Abstract：
Recommendations for treating panic disorder (PD) in older patients are scarce. The authors have systematically reviewed whether several recommended medications are superior to others and their optimal doses in this age group.
A database search of studies involving patients with PD with/without agoraphobia aged ≥ 60 years was carried out using PubMed, PsycINFO, Embase, and Clinical Trials.gov, from their inception dates to 1 March 2023. Only four (published from 2002 to 2010) of the 1292 records screened were included. A risk of bias assessment was provided. This systematic review was performed using The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA).
Two studies were randomized clinical trials, whereas two were open-label, including paroxetine, citalopram, escitalopram, and sertraline; three studies reported short-term evaluations, whereas one study included a 26-week follow-up. Medications provided benefits, with good tolerability. Preliminary results suggested greater benefits of paroxetine in reducing panic attacks vs. cognitive - behavioral therapy, and an earlier decrease in PAs with escitalopram vs. citalopram. Risk of bias was considerable.
The pharmacological management of PD in older patients has received no attention. Findings are scant, dated, and affected by methodological flaws; thus, they do not provide significant advances.
A database search of studies involving patients with PD with/without agoraphobia aged ≥ 60 years was carried out using PubMed, PsycINFO, Embase, and Clinical Trials.gov, from their inception dates to 1 March 2023. Only four (published from 2002 to 2010) of the 1292 records screened were included. A risk of bias assessment was provided. This systematic review was performed using The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA).
Two studies were randomized clinical trials, whereas two were open-label, including paroxetine, citalopram, escitalopram, and sertraline; three studies reported short-term evaluations, whereas one study included a 26-week follow-up. Medications provided benefits, with good tolerability. Preliminary results suggested greater benefits of paroxetine in reducing panic attacks vs. cognitive - behavioral therapy, and an earlier decrease in PAs with escitalopram vs. citalopram. Risk of bias was considerable.
The pharmacological management of PD in older patients has received no attention. Findings are scant, dated, and affected by methodological flaws; thus, they do not provide significant advances.
摘要：
■治疗老年患者惊恐障碍（PD）的建议很少。作者已经系统地回顾了几种推荐的药物是否优于其他药物以及该年龄组的最佳剂量。
■使用PubMed对涉及患有/没有年龄≥60岁广场恐怖症的PD患者的研究进行了数据库搜索，PsycINFO,Embase,和临床试验.gov,从成立日期到2023年3月1日。在筛选的1292条记录中，仅包括4条（从2002年到2010年发布）。提供了偏见风险评估。本系统评价使用系统评价和荟萃分析的首选报告项目(PRISMA)进行。
■两项研究是随机临床试验，而两个是开放标签，包括帕罗西汀,西酞普兰,艾司西酞普兰,和舍曲林；三项研究报告了短期评估，而一项研究包括26周的随访。药物提供了好处，具有良好的耐受性。初步结果表明，帕罗西汀在减少惊恐发作方面的益处更大。认知行为疗法，艾司西酞普兰与西酞普兰.偏见的风险是相当大的。
■老年患者PD的药物管理尚未受到重视。调查结果很少，日期,并受到方法论缺陷的影响；因此，他们没有提供重大进展。
■使用PubMed对涉及患有/没有年龄≥60岁广场恐怖症的PD患者的研究进行了数据库搜索，PsycINFO,Embase,和临床试验.gov,从成立日期到2023年3月1日。在筛选的1292条记录中，仅包括4条（从2002年到2010年发布）。提供了偏见风险评估。本系统评价使用系统评价和荟萃分析的首选报告项目(PRISMA)进行。
■两项研究是随机临床试验，而两个是开放标签，包括帕罗西汀,西酞普兰,艾司西酞普兰,和舍曲林；三项研究报告了短期评估，而一项研究包括26周的随访。药物提供了好处，具有良好的耐受性。初步结果表明，帕罗西汀在减少惊恐发作方面的益处更大。认知行为疗法，艾司西酞普兰与西酞普兰.偏见的风险是相当大的。
■老年患者PD的药物管理尚未受到重视。调查结果很少，日期,并受到方法论缺陷的影响；因此，他们没有提供重大进展。
