Anticonvulsant medications for panic disorder: a review and synthesis of the evidence

Abstract

Objectives. Currently, there are no guidelines for when to use an antiepileptic drug (AED) in nonepileptic panic disorder (PD) patients. We conducted this review to ascertain what guidance available literature can provide as to when to consider AEDs for PD patients. Methods. The primary data sources were PubMed and Google-Scholars. Search was limited to “English” and “Humans”. Only papers addressing use of nonbenzodiazepine AEDs in PD were included. Data regarding study subjects, the AED utilized, and clinical responses were collected. EEG data were used to classify reports of patients with abnormal versus those with normal and/or no EEG work-up. Results. Ten reports were identified for use of AEDs in PD patients with abnormal EEGs with a total of 20 patients (17 responders). None of the 10 reports were controlled studies. Eighteen reports were identified for use of AEDs in panic patients with either normal EEGs or unselected groups (no EEG work-up). Out of the 18 reports, three were controlled studies. Included in the 18 studies were 253 patients (137 responders). Conclusions. We preliminary concluded that EEG work-up could be useful in guiding the treatment in PD as an abnormal EEG may be indicative of a higher likelihood of a positive response to an AED.

Key words::

• Panic disorder
• EEG
• antiepileptic drugs

Statement of interest

None of the authors reports conflicts of interest.

Financial support

This work was partially supported by the Joe Young Funds from the State of Michigan to the Department of Psychiatry and Behavioral Neurosciences at Wayne State University, School of Medicine.