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Effects of the benzodiazepine antagonist flumazenil in PTSD
P K Randall1, J D Bremner, J H Krystal
1Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
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.