Pregabalin in the Treatment of Schizophrenic Anxiety

Introduction

According to DSM-IV-TR, schizophrenia includes two or more of the following symptoms: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior or negative symptoms such as affective flattening [1]. Anxiety and fear, or even panic attacks, while typical of schizophrenia, are not recognized as core symptoms, and a generally accepted therapeutic approach to anxiety in schizophrenia is lacking. Benzodiazepines (BZDs) are effective, but the combined use of antipsychotic drugs and BZDs is sometimes problematic due to the elevated risk of respiratory depression and falls on the one hand and the addictive potential of the BZDs on the other hand.

Pregabalin, a γ-amino butyric acid (GABA) analogue, was initially licensed in the USA and EU as an anticonvulsant. Meanwhile, pregabalin has also been approved by the FDA for diabetic neuropathic pain, post-herpetic neuralgia and fibromyalgia [13] [17] and by the EMEA for generalized anxiety disorder [4] [8] [11]. In addition, it appears to be effective in social phobia [9] and depression [12] [14]. Here, we report the case of a patient with schizophrenia whose anxiety responded reproducibly to add-on pregabalin treatment.

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