Pharmacologic management of anxiety and affective lability during recovery from Guillain-Barré syndrome: some preliminary observations

Kristin Brousseau^1,2 David Arciniegas^1,2,3 Susie Harris^1,2

¹Neuropsychiatry Service, Department of Psychiatry, University of Colorado School of Medicine, Denver, CO, USA; ²Brain Injury Rehabilitation Unit, Spalding Rehabilitation Hospital, Aurora, CO, USA; ³Behavioral Neurology Section, Department of Neurology, University of Colorado School of Medicine, Denver, CO, USA

Abstract: Psychiatric symptoms in Guillain-Barré syndrome (GBS) can include anxiety and affective lability, which require treatment to improve functional outcomes. Three cases in which modest doses of selective serotonin reuptake inhibitors (SSRIs), alone or in combination with anticonvulsants, reduced symptoms of anxiety and affective lability during acute rehabilitation of GBS are presented. These agents were both more effective and better tolerated than benzodiazepines and appeared to facilitate engagement in rehabilitation therapies, including psychotherapy. Further investigation of the pharmacotherapy of neuropsychiatric disturbances in this population using prospective, blinded, placebo-controlled methods is recommended.

Keywords: Guillain-Barré, anxiety, affective lability, serotonin, neuropsychiatry