anticonvulsants for the treatment of social phobia? - Social Anxiety Forum
 
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post #1 of 19 (permalink) Old 07-15-2009, 04:39 AM Thread Starter
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anticonvulsants for the treatment of social phobia?


I'm curious if anybody has ever had any success with an anticonvulsant in the treatment of social phobia, in particular Neurontin (Gabapentin) or Pregabalin?
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post #2 of 19 (permalink) Old 07-15-2009, 04:58 AM
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I was on Gabitril for it, not sure if that's the same thing but its usually used for epilepsy?

Didn't help though!
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post #3 of 19 (permalink) Old 07-15-2009, 05:25 AM
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I think it's becoming more widely used. In the UK I've heard that Pregabalin has been recently licensed for Generalized Anxiety Disorder. I haven't tried it myself since my doctor won't prescribe it but I hear it has been useful for some people. Basically it's comparable to benzos without the addiction.
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post #4 of 19 (permalink) Old 07-15-2009, 05:53 AM
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Quote:
Originally Posted by Aleforge View Post
I was on Gabitril for it, not sure if that's the same thing but its usually used for epilepsy?

Didn't help though!
Gabitril (Tiagabine) is usually used as an anticonvulsant, but is sometimes prescribed off-label for anxiety in low doses. It inhibits the reuptake of GABA and therefore raises brain GABA levels (pretty much like an SSRI does with serotonin). Neurontin and Lyrica are also anticonvulsants used in the treatment of anxiety disorders, but they have an other mechanism of action.

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post #5 of 19 (permalink) Old 07-15-2009, 07:03 AM
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Thanks for the info Medline, I wasn't sure guess I was kinda on the right track.
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post #6 of 19 (permalink) Old 07-15-2009, 07:25 AM
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i've seen it given out for anxiety (though i haven't seen SA or just anxiety on the list of off-label uses...) but i've never read of a situation where it helped significantly.

if someone's SA/anxiety is as a result of depression, or if it's worsened at least when depressed, an anti-convulsant could help in those situations when it stabilizes that person's mood and alleviates the depression. though that's kind of obvious.

when i last saw my pdoc a few days ago he said when some with bipolar and SA have their depression treated successfully with a mood stabilizer(s), sometimes their SA is better even between episodes. so maybe they can help *shrugs*
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post #7 of 19 (permalink) Old 07-15-2009, 08:00 AM
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Anticonvulsants / antiepileptics some of which are used as mood stabilizers (often off-label) can help patients with anxiety disorders also when they have no depression or bipolar disorder.

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post #8 of 19 (permalink) Old 07-15-2009, 09:08 AM
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I've tried up to 1500mg gabapentin before, and was still unable to notice any psychoactive effects. Levetiracetam (Keppra) was just as useless in my experience, though it at least isn't a sugar pill since I was constantly somnolent on it and developed flu-like symptoms.

They may however be somewhat useful for treating physical manifestations of anxiety.
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post #9 of 19 (permalink) Old 07-15-2009, 09:19 AM
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One has also to consider that there exist very much anticonvulsants now, so the drug companies are always trying to find new ways of marketing them, not just for epilepsy - exactly like it happened with the atypical antipsychotics... if you see your dead grandfather walking - take Zyprexa, you have bipolar disorder - take Zyprexa, borderline syndrome -> take Zyprexa; a Headache, Acne, your boss was unfriendly and your favorite football team lost -->> take Zyprexa... you are fat, have diabetes and a irreversible movement disorder -> take... a deep breath and realize that you're f****ed up!!!

I don't consider anticonvulsants as dangerous as (atypical) antipsychotics - especially in the long term - my point is that the market for antiepileptics is pretty much supersaturated and the drug companies are now trying to find other uses for these drugs to make more money.

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post #10 of 19 (permalink) Old 07-15-2009, 11:08 AM
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Are there no real clinical trials showing a benefit to anxiety sufferers? Blows my mind how easily they can market different drugs for so many different things without concrete studies to back it up.

