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Dr. Bob is Robert Hsiung, MD,
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Posted by Kelty on March 28, 2002, at 1:15:45
Does anyone know where I might find articles/research on using topomax and neurontin to treat anxiety? I need something to take to the doctor who is doing my prescribing. I am thinking of one of these drugs as an adjunct to my antidepressant because I hear that they are being used in treatment of anxiety, migraines and fibromyalgia, which are all issues for me.
TSAWest kindly quoted an article for me on the use of neurontin in migraine prophylaxis, I also need something that mentions it's use for anxiety.
Thanks in advance for any input.
Posted by TSA West on March 28, 2002, at 2:44:17
In reply to Info on topomax and neurontin to take to the doc., posted by Kelty on March 28, 2002, at 1:15:45
Hospital Pharmacy (Journal), August 2001 - "Gabapentin and Anxiety":
The following case studies involve the adjunctive use of gabapentin with antidepressants to treat anxiety in the context of depression.
Case 1 <http://gateway.ovid.com/rel460/server1/gifs/ftup.gif>;The first patient was a 52-year-old white female with a benign past medical history. She had a 10-year history of dysthymia and major depression without psychotic features. During this time, she experienced significant generalized anxiety that continued even when her depressive symptoms improved. She denied obsessions, compulsions, panic attacks, or psychotic features.
The patient had been treated with trials of sertraline 150 mg per day, doxepin 200 mg at the hour of sleep, and nefazedone up to 400 mg per day, all of which had failed. The patient's most recent depression began 8 months prior, after her son had left for college. She experienced impairments in sleep, appetite, motivation, concentration, libido, and general energy.
The patient's symptoms improved on citalopram 40 mg per day but she was left with significant generalized anxiety. The patient was given a trial of adjunctive gabapentin 300 mg three times daily. Within one week the patient had complete resolution of her anxiety without additional side effects. Her response was sustained at 6-month follow-up (see Table 1).
TABLE 1
Case 2 <http://gateway.ovid.com/rel460/server1/gifs/ftup.gif>;The second patient was a 38-year-old African American male who had a history of antisocial personality disorder complicated by polysubstance dependence involving cocaine, alcohol, and benzodiazepines. He presented with a several-month history of depressed mood, severe insomnia, poor attention and concentration, generalized anxiety, decreased appetite, and a 15-pound weight loss. The patient was treated with doxepin 200 mg per day with significant improvement of his depressive symptoms over 2 weeks. He was left with generalized anxiety that made it difficult for him to avoid the abuse of benzodiazepines. The patient was started on adjunctive gabapentin 400 mg three times daily, and at 1-week follow-up had complete resolution of his anxiety with a complete cessation of benzodiazepine use. His response was maintained at 4-month follow-up (see Table 1).
Case 3 <http://gateway.ovid.com/rel460/server1/gifs/ftup.gif>;The third patient was a 36-year-old white female with a history of borderline personality disorder, major depression, and benzodiazepine and opiate addiction. She was admitted due to depressed mood, a 20-pound weight loss, insomnia, and decreased motivation with concurrent generalized anxiety. The patient was started on sertraline, which was titrated to a dose of 200 mg over 1 month. Within 6 weeks, the patient had complete resolution of her depressive symptoms except for the generalized anxiety. The patient was started on adjunctive gabapentin 300 mg three times daily. This was titrated to 600 mg three times daily over a 1-week period. Within 10 days, the patient's anxiety had completely resolved, which facilitated her ongoing drug rehabilitation treatment. The patient remained well at 3-month follow-up without symptoms of depression or anxiety (see Table 1).
Outpatient Cases <http://gateway.ovid.com/rel460/server1/gifs/ftup.gif>;Seven outpatients with anxiety, with or without concurrent depression, were treated successfully with gabapentin. Those patients with concurrent depression who were treated with antidepressants alone experienced improvement of mood without reduction of anxiety until gabapentin was added (see Table 1).
Posted by BarbaraCat on April 1, 2002, at 15:28:01
In reply to Info on topomax and neurontin to take to the doc., posted by Kelty on March 28, 2002, at 1:15:45
Hi Kelty,
I've just started Topamax in conjunction with 45 mg. Remeron 600 mg lithium and 10 mg Ambien (plus natural thyroid). I too have anxiety and fibromyalgia as well as depression. I'm now up to 50 mg of Topamax taken at night and haven't as yet noticed anything except for the yawns (I'm about to take myself to bed).If you do begin Topamax treatment, please keep me informed of how your treatment is going. I'll make a note to get back to you in 2 or so weeks (if I don't hear from you sooner) to let you know how my progress is going. I'm especially interested in the fibromyalgia dx. I've heard that Neurontin has a better track record for fibro pain, but I'm taking Topamax because of it's additional weight loss benefits. Best wishes, Barbara
> Does anyone know where I might find articles/research on using topomax and neurontin to treat anxiety? I need something to take to the doctor who is doing my prescribing. I am thinking of one of these drugs as an adjunct to my antidepressant because I hear that they are being used in treatment of anxiety, migraines and fibromyalgia, which are all issues for me.
>
> TSAWest kindly quoted an article for me on the use of neurontin in migraine prophylaxis, I also need something that mentions it's use for anxiety.
>
> Thanks in advance for any input.
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