# 一位服用alprazolam 0.5毫克口服每日三次達六個月的個案告訴護理師她今天想要停藥，因為她感覺好多了。哪一種回應最適當？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391723&lang=zh-tw  
> language: zh-TW  
> subject: Crisis Intervention  
> category: PSI

## 題目

一位服用alprazolam 0.5毫克口服每日三次達六個月的個案告訴護理師她今天想要停藥，因為她感覺好多了。哪一種回應最適當？

## 選項

1. 「一旦開始使用，這種藥就必須終身服用。」
2. 「不要完全停藥，改成需要時才服用。」
3. 「突然停藥可能造成戒斷性癲癇發作，因此醫師會逐步減量。」 **✔ 正確答案**
4. 「這是很好的進展；你今天可以停藥。」

**正確答案: 3**

## 解析

正確（3）：長期使用後驟然停用半衰期短的苯二氮平類藥物如alprazolam，可能誘發戒斷性癲癇、反彈性焦慮、自律神經不穩定及嚴重失眠。標準做法是依處方醫師指示緩慢減量（通常每週減少25%或更慢）。（1）不正確 — 規則服用六個月後驟然停藥是危險的。（2）不正確 — 不需終身用藥；透過適當減量可安全停藥。（4）不正確 — 改為需要時服用無法解決已建立的生理依賴，仍可能引發戒斷。

## 深入解析

Memory Tip: short-acting benzo + abrupt stop = seizure.

## 臨床情境

Scenario A 42-year-old female on alprazolam 0.5 mg PO TID for 6 months asks to stop today.

## 重要概念

- **Benzodiazepine dependence** — Physiologic adaptation to benzodiazepines after weeks to months of continuous use.
- **Discontinuation taper** — A structured dose reduction schedule used to safely discontinue long-term benzodiazepine therapy.
- **Rebound anxiety** — Return of anxiety symptoms more intense than baseline shortly after stopping a short-acting benzodiazepine.

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