äᾹԤä辺ͧءԹ äѧդ ͧҡѡɳҡâͧäẺҧ¡ä蹵˹ҧҨ ¡ä ҷŧ㨔 ¹¡ äᾹԤ ѾͶ֧äҡ
ʺѺҡᾹԤ鹨Ẻѹ Դ˹ ҡѡ繷ккҧԹ ֡ç ִѴ ˹͡ ѹ 繵 ͡ҡѧҡ ¹ ͧ蹻ǹ ҡҹԴ鹷ʺҡԴҵͧе ä ҧҵͧ繺ʵ ҡõҧѡԴ鹷ѹФعç樹ҳ 10 ҷ Ф˹Ǥŧ ҡѡ㹤觪֧˹觪 ѧҡҡᾹԤѡ֡㹪ǧҡѡԴ ѧҨա
ôԹäҡѺѡҡᾹԤдԹäеҧ ӴѺѧ
з 1 ԴҡᾹԤ
2 ԴҡᾹԤ ѡǡѧҨ繫 öҴǧ˹ҨԴᾹԤա (unexpected)
з 3 ҵͧäçҧҧᾷǨ辺ҡ äʹ ä ҵ ҷӧҹѡǹ¹ᾷǨѹ
4 ա§ʶҹʶҹó觼֡Ҩ ԴҡᾹԤ ˹(Agoraphobia)
з 5 դա§ҡ
6 Դ Ҩ֧ä 繼ŨҡҡᾹԤ ҹҹ ѧҺ˵ öµͧ ҧç Դ֡Դѧµͤͺ ҧҨѹ仾;ҵǵ
ҡᾹԤԴ ˹ФҴҡ ǹҡѡ ˵§Ѻ˵ءóǴԴҡ ԴҡᾹԤԹ ҧþԹ ¡§ҡ÷ԴѺʶҹоա§ʶҹ Դҡա§Դҡ֡ҵöǺ ҡ ҧҡ͡˹褹СҶ Դҡâաê·ѹ ¡ҡáǹ Agoraphobia
ҧҨ˵ءе鹨ԧ ͡ѧ˹ѡ ʹͧäչ ( Ѵ ѡäǴù) ʾԴ ֧ 㹡óẺա§觡еҹ ͡ҡäҧ ä е´繾 ҡáᾹԤ ѧ觴ǹػäᾹԤ· óչѺõǨᾷ¡˵طҧáе鹵ҧ СѡҨеҧҡäᾹԤ
Դҡüǹҡ ѡպçҺἹءԹἹääҧԹ ҡʴʺ ᾷѡǨҧ»Դ ֧õǨ Ǩ俿(EKG) Ǩŵҫǹ (Echocardiogram) ͵Ǩ硫ʹ ѡҡ÷ӧҹͧлʹѧԴ ҧѺӵͺͧҡ÷ʺ ԴҡաçҺѡӵͺǡѹ ѧҡԴҡᾹԤѺõǨҧ͵Ǩе ѧ辺觼ԴԷҧҧ äᾹԤҨäʺҡõͧԨóл֡ҨԵᾷ Ѻѡҷ
äᾹԤ㹪ǧ »ҳ 15-24 աǧ¼˭ҳ 30 ˵آͧäᾹԤ繼ŷ駻Ѩ·ҧҾ Եоĵԡ¹
˵ ҧҾ äᾹԤäǢͧѺѹء ·ҡᾹԤع ѡխҵԻä ᾹԤҡҤ 2-4 ֡кҷӻҷ äᾹԤա÷ӧҹͧͻ norepinephrine(NE) ҡͧǹ locus ceruleus nucleus dz floor ͧ 4th ventricle ٧ NE Ԩռšекҧͧҧ·ӧҹҡ Ǣ ˧͡ҡ 繵
˵شҹԵ Ҽѡѧ༪ԭѺѧ
˵ ҧĵԡ¹ §˵ءóҡᾹԤ Դĵԡա§˵ءó ԴҡAgoraphobia
ѡäᾹԤԵᾷҷռšѺ NE ŴҡᾹԤ ѺôŷҧҹԵ ѡҡAgoraphobia
ŴҹԵ ѺԴҡ agoraphobia ͧӾĵԡӺѴҪ½֡ö͡ҡҹµͧ Ǻ仡ѺѡҴ ¼¨Ѻý֡¡ѺзҹҤ¡ѧ ֡ҳ 15-30 ҷ ͡ҡҹռ͡仴¨֧зҧش ҷ跹Ǿѡ зҧ鹷й·ءѹ ö͡ҡҹ
ͻѺŢͧ NE 㹡ѡáԵᾷ㹡benzodiazepine Alprazolam, Clonazepam ѺҴҡᾹԤҡâҧ§ءѻ쨹öǺҡ һѺһҳ 4-6 ѻ ШԵᾷФ㹢Ҵ٧ش鹵ա 4-8 ѻ Ǩ֧ Ŵŧ֧ҴشöǺҡ騹ú 6 ͻͧѹԴҡáԺ ҡ繪ǧŴҨ 4-8ѻ ҨԴҡ 觷ҡöŵͧͧͧء Թͩմҷء benzodiazepine §ҧҹҹ㹼ä ᾹԤԴõԴʹ
ҵҹѡ ѺŴҴҤ¡Ѻҡ benzodiazepine 袹Ҵ㹡ѡäᾹԤ鹨й¡ä Ҩҡ Tricyclic antidepressants Amitriptyline, Nortriptyline, Imipramine ֧ѧ㹪ǧŴҡҡŴҧǴҨԴҡáѧ ǹ Ѻ Ҩҵҹҡ SSRIs( Sertraline,Citralopam, Paroxetine, Fluoxetine ) ҡҨԴҡâͧäŧ㹪ǧѻá Fluoxetine Ǵҡ Tricyclic Antidepressants
ػäᾹԤԴҡᾹԤͧ ˵ءе Ҵ١ Դҡ ҵͧѧè蹵˹عç ҡᾹԤѹ Դҡʺҹ ҡѺûԹҧ辺Դ äᾹԤաä֧ͧ֡ Сѡ¨ԵᾷЪҡôբҧ
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