Antiepileptic Drugs in the Treatment of Anxiety Disorders

Abstract

In addition to epilepsy, antiepileptic drugs are used in neurologic conditions such as chronic pain and in the treatment of bipolar disorder in psychiatry. There are studies reporting its use in the treatment of anxiety disorders. The efficacy of antiepileptic drugs as carbamazepine, valproic asid, lamotrigine, topiramate, gabapentin, pregabalin in anxiety disorders has been shown in some clinical studies. The strongest evidence has been presented for pregabalin in generalized anxiety disorder, pregabalin and gabapentin in social anxiety disorder and lamotrigine in posttraumatic stres disorder. While certain studies report the effectiveness of antiepileptic drugs in the treatment of anxiety disordes, others report them as ineffective. Double blind placebo controlled drug trials are essential for clearly presenting anxiolytic activity of antiepileptic drugs which would lead the way to further wide scale use in clinical practice. This article focuses on recent literature to show the potential use of antiepileptic drugs in patients suffering from generalized anxiety disorder, social anxiety disorder, posttraumatic stres disorder, panic disorder along with a brief review of neuroanatomic structures and neurotransmitters associated with epilepsy and anxiety disorders.

Keywords

• anxiety disorder, antiepileptics, drug therapy, treatment efficacy

Anksiyete Bozukluklarının Tedavisinde Antiepileptik İlaçların Kullanımı

Abstract

Antiepileptik ilaçlar epilepsi dışında kronik ağrı gibi farklı nörolojik durumlarda, psikiyatri alanında bipolar bozukluk tedavisinde kullanılmaktadır. Anksiyete bozukluklarında da kullanımına ilişkin çalışmalar vardır. Karbamazepin, valproat, lamotrijin, topiramat, gabapentin, pregabalin gibi antiepileptiklerin anksiyete bozukluklarında etkili olduğu çeşitli çalışmalarda gösterilmiştir. Pregabalin yaygın anksiyete bozukluğu, pregabalin ve gabapentin sosyal anksiyete bozukluğu, lamotrijin travma sonrası stres bozukluğu için güçlü kanıtlar sunmaktadır. Antiepileptik ilaçların anksiyete bozukluklarında etkili olduğunu bildiren çalışmalarla birlikte etkin olmadığını gösteren çalışmalar da vardır. Antiepileptik ilaçların anksiyolitik etkisinin klinik uygulamaya yansıması için daha geniş örneklem gruplarıyla, çift kör çalışmalara gereksinim vardır. Bu makalede antiepileptik ilaçların yaygın anksiyete bozukluğu, sosyal anksiyete bozukluğu, travma sonrası stres bozukluğu, panik bozukluğunda kullanımı ile epilepsi ve anksiyete bozukluklarındaki ortak nöroanatomik yapılar ve kimyasal ileticiler literatür ışığında gözden geçirilmiştir.

Keywords

• anksiyete bozukluğu, antiepileptikler, ilaç tedavisi, tedavi etkinliği

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