惊恐障碍的难治性
一种简单、基于测量的方法可以补充难治型惊恐障碍临床指南内容。惊恐障碍严重程度量表(PDSS，见下表)，惊恐障碍临床试验的一种常见使用结果，也是一种优异的、临床常见使用的量表[3]。该量表是一个简短的临床等级量表，包括7个条目（每一项评分从0到4），分别对不同的惊恐障碍症状范围进行抽样评估。在临床实验中，PDSS总分低于4分（包括4分）通常认为症状缓解，但通常PDSS基线总得分降低50%才会认为出现临床症状改善。
PDSS惊恐障碍严重程度量表
预后影响
慢性和持续性疾病很有可能增加患上其他并发症的概率，包括后遗症，如广场恐惧症、重度抑郁、其他焦虑障碍、药物滥用以及增加自杀的风险；社会功能受损，如生活质量降低、失业或待业以及与社会隔离。此外，难治型惊恐障碍患者患上慢性免疫疾病或躯体疾病的风险性很高，如心血管和神经退行性疾病。
下一步药物选择
2、使用另一种抗抑郁药物。
苯二氮卓类药物与SSRIs、SNRIs和TCAs药物相比，前者具有长期耐受性，因为其不会导致体重增加或性功能障碍。一般来说，高药效、短半衰期的苯二氮卓类药物更可取，因为它们的药物代谢更好预测，代谢机制更简单。常规剂量(vs. PRN)就可达到最佳的抗焦虑效果。获取更多有关剂量和药物使用的详细信息，请见表2。
6、其他干预措施。
结论
参考文献：
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