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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by ed_uk on December 4, 2004, at 18:00:52
Hi,
Has anyone ever tried ondansetron (Zofran) for anxiety? It's very expensive!
Ed.
Posted by Cairo on December 5, 2004, at 9:44:24
In reply to Zofran and anxiety, posted by ed_uk on December 4, 2004, at 18:00:52
I've tried Zofran for Fibromyalgia which includes depression and anxiety, but with no success for either pain, anxiety or depression. I remember reading somewhere that only 50% responded to ondansetron in a trial study for Fibromyalgia. Only my pocketbook had a favorable outcome as I was able to get ahold of samples instead of mortgaging my house to pay for it.
Here's a brief search on PubMed, though:
Olivier B, van Wijngaarden I, Soudijn W.
5-HT(3) receptor antagonists and anxiety; a preclinical and clinical review.
Eur Neuropsychopharmacol. 2000 Mar;10(2):77-95."Compared to the established anxiolytics (benzodiazepine receptor agonists and, to a lesser extent, 5-HT(1A) receptor agonists) 5-HT(3) receptor antagonists display a different anxiolytic profile. They are anxiolytic in a limited number of animal anxiety models. If active, they often are very potent and display bell-shaped dose response curves, whereas the ratio between therapeutic activity and side effects appears remarkably large. 5-HT(3) receptor antagonists remain active after chronic dosing and no indications for tolerance, dependence or rebound effects were found, which seems to make these drugs an attractive alternative to the benzodiazepines. However, the large body of animal data indicating a complete lack of psychotropic activity of 5-HT(3) receptor antagonists weakens the prediction of anxiolytic activity in these drugs."
Costall B, Naylor RJ.
5-HT3 receptors.
Curr Drug Targets CNS Neurol Disord. 2004 Feb;3(1):27-37"5-HT(3) receptor antagonists seem to be of limited use in psychiatric disorders: where effects have been seen, they seem to be unusually sensitive to dose and stage of disease."
Cairo
Posted by ed_uk on December 5, 2004, at 10:16:37
In reply to Re: Zofran and anxiety, posted by Cairo on December 5, 2004, at 9:44:24
Hi Cairo,
As far as I know, the development of 5-HT(3) antagonists as anxiolytics has been abandoned. I expect that ondansetron might be useful for a small proportion of anxiety disorder sufferers but probably not most.
Regards,
Ed.
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.
Posted by ed_uk on December 5, 2004, at 15:53:47
In reply to Re: Zofran and anxiety » ed_uk, posted by sfy on December 5, 2004, at 15:08:37
>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.
Thank you for the info. I'm sorry it didn't help you.
Regards,
Ed.
This is the end of the thread.
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