Treatment of Social Phobia With Gabapentin

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 social phobia. Sixty-nine patients were randomly assigned to receive double-blind treatment with either gabapentin (dosed flexibly between 900 and 3,600 mg daily in three divided doses) or placebo for 14 weeks. A significant reduction (p < 0.05) in the symptoms of social phobia was observed among patients on gabapentin compared with those on placebo as evaluated by clinician- and patient-rated scales. Results were similar for the intent-to-treat and week-2 completer populations. Adverse events were consistent with the known side effect profile of gabapentin. Dizziness (p = 0.05), dry mouth (p = 0.05), somnolence, nausea, flatulence, and decreased libido occurred at a higher frequency among patients receiving gabapentin than among those receiving placebo. No serious adverse events or deaths were reported. On the basis of these limited data, it seems that gabapentin offers a favorable risk-benefit ratio for the treatment of patients with social phobia. Further studies are required to confirm this effect and to determine whether a dose-response relationship exists.

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

“…shown to be effective in SAD in DBPC studies (Pande et al 1999(Pande et al , 2004. In an unpublished study, pregabalin was not effective in SAD.…”

“…In comparator studies, it was more effective than placebo and as effective as pregabalin (Montgomery et al 2006b) and duloxetine (Hartford et al 2007;Nicolini et al 2008). In a further comparator study, it was more effective than buspirone (Davidson et al 1999); however, scores were only significantly lower for HAM-A psychic anxiety factor, anxious mood, and tension, but not for HAM-A total and CGI for venlafaxinetreated patients than for placebo-treated patients. In a study with diazepam as active control, the benzodiazepine was significantly superior to placebo, but neither dose of venlafaxine-XR was different from placebo on HAM-A total score (Hackett et al 2003).…”

“…Buspirone was superior to placebo in some studies (Davidson et al 1999;Enkelmann 1991;Pollack et al 1997) and as effective as benzodiazepines (Feighner et al 1982;Jacobson et al 1985;Rickels et al 1982;Ross and Matas 1987;Strand et al 1990). However, it was less effective than venlafaxine (Davidson et al 1999) or hydroxyzine (Lader and Scotto 1998). Experience in long-term treatment was gained in a 24-week comparison of buspirone with abecarnil, a drug that has not been marketed due to its side-effect profile …”

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

“…40 -42 For example, in a study of patients with social phobia, those treated with gabapentin (n ϭ 34) showed a significantly greater reduction in scores on the Liebowitz Social Anxiety Scale compared with placebo recipients (n ϭ 35; p ϭ 0.008). 40 Animal studies and several small, uncontrolled clinical trials show that gabapentin may reduce alcohol withdrawal symptoms. In a comparison with phenobarbital, the severity of alcohol withdrawal craving decreased at similar rates in both treatment groups.…”

Psychiatric Uses of Newer Anticonvulsants

“…14 Apart from its use in bipolar disorder, gabapentin has been used in patients with anxiety, panic disorder, social phobia, aggressive behavior, and posttraumatic stress disorder (PTSD). [15][16][17][18][19][20][21] Gabapentin has also been used in treating obsessive-compulsive disorder. 15,22,23 Other areas of clinical use have been in the treatment of substance abuse disorders [24][25][26][27] and in the treatment of agitation and disruptive behavior in Alzheimer's disease.…”