Psychiatry Department, State University of New York (SUNY) Upstate Medical University, Syracuse, NY, USA.
Ann Pharmacother. 2010 Dec;44(12):1930-2. doi: 10.1345/aph.1P353. Epub 2010 Nov 9.
Glutamate is a major excitatory neurotransmitter, while γ-aminobutyric acid (GABA) is a predominant inhibitory neurotransmitter in the central nervous system. This GABA-glutamate imbalance is thought to play a role in the development of anxiety. Acamprosate calcium is thought to restore this chemical imbalance in alcohol withdrawal.
To examine acamprosate calcium as augmentation therapy for treatment of anxiety.
This 8-week, open-label study was designed to evaluate patients with anxiety who were stable on current medications (selective serotonin-reuptake inhibitors and serotonin-norepinephrine-reuptake inhibitors) but still symptomatic. Acamprosate was dosed at 1998 mg/day. Assessments included the Hamilton Rating Scale for Anxiety (HAM-A) and the Hospital Anxiety and Depression Scale.
Thirteen patients enrolled in the study and received study medication. Acamprosate reduced anxiety symptoms (mean HAM-A score reduction to 8.87 from a baseline of 20). Sixty-two percent of patients receiving acamprosate achieved remission (HAM-A score ≤ 7). Modal dose was 1998 mg/day (range 999-1998). The most commonly reported adverse events were nausea (n = 1), gastrointestinal upset (n = 1), and increased dream activity (n = 1).
Acamprosate calcium may be effective augmentation therapy in patients with treatment-resistant anxiety.
谷氨酸是中枢神经系统中的主要兴奋性神经递质，而γ-氨基丁酸（GABA）是主要的抑制性神经递质。这种 GABA-谷氨酸失衡被认为在焦虑症的发展中起作用。钙乙酰天冬氨酸被认为可以在酒精戒断时恢复这种化学失衡。
研究钙乙酰天冬氨酸作为焦虑症治疗的增效治疗。
这项为期 8 周的开放性研究旨在评估在当前药物（选择性 5-羟色胺再摄取抑制剂和 5-羟色胺去甲肾上腺素再摄取抑制剂）稳定但仍有症状的焦虑症患者。钙乙酰天冬氨酸的剂量为 1998mg/天。评估包括汉密尔顿焦虑量表（HAM-A）和医院焦虑抑郁量表。
13 名患者入组并接受了研究药物治疗。钙乙酰天冬氨酸降低了焦虑症状（HAM-A 评分从基线的 20 分降至 8.87 分）。62%的接受钙乙酰天冬氨酸治疗的患者达到缓解（HAM-A 评分≤7）。最常见的不良反应是恶心（n=1）、胃肠道不适（n=1）和梦境活动增加（n=1）。
钙乙酰天冬氨酸可能是治疗抵抗性焦虑症的有效增效治疗。
