Effects of the benzodiazepine antagonist flumazenil in PTSD.
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.


METHODS
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.


CONCLUSIONS
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.
D001008:Anxiety Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D001143:Arousal / Q000187:drug effects / Q000502:physiology; D003130:Combat Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D004311:Double-Blind Method; D005442:Flumazenil; D018757:GABA Modulators; D058787:GABA-A Receptor Antagonists; D006801:Humans; D007262:Infusions, Intravenous; D016584:Panic Disorder / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D011963:Receptors, GABA-A / Q000502:physiology; D014728:Veterans / Q000523:psychology*; D014744:Vietnam
D018757:GABA Modulators; D058787:GABA-A Receptor Antagonists; D011963:Receptors, GABA-A; D005442:Flumazenil