pregabalin and Stress-Disorders--Post-Traumatic

Despite increasing focus on the use of antidepressants and other agents for the treatment of anxiety, benzodiazepines have remained a mainstay of anxiolytic pharmacotherapy due to their robust efficacy, rapid onset of therapeutic effect, and generally favorable side effect profile. In this article, we examine issues related to the long-term use of benzodiazepines, including concerns about the development of therapeutic tolerance, dose escalation, and adverse cognitive effects. We also consider currently available alternatives to benzodiazepines and novel mechanisms of action that may prove fruitful in the development of future generations of anxiolytics.

Topics: Anti-Anxiety Agents; Anticonvulsants; Antipsychotic Agents; Anxiety Disorders; Benzodiazepines; Cognition Disorders; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Tolerance; gamma-Aminobutyric Acid; Humans; Long-Term Care; Pregabalin; Risk Assessment; Stress Disorders, Post-Traumatic

It has been suggested that the anticonvulsant drug pregabalin may be useful in some anxiety disorders. The goal of this study was to evaluate the effectiveness of pregabalin augmentation of standard treatment (selective serotonin reuptake inhibitors and sodium valproate) for patients with chronic posttraumatic stress disorder (PTSD).. This doubleblind, placebo-controlled clinical trial was conducted at Ibn-E-Sina Psychiatric Hospital (Mashhad, Iran) in 2013. Thirty-seven male patients diagnosed with combat-related PTSD based on DSM-IV-TR criteria were randomly assigned to two groups: 18 patients, the case group, received pregabalin (300 mg/day) while 19 patients, the control group, received placebo for 6 weeks. Assessments were done at baseline and at 2, 4, and 6 weeks after the onset of treatment, using the PTSD Check List-Military Version (PCL-M), the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, and the Spitzer Quality of Life Index.. Pregabalin was just significantly effective in improving PCL-M scores (p=0.045) in comparison to placebo. Although depression and anxiety scores diminished significantly in both groups (p=0.001 and 0.0001, respectively), comparison of the efficacy of pregabalin and placebo did not show significant differences in depression, anxiety, and quality of life scores (p=0.614, 0.144, and 0.076, respectively).. Pregabalin effectively reduced the severity of PTSD symptoms but it was not effective in improving the severity of depression, anxiety, and quality of life. Further investigations are required to confirm or refute these findings.

Topics: Adult; Anticonvulsants; Antidepressive Agents; Anxiety; Combat Disorders; Depression; Double-Blind Method; Drug Synergism; gamma-Aminobutyric Acid; Humans; Male; Middle Aged; Pregabalin; Quality of Life; Stress Disorders, Post-Traumatic; Treatment Outcome; Valproic Acid

Posttraumatic stress disorder (PTSD) can be a very debilitating condition. Effective approaches to prevent and treat PTSD are important areas of basic science research. Pregabalin (PGB), a gabapentinoid derivative of γ-aminobutyric acid, possesses the potential to positively affect neurobehavioral changes associated with PTSD. Using a rodent model of PTSD, the aims of this study were to determine the effects of PGB as a possible prevention for the development of PTSD-like symptoms and its use as a possible treatment. A prospective, experimental, between groups design was used in conjunction with a three-day restraint/shock PTSD stress model. Sixty rats were randomly assigned between two groups, non-stressed and stressed (PTSD). Each of the main two groups was then randomly assigned into six experimental groups: control vehicle, control PGB, control naïve, PTSD vehicle, PTSD Pre-PGB (prophylactic), PTSD Post-PGB (non-prophylactic). The neurobehavioral components of PTSD were evaluated using the elevated plus maze (EPM), Morris water maze (MWM), and forced swim test (FST). Pregabalin administered 24 hours before the initial PTSD event or for 10 days following the last PTSD stress event did not statistically improve mean open arm exploration on the EPM, spatial memory, and learning in the MWM or behavioral despair measured by the FST (p > 0.05).

Topics: Animals; Disease Models, Animal; Exploratory Behavior; Humans; Male; Maze Learning; Pregabalin; Prospective Studies; Rats; Spatial Memory; Stress Disorders, Post-Traumatic; Swimming

Over the last decade a consistent increase in stress-related psychological consequences at the workplace, usually called 'mobbing', has been seen. It claimed physical, psychical and social distress as its victims, leading to an increased incidence of many illnesses, such as psychosomatic disorders (ache, high blood pressure, chronic fatigue and insomnia) and psychiatric disturbances (high level of anxiety, depression and suicidal attempts). It was recently demonstrated that mobbing is significantly widespread among healthcare workers, especially among female nurses. In this report, we illustrate the case of a nurse who, after a brilliant career, underwent mobbing at the workplace, showing depression, anxiety and sleep disorders that required hospitalisation and a substantial intervention.

