Monotherapy treatment of paruresis with gabapentin.

Paruresis, the difficulty or inability to urinate in the presence of others, is a highly prevalent (7-32%) social anxiety subtype that is both chronic and pervasive. Paruresis negatively impacts quality of life. Treatment strategies have focused on psychological interventions. To date, standard social anxiety pharmacotherapies utilized in the treatment of paruresis have shown minimal efficacy. A PUBMED search revealed no references to paruresis treatment with selective serotonin reuptake inhibitors or gabapentin. This case report presents the first instance of successful monotherapy treatment of paruresis with gabapentin. The patient's relative medicine noncompliance resulted in an on-off-on treatment design with a dose-dependent response. Efficacy persisted throughout a 7-month treatment course. Gabapentin should be studied further for its potential use in the treatment of paruresis.