Gallo Alexander T, Addis Stephen, Martyn Vlad, Ramanathan Hishani, Wilkerson Grace K, Hood Sean D, Stampfer Hans, Hulse Gary K
Division of Psychiatry, Medical School, The University of Western Australia, Nedlands, WA 6009, Australia.
Fresh Start Recovery Programme, Subiaco, Western Australia, Subiaco, WA 6008, Australia.
Behav Sci (Basel). 2022 Nov 2;12(11):430. doi: 10.3390/bs12110430.
Generalised anxiety disorder (GAD) is a common anxiety disorder associated with social and occupational impairment. Recently, a theory was postulated that dysfunctional gamma aminobutyric acid type A receptors (GABA) are implicated in anxiety symptomology, which could be corrected by flumazenil, an antagonist at the benzodiazepine binding site on the GABA receptor.
Participants had a primary diagnosis of GAD and were treated initially with an eight-day continuous low-dose flumazenil infusion (total 32 mg at a rate of 4 mg/24 h). Some participants were re-treated with a further four- or eight-day infusion. Treatment response was measured as a 50% reduction in anxiety or stress scores on the Depression Anxiety Stress Scale-21 (DASS-21). Remission was measured as scores ≤3 or ≤7 on the anxiety and stress subscales of the DASS-21, respectively.
Eight cases are reported. All cases met the criteria for treatment response on the anxiety and stress subscale of the DASS-21. Remission was achieved in seven participants on the anxiety subscale and in five on the stress subscale. No changes in hepatic, renal, or haematological function were likely attributed to flumazenil.
Data suggest that low-dose continuous flumazenil infusion manages GAD symptoms and is safe. Although these results are promising, future randomised control trials are required to confirm these results.
广泛性焦虑障碍（GAD）是一种常见的焦虑症，与社交和职业功能受损有关。最近，有理论假设A型γ-氨基丁酸（GABA）受体功能失调与焦虑症状有关，而氟马西尼（一种GABA受体苯二氮䓬结合位点的拮抗剂）可以纠正这种失调。
参与者的初步诊断为GAD，最初接受为期八天的连续低剂量氟马西尼输注治疗（以4毫克/24小时的速度，总量32毫克）。一些参与者再次接受为期四天或八天的输注治疗。治疗反应以抑郁焦虑压力量表-21（DASS-21）上焦虑或压力得分降低50%来衡量。缓解则分别以DASS-21焦虑和压力分量表得分≤3或≤7来衡量。
报告了8例病例。所有病例在DASS-21焦虑和压力分量表上均符合治疗反应标准。7名参与者在焦虑分量表上实现缓解，5名在压力分量表上实现缓解。肝、肾或血液学功能的变化不太可能归因于氟马西尼。
数据表明，低剂量连续输注氟马西尼可控制GAD症状且安全。尽管这些结果很有前景，但仍需要未来的随机对照试验来证实这些结果。
