PubMed · 6625863
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E Weitzner. 1983. Panic and anxiety.. https://doi.org/10.1001/archpsyc.1983.01790090111017
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The pharmacotherapy of anxiety disorders has revolutionary changed in the last few years. This ICD-10 based review of the literature provides help for general practitioners and other specialists in the short and long term treatment of anxiety as well as in the discontinuation of pharmacologic treatment. The author describes the use of high potency benzodiazepines, selective serotonin reuptake inhibitors and 5 HT1A partial agonists and summarizes the disadvantages of some older drugs still in use for the treatment of anxiety disorders.
OBJECTIVE: Evidence from preclinical and clinical studies suggests a role for alterations in the benzodiazepine/GABAA receptor complex in stress and anxiety. Flumazenil is a relatively pure benzodiazepine/GABAA antagonist with limited intrinsic activity. In panic disorder patients, but not healthy controls, flumazenil has been demonstrated to provoke panic attacks. METHOD: Vietnam combat veterans with PTSD (n = 14) received 90-second intravenous infusions of flumazenil 2 mg or placebo in a double-blind, crossover study design. PTSD symptomology was assessed using the PTSD Symptom Scale, and anxiety symptoms were measured with visual analogue rating scales. RESULTS: There was no significant difference in PTSD and anxiety symptoms between administration of flumazenil and placebo. CONCLUSION: Flumazenil administration does not produce an increase in anxiety and PTSD symptoms in patients with PTSD. This suggests that PTSD and panic disorder are dissimilar in terms of benzodiazepine/GABAA system function.