Long-Term Management of Generalised Anxiety Disorder with Low-Dose Continuous Infusions of Flumazenil: A Case Series
Background: Generalised anxiety disorder (GAD) is a common anxiety disorder associated with social and occupational impairment. Recently, a theory was postulated that dysfunctional gamma aminobutyric acid type A receptors (GABA<sub>A</sub>) are implicated in anxiety symptomology, which c...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Behavioral Sciences |
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| Online Access: | https://www.mdpi.com/2076-328X/12/11/430 |
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| author | Alexander T. Gallo Stephen Addis Vlad Martyn Hishani Ramanathan Grace K. Wilkerson Sean D. Hood Hans Stampfer Gary K. Hulse |
| author_facet | Alexander T. Gallo Stephen Addis Vlad Martyn Hishani Ramanathan Grace K. Wilkerson Sean D. Hood Hans Stampfer Gary K. Hulse |
| author_sort | Alexander T. Gallo |
| collection | DOAJ |
| description | Background: Generalised anxiety disorder (GAD) is a common anxiety disorder associated with social and occupational impairment. Recently, a theory was postulated that dysfunctional gamma aminobutyric acid type A receptors (GABA<sub>A</sub>) are implicated in anxiety symptomology, which could be corrected by flumazenil, an antagonist at the benzodiazepine binding site on the GABA<sub>A</sub> receptor. Method: Participants had a primary diagnosis of GAD and were treated initially with an eight-day continuous low-dose flumazenil infusion (total 32 mg at a rate of 4 mg/24 h). Some participants were re-treated with a further four- or eight-day infusion. Treatment response was measured as a 50% reduction in anxiety or stress scores on the Depression Anxiety Stress Scale—21 (DASS-21). Remission was measured as scores ≤3 or ≤7 on the anxiety and stress subscales of the DASS-21, respectively. Results: Eight cases are reported. All cases met the criteria for treatment response on the anxiety and stress subscale of the DASS-21. Remission was achieved in seven participants on the anxiety subscale and in five on the stress subscale. No changes in hepatic, renal, or haematological function were likely attributed to flumazenil. Conclusion: Data suggest that low-dose continuous flumazenil infusion manages GAD symptoms and is safe. Although these results are promising, future randomised control trials are required to confirm these results. |
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| institution | Directory Open Access Journal |
| issn | 2076-328X |
| language | English |
| last_indexed | 2024-03-09T19:16:41Z |
| publishDate | 2022-11-01 |
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| record_format | Article |
| series | Behavioral Sciences |
| spelling | doaj.art-f3429278bae742d7a301bae6c00ed4952023-11-24T03:45:39ZengMDPI AGBehavioral Sciences2076-328X2022-11-01121143010.3390/bs12110430Long-Term Management of Generalised Anxiety Disorder with Low-Dose Continuous Infusions of Flumazenil: A Case SeriesAlexander T. Gallo0Stephen Addis1Vlad Martyn2Hishani Ramanathan3Grace K. Wilkerson4Sean D. Hood5Hans Stampfer6Gary K. Hulse7Division of Psychiatry, Medical School, The University of Western Australia, Nedlands, WA 6009, AustraliaFresh Start Recovery Programme, Subiaco, Western Australia, Subiaco, WA 6008, AustraliaFresh Start Recovery Programme, Subiaco, Western Australia, Subiaco, WA 6008, AustraliaDivision of Psychiatry, Medical School, The University of Western Australia, Nedlands, WA 6009, AustraliaDivision of Psychiatry, Medical School, The University of Western Australia, Nedlands, WA 6009, AustraliaDivision of Psychiatry, Medical School, The University of Western Australia, Nedlands, WA 6009, AustraliaDivision of Psychiatry, Medical School, The University of Western Australia, Nedlands, WA 6009, AustraliaDivision of Psychiatry, Medical School, The University of Western Australia, Nedlands, WA 6009, AustraliaBackground: Generalised anxiety disorder (GAD) is a common anxiety disorder associated with social and occupational impairment. Recently, a theory was postulated that dysfunctional gamma aminobutyric acid type A receptors (GABA<sub>A</sub>) are implicated in anxiety symptomology, which could be corrected by flumazenil, an antagonist at the benzodiazepine binding site on the GABA<sub>A</sub> receptor. Method: Participants had a primary diagnosis of GAD and were treated initially with an eight-day continuous low-dose flumazenil infusion (total 32 mg at a rate of 4 mg/24 h). Some participants were re-treated with a further four- or eight-day infusion. Treatment response was measured as a 50% reduction in anxiety or stress scores on the Depression Anxiety Stress Scale—21 (DASS-21). Remission was measured as scores ≤3 or ≤7 on the anxiety and stress subscales of the DASS-21, respectively. Results: Eight cases are reported. All cases met the criteria for treatment response on the anxiety and stress subscale of the DASS-21. Remission was achieved in seven participants on the anxiety subscale and in five on the stress subscale. No changes in hepatic, renal, or haematological function were likely attributed to flumazenil. Conclusion: Data suggest that low-dose continuous flumazenil infusion manages GAD symptoms and is safe. Although these results are promising, future randomised control trials are required to confirm these results.https://www.mdpi.com/2076-328X/12/11/430GABAanxiety disordertreatment responseflumazenilinfusionremission |
| spellingShingle | Alexander T. Gallo Stephen Addis Vlad Martyn Hishani Ramanathan Grace K. Wilkerson Sean D. Hood Hans Stampfer Gary K. Hulse Long-Term Management of Generalised Anxiety Disorder with Low-Dose Continuous Infusions of Flumazenil: A Case Series Behavioral Sciences GABA anxiety disorder treatment response flumazenil infusion remission |
| title | Long-Term Management of Generalised Anxiety Disorder with Low-Dose Continuous Infusions of Flumazenil: A Case Series |
| title_full | Long-Term Management of Generalised Anxiety Disorder with Low-Dose Continuous Infusions of Flumazenil: A Case Series |
| title_fullStr | Long-Term Management of Generalised Anxiety Disorder with Low-Dose Continuous Infusions of Flumazenil: A Case Series |
| title_full_unstemmed | Long-Term Management of Generalised Anxiety Disorder with Low-Dose Continuous Infusions of Flumazenil: A Case Series |
| title_short | Long-Term Management of Generalised Anxiety Disorder with Low-Dose Continuous Infusions of Flumazenil: A Case Series |
| title_sort | long term management of generalised anxiety disorder with low dose continuous infusions of flumazenil a case series |
| topic | GABA anxiety disorder treatment response flumazenil infusion remission |
| url | https://www.mdpi.com/2076-328X/12/11/430 |
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