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Etifoxine Versus Alprazolam for the
Treatment of Adjustment Disorder with
Anxiety: a Randomized Controlled TrialStein, Dan J*
Oleh: Yuzana Tiarasia, S.Ked
Pembimbing: dr. Sheno Almes
SMF/ Bagian Ilmu Kesehaan !i"a
FKIK #$IB % &SK! Soe'ra'o Beng(ulu
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Etifoxine) *eri+a benzoazinee-e( aniansieas
ani(on+ulsan dengan e-e( sedai- ringan
) 0i-oine se1ara langsung s'esi-i( berinera(si dgn(anal (lorida 'd (om'le( rese'or 2ABAAmenginhibisi ransmisi sina'i( 2ABAergi1
) 0-e( a( langsung: be(er3a 'd rese'or
benzodiaze'in 'eri-erme neuroseroid oa(dengan e-e( aniansieas
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) 4igand 'roein ranslo(aormenurun(an a(i+iasma(ro-ag 'eradangan seelah 1edera sara-
merangsang regrowth a(son) Tida( men5ebab(an (eerganungan withdrawal
) 0-e( sam'ing:6 SSP, e-e( (anu( ringan
6 &ea(si alergi: ruam (uli, angioedema, uri(aria
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) T 7 8 3am dengan 9ma di dalam darah ; 3am
) *osis
6 Oral: 1a's
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Alprazolam)Aniansieas golongan benzodiaze'in
) Me(anisme (er3a: 'oensiasi inhibisi neuron dengan
2ABA sebagai mediaorn5abe(er3amem'erlamba 'er'indahan za (imia di oa( 5angmung(in men3adi ida( seimbang
) Indi(asi: gangguan ansieas, gangguan 'ani(
ansieas a(iba de'resi
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) Konraindi(asi: (ehamilan, alergi, asma, glau(oma,'en5a(i li+er/ gin3al, (onsumsi al(ohol,
(eerganungan oba/al(ohol) 0-e( sam'ing:
6 *e'resi SSP(anu( aa(sia % !aundi1e
6 Mood de'resi, ide bunuh diri % Tremor
6 ?i'era(+ias, agiasi, halusinasi % Oliguria6 $5eri dada
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) *osis
Initial dose: =,< % =,< mg ; /hari @PO
*osis da'a diing(a(an beraha' seia' ;%> hari3i(a dibuuh(an da'a dioleransi
*osis 'emeliharaan: da'a diing(a(an sam'aidosis ma(s > mg dgn dosis erbagi
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AbstrakLatar belakang:
2angguan 'en5esuaian dengan ansieas @A*A
're+alensi inggi*aa mengenai 'redi(or res'on era'isedi(i
0i-oine sbg agen inso-ar 5g men3an3i(an d(
men5ebab(an (eerganungan(en5aaan:
'enggunaan benzodiaze'ine CC
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Abstrakdila(u(an u3i (onrol a1a( ei-oine +s al'razolam
'ada A*A -o(us 'ada e-i(asi dan (eamanan,
ermasu( in+esigasi 'redi(or res'on (linis
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Abstrak
Metode:#3i a1a( double blinded, multicenter (om'arai-
'ada (elom'o( 'aralel 'asien ra"a 3alan dgn
A*A.Kelom'o( 'erama: D minggu E D minggu seelah era'i
diberheni(an
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Abstrak) Primary outcome: diu(ur denganHamilton
Anxiety Rating Scale @?AMA
) Secondary outcome:Sheehan Disability Scale@S*S, the linical !lobal Impression"hange Scale#!I"$ % Sel& Report &or the Assesment o&Ad'ustment Disorder
)Analisis non"in&eriority: menilai Prim.ou1ome) &egresi logisi( muli+aria: 'redi(or res'on
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AbstrakHasil:
) = 'asien de"asa ra"a 3alan dengan A*A
dii(u(an dlm 'eneliian 'd D la5anan 'rimer.) D 'asien 5ang berhasil men5elesai(an
'eneliian @nGH ei-oine, nG= al'razolam
0i-oine Al'razolam: 'enurunan s(or
?AMA 'ada hari (eH dgn 'erbedaan s(orD.H @9I =J u( al'razolam.
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AbstrakSeelah era'i diheni(an, s(or ?AMA membai(
'ada (elom'o( ei-oine, ea'i me 'd
(elom'o( al'razolam) Perbedaan anar (elom'o( dalam 'erubahan reraa
anara hari (eH dan (e;
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Abstrak) 0-e( sam'ing er(ai era'i dila'or(an 'd 'asien5ang menda'a(an al'razolam @0S er(ai SSP,
eruama slh h/ diheni(an.) Tida( diemu(an 'redi(or res'on era'i 5gsigni-i(an
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AbstrakKesimpulan
) #3i (onrol a1a( mendu(ung e-i(asi (eamanan
ei-oine dlm 'enaala(sanaan A*A, eruama(ei(a h/ diheni(an.
