|
The MGH Psychiatry Academy needs to stipulate that, though clinically informed, the statement below is anecdotal, reflecting the judgment and opinion of the contributing author.
Searching for pharmacological compounds that are non-addicting, atypical antipsychotics, b-blockers, a1-adrenergic antagonists, tricyclic antidepressants, buspirone, and triiodothyronine have been used in combination with SSRIs to treat various anxiety disorders.(1) Mood stabilizers, specifically anticonvulsants have also been used alone or in combination with SSRIs. Gabapentin has been effective in the treatment of panic disorder (2), social anxiety disorder (3) and refractory GAD (1), acting as a calcium ion channel antagonist and possibly enhancing g-aminobutyric acid (GABA) synthesis.(4) Gabapentin has also been found useful in individuals with civilian or combat-related PTSD, improving sleep duration, nightmare frequency and severity, and intrusive recollections.(5)
(1) Pollack MH, Otto, MW, et al. 2008. Novel treatment approaches for refractory anxiety disorders. Depression and Anxiety 25:467–476.
(2) Pande AC, Pollack MH, Crockatt J, et al. 2000. Placebo-controlled study of gabapentin treatment of panic disorder. J Clin Psychopharmacol. 20:467-471.
(3) Pande AC, Davidson JRT, Jefferson JW, Janney CA, Katzelnick DJ, Weisler RH, Greist JH, Sutherland SM. 1999. Treatment of social phobia with gabapentin: a placebo-controlled study. J Clin Psychopharmacol 19:341–348.
(4) Pollack MH, Matthews J, Scott EL. 1998. Gabapentin as a potential treatment for anxiety disorders. Am J Psychiatry 155:992–993.
(5) Brannon N, Labbate L, Huber M. 2000. Gabapentin treatment for posttraumatic stress disorder. Can J Psychiatry 45:84.
John A. Fromson, M.D.
Associate Director of Postgraduate Medical Education
Department of Psychiatry
Massachusetts General Hospital
Assistant Clinical Professor of Psychiatry
Harvard Medical School
|
