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Adjunctive zonisamide for treatment refractory anxiety.
G Kinrys1, D Vasconcelos e Sa, F Nery
1Anxiety Disorders Research Program, Cambridge Health Alliance, Cambridge, MA, USA. gkinrys@challiance.org
International Journal of Clinical Practice
|May 17, 2007
Summary
This pilot study suggests zonisamide effectively treats refractory anxiety when added to other medications. Most patients showed significant improvement with mild side effects, warranting further research.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Anxiety disorders are prevalent and often treatment-resistant.
- Existing anxiolytic therapies have limitations for severe cases.
- Novel therapeutic strategies are needed for refractory anxiety.
Purpose of the Study:
- To evaluate the efficacy and tolerability of zonisamide as an adjunctive treatment in patients with treatment-refractory anxiety.
- To assess the impact of zonisamide on anxiety symptom severity and overall clinical improvement.
Main Methods:
- A pilot, open-label, naturalistic study was conducted on 10 patients with treatment-refractory anxiety.
- Adjunctive zonisamide was administered to patients non-responsive to standard anxiolytic therapy.
- Primary outcome measures included the Hamilton Anxiety Scale (HAM-A) and Clinical Global Impression (CGI) scales.
Main Results:
- Patients experienced significant reductions in HAM-A scores (p < 0.001) and CGI-Severity scores (p < 0.002).
- 60% of patients met responder criteria (CGI-Improvement ≤ 2).
- Zonisamide was generally well-tolerated at a mean dose of 160 mg/day, with mild adverse events.
Conclusions:
- Zonisamide shows promise as an effective augmentation strategy for treatment-refractory anxiety.
- The anticonvulsant zonisamide may offer a new therapeutic option for severe anxiety.
- Larger, controlled trials are necessary to confirm these preliminary findings.
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