So it goes
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post #11 of 19 (permalink) Old 07-15-2009, 11:43 AM
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Quote:
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Are there no real clinical trials showing a benefit to anxiety sufferers? Blows my mind how easily they can market different drugs for so many different things without concrete studies to back it up.

So it goes
There exist clinical trials showing benefits for anxiety sufferers, at least for Lyrica (pregabalin) the (published) data is good. But mostly those drugs are used off-label. When a drug is FDA approved for treating a specific disease the manufacturer can not make claims (with heavy marketing) that the medication can be used to treat other diseases too just like that - if he does he could lose 100 millions of dollars to the FDA.

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post #12 of 19 (permalink) Old 07-15-2009, 11:56 AM
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klonopin is a anti convulsant as well as all the benzos have anti convulsant properties. yea I think they have good potential. lamictal helps mine. it perks me up and allows me to talk more, therefore i have more confidence.

chea
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post #13 of 19 (permalink) Old 07-15-2009, 12:08 PM
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Benzos and Barbiturates are of course anticonvulsants and powerful anxiolytics, but I think jim_morrison meant the subclass of mood stabilizers (on & off-label). Klonopin has (some) mood stabilizing action but not benzos in general.

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post #14 of 19 (permalink) Old 07-15-2009, 02:51 PM
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Depakote made me very social (/compliant) for about a month, then its effects just went away and I was left with the insatiable appetite and hypersensitive teeth.

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post #15 of 19 (permalink) Old 07-15-2009, 03:20 PM
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Gabapentin and pregabalin develop tolerance to the good effects within days (for me), just leaving a depressing anticonvulsant effect. Presumably, this is the loss of increased GABA synthesis these two initially give.

I've never tried the other anticonvulsants, but I doubt any of them would be a particularly good idea for anxiety unless you are on cholinergics for the cognitive/memory effects (I'm assuming most impair cognition here). Meh, if I'm going down that route, I'd just choose benzos.


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post #16 of 19 (permalink) Old 07-15-2009, 08:38 PM Thread Starter
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Quote:
Originally Posted by Medline View Post
Benzos and Barbiturates are of course anticonvulsants and powerful anxiolytics, but I think jim_morrison meant the subclass of mood stabilizers (on & off-label). Klonopin has (some) mood stabilizing action but not benzos in general.
Yeah I was curious about Lyrica and Neurontin in particular because I've heard that they increase neuronal GABA levels, and now since Lyrica has been approved for GAD in the EU.

Hmm I wasn't aware that Klonopin had mood stabilizing effects, but now that you mention it, I do notice that it does help stabilize my mood when I take it, interesting.
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post #17 of 19 (permalink) Old 07-16-2009, 07:20 PM Thread Starter
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Quote:
Originally Posted by RockiNToM View Post
I think it's becoming more widely used. In the UK I've heard that Pregabalin has been recently licensed for Generalized Anxiety Disorder. I haven't tried it myself since my doctor won't prescribe it but I hear it has been useful for some people. Basically it's comparable to benzos without the addiction.
yeah, I'm kinda curious if Lyrica would be just as effective as a benzo, without the chance of addiction.
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post #18 of 19 (permalink) Old 01-04-2014, 12:44 AM
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post #19 of 19 (permalink) Old 01-04-2014, 02:31 AM
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Quote:
Originally Posted by RockiNToM View Post
I think it's becoming more widely used. In the UK I've heard that Pregabalin has been recently licensed for Generalized Anxiety Disorder. I haven't tried it myself since my doctor won't prescribe it but I hear it has been useful for some people. Basically it's comparable to benzos without the addiction.
I think that last sentence is debatable. Tolerance to Pregabalin definitely occurs and some anecdotal reports suggest abuse and addiction could be an issue for some.

Lots of potential side-effects with lyrica/pregabalin too, some of them serious. I'm not saying it is a bad medication, just that it should be treated with caution as it is still relatively new.

Personally I think I would rather take my chances with a benzo before moving on to anticonvulsants.
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