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Antiepileptic Drugs in the Treatment of Anxiety Disorders

Role in Therapy

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Abstract

Pharmacotherapy for anxiety disorders is an active area of research. A variety of drug groups have been shown to be effective in treating many of the anxiety disorders, with selective serotonin reuptake inhibitors (SSRIs) being considered first-line agents for virtually all anxiety disorders. There is a clinical need for alternative drug treatments, as many patients do not achieve a complete response and experience significant adverse effects. The successful use of antiepileptic drugs in mood disorders has led clinicians and researchers to investigate their potential efficacy in other psychiatric disorders, particularly in anxiety disorders.

There have been a number of investigations conducted in the form of case reports, case series and open-label trials, suggesting the potential usefulness of antiepileptic drug treatment in a variety of anxiety disorders. More reliable evidence for the use of antiepileptic drugs in anxiety disorders can be gleaned from recent placebo-controlled trials. Thus far, the strongest placebo-controlled evidence has demonstrated the efficacy of pregabalin in treating social phobia and generalised anxiety disorder, while smaller or less robust controlled trials have suggested the potential efficacy of gabapentin in social phobia, lamotrigine in post-traumatic stress disorder, and valproic acid in panic disorder.

Antiepileptic drugs may have a place in the treatment of anxiety disorders; however, further investigation is warranted to determine in what circumstances they should be used as monotherapy or as augmenting agents in individuals who are partially or non-responsive to conventional therapy.

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The authors have provided no information on sources of funding or on conflicts of interest directly relevant to the content of this review.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada

    Michael Van Ameringen & Catherine Mancini

  2. Anxiety Disorders Clinic, 3G Clinic, McMaster University Medical Centre, Hamilton Health Sciences, Box 2000, Hamilton, Ontario, L8N 3Z5, Canada

    Michael Van Ameringen, Catherine Mancini, Beth Pipe & Mark Bennett

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  1. Michael Van Ameringen
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  2. Catherine Mancini
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  3. Beth Pipe
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  4. Mark Bennett
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Correspondence to Michael Van Ameringen.

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Van Ameringen, M., Mancini, C., Pipe, B. et al. Antiepileptic Drugs in the Treatment of Anxiety Disorders. Drugs 64, 2199–2220 (2004). https://doi.org/10.2165/00003495-200464190-00004

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