) 0i-oine memili(i (eunungan dalam e-e( aniansieas an'a (eerganungan.
) Farma(oera'i 'd 'asien dengan ge3ala ansieasbera 3uga sama se1ara e-i(asi
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Introduction) 2angguan 'en5esuaian diandai dgn 'er(embangan
s1r (linis ge3ala emosi/ 'erila(u sbg res'on hd'
stressor) Pada *SM
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) 2angguan 'en5esuaian er(ai dengan morbidias erganggun5a (ualias hidu'
) Iner+ensi 9BT menun3u((an d( signi-i(an dalammengurangi "a(u sam'ai 'asien da'a (embali(er3a 3( dibanding(an dgn an'a h/
) Benzodiaze'ine sanga sering direse'(an mes(i'un
0S CC ermasu( dis-ungsi (ognii- risi(o 'oensial(eerganungan
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) 0i-oine:benzoazin, non ben(odia(epine
) Per1obaan sebelumn5a: ei-oine, bus'irone
loraze'ame-i(asi sama 'ada A*A. 0i-oinememili(i 0S minimal dlm (ognii- 'si(omoor, d(er(ai (eerganungan
) Ob3e(i- 'eneliian: membanding(an e-i(asi
(eamanan ei-oine dgn al'razolam, e+aluasi e-e((linis 'ersisen slh h/ berheni sera menenu(an'redi(or res'on -arma(oera'i
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Material & MethodsStudy design
) Peneliian 'ros'e(i- di A-ri(a Selaan, 5aiu u3i
a1a(, double blinded, multicenter % (om'arai-.) Parisi'asi D centresdi 9a'e To"n!ohannesburg
) $onin-eriori5 design: membanding(an ei-oinedengan agen anxiolytic5g sering diberi(an
dari'ada 'enggunaan 'lasebo) Perhaian uama 'ada (un3ungan slh h/ berheni
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) Penggunaan ?AMA u(primary outcome E'enenuan 'redi(or res'on h/
) Semua 'rosedur dila(u(an dengan sandar ei( dari(omie ei( sera 'emeri(sa sudah dila(u(an'elaihan (husus sebelumn5a
) Oba diberi D 1a's 'agi, siang malam @D
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Pasien
Krieria In(lusi
D.4a(ila(i aau 'erem'uan 'asien ra"a 3alan usia DH8< ahun 5ang ermasu( (edalam (rieria A*Aberdasar(an *SMI
.Tambahan:
s(or ?AMA L= @wor), &amily % social$" S*S L < hari (eH,pG=.=D hari (e;
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Discussion) Temuan uama 'eneliian mendu(ung al'razolam3i(a dibanding(an dgn ei-oine 'ada hari (e H.#3i non"in&eriority ei-oine d( d' diun3u((an'ada hari (eH.
) S(or ?AMA sedi(i mening(a 'd al'razolamseelah era'i diheni(anbeda signi-i(an
)0-e( sam'ing (elom'o( al'razolamCC) Tida( ada 'redi(or res'on era'i 5g signi-i(an
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)Al'razolam dalam A*A(onsisen6 0-i(asi dalam era'i 'd (ondisi ini
6 +nset o& action 1e'a
6 0-e(i- unu( ge3ala somai( ansieas
6 Poensial unu( (eerganungan
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) 0i-oine 'ada A*A 3uga (onsisen dalam:6 Indi(asi non"in&eriority unu( agen ini 3i(a
dibanding(an dengan bus'irone loraze'am
6 Peneliian sebelumn5a: &es'on 'erbai(an (linis lebih bai( dengan ei-oine
Tida( erda'a 'erbedaan (e1.onse
Ke(ambuhan ansieas lebih besar 'ada loraze'am
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)Al'razolam am'a( (onsisen men5ebab(an e-e(sam'ing emergensi er(ai era'i CCC
@er(ai SSPmes(i'un s1r saisi( d( signi-i(an,namun (onsisen dengan (onsensus hd' 0S (ognii- 'oensial (eerganungan
) Teruama 0S mun1ul saa h/ diheni(an.
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!onclusion) #3i (onrol a1a( mendu(ung e-i(asi (eamanan
ei-oine dlm 'enaala(sanaan A*A, eruama(ei(a h/ diheni(an.
) 0i-oine memili(i (eunungan dalam e-e( aniansieas an'a (eerganungan.
) 0-i(asi sama 'd 'asien dengan ge3ala ansieas bera@-arma(oera'i
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Terima(asih
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