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Re: Zofran and anxiety » ed_uk

Posted by sfy on December 5, 2004, at 15:08:37

In reply to Zofran and anxiety, posted by ed_uk on December 4, 2004, at 18:00:52

I participated in a clinical study at NIMH about 8 years ago in which they were testing whether ondanesetron mediated social anxiety symptoms in general and artificially induced anxiety in particular. It did nothing at all for my anxiety and that seems to have been the general consensus as evidenced by this article on the study results:

Neuropsychopharmacology. 1997 Dec;17(6):360-9.

Effects of the 5-HT3 antagonist, ondansetron, on the behavioral and physiological effects of pentagastrin in patients with panic disorder and social phobia.

McCann UD, Morgan CM, Geraci M, Slate SO, Murphy DL, Post RM.

Biological Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892-1272, USA.

Pentagastrin, a cholecystokinin (CCK) agonist, produces anxiety and panic in patients with panic disorder and social phobia. Preclinical data suggests that pentagastrin-induced anxiogenesis may be mediated via 5-HT3 receptors. In the present study, 14 patients with panic disorder or social phobia underwent pharmacological challenge in three conditions: (1) pretreatment with saline followed by pentagastrin infusion; (2) pretreatment with ondansetron followed by pentagastrin infusion; and (3) pretreatment with saline followed by saline infusion. As expected, pentagastrin administration led to increased anxiety, physical symptoms of panic attacks, pulse, plasma adrenocorticotropic hormone (ACTH), and cortisol. Pentagastrin's behavioral effects were not blocked by ondansetron, and in fact, tended to be exaggerated. Ondansetron pretreatment did not alter the pentagastrin-induced cortisol increase but significantly prolonged the pentagastrin-induced increase in ACTH. These findings suggest that pentagastrin's behavioral effects are not mediated by 5HT3 receptors. Mechanisms by which peripherally administered CCK agonists lead to anxiety remain to be elucidated.


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