Placebo-Controlled Study of Gabapentin Treatment of Panic Disorder

Abstract

A randomized, double-blind, placebo-controlled, parallel-group study was conducted to evaluate the efficacy and safety of gabapentin in relieving the symptoms of panic disorder. One hundred three patients were randomly assigned to receive double-blind treatment with either gabapentin (dosed flexibly between 600 and 3,600 mg/day) or placebo for 8 weeks. No overall drug/placebo difference was observed in scores on the Panic and Agoraphobia Scale (PAS) (p = 0.606). A post hoc analysis was used to evaluate the more severely ill patients as defined by the primary outcome measure (PAS score > or = 20). In this population, the gabapentin-treated patients showed significant improvement in the PAS change score (p = 0.04). In patients with a PAS score of 20 or greater, women showed a greater response than men regardless of treatment. Adverse events were consistent with the known side effect profile of gabapentin and included somnolence, headache, and dizziness. One patient experienced a serious adverse event during the study. No deaths were reported. The results of this study suggest that gabapentin may have anxiolytic effects in more severely ill patients with panic disorder.

Residual symptoms and recurrence during maintenance treatment of late-life depression

“…Future studies need to test pharmacological approaches beyond higher-dose SSRIs, including augmentation with GABAergic agents that have some controlled data to support their efficacy in anxiety disorders, such as clonazepam (Davidson and Moroz, 1998) or anticonvulsants like gabapentin (Pande et al, 1999;Pande et al, 2000), pregabalin (Rickels et al, 2005), and lamotrigine (Hertzberg et al, 1999).…”

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

“…Because of the small sample size, evidence can only be seen as preliminary (C1). Á In a DBPC study, the anticonvulsant gabapentin was only superior to placebo in more severely ill panic patients (Pande et al 2000) (E). Á In panic disorder, buspirone was not superior to placebo (Sheehan et al 1990(Sheehan et al , 1993 and less effective than imipramine (Sheehan et al 1990), clorazepate (Schweizer and Rickels 1988) and alprazolam (Sheehan et al 1993) (E).…”

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