All effective pharmacologic agents used to treat panic disorder augment
gamma-aminobutyric acid (GABA) transmission. Anxiolytics and
antidepressants that lack GABA activity are not effective in panic
disorder. To test the hypothesis that GABA activity is a component of
antipanic drug efficacy, the authors treated nine medication-free panic
disorder subjects with oral baclofen (30 mg/day for 4 weeks) in a
double-blind, placebo-controlled crossover trial. Baclofen, a selective
GABA agonist, was significantly more effective than placebo in reducing the
number of panic attacks and scores on the Hamilton anxiety scale, Zung
scale, and Katz-R nervousness subscale. The authors discuss possible
mechanisms of antipanic drug efficacy.
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