Topics: Adjustment Disorders; Alprazolam; Anti-Anxiety Agents; Crowding; Diagnosis, Differential; Drug Therapy, Combination; Female; gamma-Aminobutyric Acid; Humans; Middle Aged; Paroxetine; Pregabalin; Stress Disorders, Post-Traumatic

Anxiety disorders are frequently under-diagnosed conditions in primary care, although they can be managed effectively by general practitioners.. This paper is a short and practical summary of the World Federation of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety disorders, obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) for the treatment in primary care. The recommendations were developed by a task force of 30 international experts in the field and are based on randomized controlled studies.. First-line pharmacological treatments for these disorders are selective serotonin reuptake inhibitors (for all disorders), serotonin-norepinephrine reuptake inhibitors (for some) and pregabalin (for generalized anxiety disorder only). A combination of medication and cognitive behavior/exposure therapy was shown to be a clinically desired treatment strategy.. This short version of an evidence-based guideline may improve treatment of anxiety disorders, OCD, and PTSD in primary care.

Topics: Antidepressive Agents, Tricyclic; Antipsychotic Agents; Anxiety Disorders; Benzodiazepines; Dose-Response Relationship, Drug; gamma-Aminobutyric Acid; Histamine Antagonists; Humans; Obsessive-Compulsive Disorder; Pregabalin; Selective Serotonin Reuptake Inhibitors; Stress Disorders, Post-Traumatic

Topics: Afghanistan; Anticonvulsants; Antidepressive Agents; Anxiety; Depressive Disorder; gamma-Aminobutyric Acid; Humans; Male; Middle Aged; Pregabalin; Russia; Stress Disorders, Post-Traumatic; Warfare

This study evaluated the efficacy of pregabalin augmentation of antidepressant treatment in patients with posttraumatic stress disorder (PTSD). Nine patients meeting Diagnostic and Statistical Manual, fourth edition criteria for PTSD who were on stable doses of antidepressants were treated open label with flexibly dosed pregabalin for 6 weeks. All patients were assessed with the Short PTSD Rating Interview, Montgomery-Asberg Depression Rating Scale, Patient Global Impression-severity, Visual Analog Scale-pain, and Sheehan Disability Scale at baseline and weeks 2, 4, and 6. Significant reductions were observed in all effectiveness measures from week 4 to the end of the study. In particular, the numerical improvement of the Visual Analog Scale-pain score was most robust (-53.4%, P=0.007). Pregabalin augmentation was effective and well tolerated during the study. Our findings warrant adequately powered, placebo-controlled clinical trials to confirm the usefulness of pregabalin augmentation of antidepressants in patients with PTSD.

Topics: Accidents; Adult; Anti-Anxiety Agents; Antidepressive Agents; Drug Therapy, Combination; Female; gamma-Aminobutyric Acid; Humans; Male; Middle Aged; Pilot Projects; Pregabalin; Psychiatric Status Rating Scales; Stress Disorders, Post-Traumatic; Treatment Outcome

The short- and long-term behavioral effects of a brief course of pregabalin, an antiepileptic structural analogue of alpha-aminobyturic acid with analgesic and anxiolytic effects, were assessed in an animal model of post-traumatic stress disorder (PTSD).. Two-hundred thirty-three adult male Sprague-Dawley rats were employed. Behavioral responses to traumatic stress exposure (predator urine scent) were assessed immediately after (1 h) and 30 days after treatment with saline or pregabalin (at doses of 30, 100 and 300 mg/kg) in terms of behavior in the elevated plus maze (EPM) and the acoustic startle response (ASR) paradigms. At day 31 the freezing response to a trauma cue (clean cat litter) was assessed. The same treatment regimen initiated at day 7 was assessed at day 30 and in response to the trauma cue on day 31 in a separate experiment.. In the short term, doses of 100 mg/kg and 300 mg/kg of pregabalin effectively attenuated anxiety-like behaviors. In the longer-term, pregabalin did not attenuate the onset of PTSD-like behaviors or the prevalence rates of severe cue-responses, for either the immediate or the delayed treatment regimens.. Pregabalin may present an alternative compound for acute anxiolytic treatment after exposure to trauma, but has no long-term protective/preventive effects.

Topics: Acoustic Stimulation; Analysis of Variance; Animals; Anticonvulsants; Anxiety; Behavior, Animal; Cues; Disease Models, Animal; Dose-Response Relationship, Drug; Electronic Data Processing; gamma-Aminobutyric Acid; Male; Maze Learning; Pregabalin; Rats; Rats, Sprague-Dawley; Reflex, Acoustic; Stress Disorders, Post-Traumatic; Time Factors

Topics: Adolescent; Child; Child Abuse, Sexual; Female; gamma-Aminobutyric Acid; Humans; Middle Aged; Pregabalin; Psychometrics; Severity of Illness Index; Stress Disorders, Post-Traumatic