricted to the short-term treatment of acute anxiety or as therapy for refractory anxiety after failed trials of several other drugs. Of note,some subgroups of patients do well with low doses of benzodiazepines and are able to safely taper from high doses,especially when cognitive–behavioral therapy (CBT) is added.
Because of the side effects of benzodiazepines,antiepileptic agents have been used more extensively for the treatment of anxiety. Antiseizure drugs were initially used for mood stabilization in mood disorders; however,their anxiolytic properties were quickly noted. Many agents in this drug class are being used in an off-label fashion to treat anxiety,especially gabapentin (Neurontin,Pfizer) and pregabalin (Lyrica,Pfizer). Less information is available for topiramate (Topamax,Janssen),lamotrigine (Lamictal,GlaxoSmithKline),and valproate (Depacon,Abbott). In higher doses,the antiseizure class can produce adverse effects similar to those of the benzodiazepines.
All tricyclic antidepressants (TCAs) function as norepinephrine reuptake inhibitors,and several mediate serotonin reuptake inhibition as well. Although several medications in this drug class are comparable in efficacy to the SSRIs or SNRIs for anxiety disorders,TCAs carry a greater number of adverse effects and are potentially lethal in an overdose. For this reason,TCAs are rarely used in the treatment of anxiety disorders. A notable exception is clomipramine (Anafranil,Malinckrodt),which may be more efficacious than SSRIs or SNRIs in patients with OCD.
Hydroxyzine (Atarax,Pfizer),mirtazapine (Remeron,Organon),nefazodone (Bristol-Myers Squibb),and atypical neuroleptic agents are commonly used to treat anxiety. Although all of these medications are efficacious for anxiety disorders,especially OCD,they are not considered first-line treatments and are typically used as an adjunct to an SSRI or an SNRI. Hydroxyzine is indicated for anxiety and probably achieves anxiolysis by inhibiting the histamine H1 receptor and the serotonin-2a receptor.","department":"