Dr. S. E. Oriaifo, Prof. E. K. I. Omogbai, Dr. N. I. Oriaifo, Dr. M. O. Oriaifo and Dr. E. O. Okogbenin
Generalised anxiety disorder (GAD) is the most common of the anxiety disorders seen in primary care and the 12-month prevalence in Nigeria may exceed 2.8%. The aim of this case-report is to highlight the use of furosemide in generalised anxiety disorder comorbid with dizziness in an adult female patient. Low-dose furosemide, 20mg to 40mg daily, attenuated the symptoms of generalised anxiety disorder, diagnosed in a young female patient with the Penn State Worry Questionnaire. It ameliorated the symptoms of pessimistic worry, muscle tension, dizziness, easy fatiguability, poor concentration, insomnia and irritability when used alone. Furosemide’s action in GAD may be due to its down-regulation of protein kinase C signalling which may be critical in establishing and maintaining a hyperglutamatergic state in key brain areas. Furosemide’s action may thus significantly reduce the simplified excitotoxicity index of glutamate/gamma-amino butyric acid. Upregulation of dopamine signalling by furosemide may facilitate contingency awareness and the assigning of motivational value or valence to unexpected events that may also be critical for the prevention of generalised anxiety. The safety profile of furosemide and low cost warrants its being further explored in GAD, a disease that still exerts much toll on human health since present medication is only effective in a fraction of patients.
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