Valproic acid for the treatment of social anxiety disorder
ABSTRACT The aim of the study was to examine the efficacy of valproic acid in participants with social anxiety disorder. Following a 2-week single-blind, placebo run-in period, 17 participants were enrolled in a 12-week open flexible-dose trial of valproic acid (500-2500 mg). The primary outcome measures were the mean change from baseline in the Liebowitz Social Anxiety Scale (LSAS) total score and responder status [defined as a Clinical Global Impression of Improvement score (CGI-I) < or =2]. Social anxiety symptoms as measured by the LSAS and CGI-I scores significantly improved with treatment. The mean reduction in the LSAS was 21.3 points in the last visit carried forward analysis and 19.1 points for the completer analysis, with 41.1% and 46.6% participants, respectively, achieving responder status. The results from this open-label trial suggest the potential efficacy of valproic acid for the treatment of social anxiety disorder. Placebo-controlled trials are indicated to confirm these findings.
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ABSTRACT: INTRODUCTION Anxiety disorders are chronic conditions that may require long-term drug treatments. Antidepressants represent the current gold standard but they fail in up to one-third of patients. Moreover, benzodiazepines, currently used in the acute treatment, are limited by the high risk of tolerance, dependence, and abuse. OBJECTIVES This paper is aimed at reviewing international literature on the use of anticonvulsant drugs in anxiety disorders. METHODS References were identified by searches of Medline/PubMed and PsychINFO. Only papers published in English were reviewed. RESULTS Despite a considerable number of open studies and anecdotal reports, the number of controlled studies is scanty. The majority of publications have several methodological limitations including inadequate sample size; lack of placebo control; the use of different outcome measures; and lack of controlling for patient variables such as comorbidity, diagnostic subtype, and concomitant medications. Pregabalin is the only anticonvulsant with good evidence in generalized anxiety disorder. Pregabalin and gabapentin may be promising in social phobia but further controlled studies are needed. A number of compounds are still at an early stage of evidence and may deserve further controlled trials: topiramate in posttraumatic stress disorder and obsessive compulsive disorder, valproate and gabapentin in panic disorder. CONCLUSION Anticonvulsant drugs may be valuable options in some selected patients with difficult to treat anxiety disorders refractory to first-line agents. Further studies are warranted to identify specific clinical phenotypes where anticonvulsants may be successfully used in the acute and long-term treatment of anxiety disorders.
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ABSTRACT: Anxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated.BMC Psychiatry 07/2014; 14(Suppl 1):S1. DOI:10.1186/1471-244X-14-S1-S1 · 2.24 Impact Factor
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ABSTRACT: Abstract Symptoms of anxiety are common in patients with depression. In this retrospective case series we investigated the effect of Pregabalin as an add-on medication in unipolar depressed patients with high levels of anxiety. The therapeutic effect of Pregabalin showed a fast onset and was comparable to the anxiolytic effect of benzodiazepines.Psychiatry Research 01/2014; 215(1-1):246 - 248. DOI:10.1016/j.psychres.2013.10.007 · 2.68 Impact Factor