Efficacy, Safety, and Tolerability of Venlafaxine Extended Release and Buspirone in Outpatients With Generalized Anxiety Disorder

Davidson,; Rl, DuPont; Hedges, Dawson W.; Jt, Haskins

doi:10.4088/jcp.v60n0805

Cited by 255 publications

(112 citation statements)

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“…Problems with sedation, abuse, tolerance, dependence/ withdrawal, as well as cognitive impairment, are causes of concern with the use of benzodiazepines (Shader and Greenblatt, 1993). Issues with longer onset of symptom relief (4-6 weeks) as well as side effects including nausea, insomnia, restlessness, agitation, weight gain, and sexual side effects are associated with the use of SSRIs as anxiolytics (Davidson et al, 1999;Lydiard et al, 1996). Similarly treatment with buspirone is also characterized by a delayed onset of anxiolytic activity as well as gastrointestinal side effects (Rakel, 1990).…”

Section: Discussionmentioning

confidence: 99%

The Behavioral Profile of the Potent and Selective mGlu5 Receptor Antagonist 3-[(2-methyl-1,3-thiazol-4-yl)ethynyl]pyridine (MTEP) in Rodent Models of Anxiety

Busse

Brodkin

Tattersall

et al. 2004

Neuropsychopharmacol

155

112

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Previous reports have demonstrated the anxiolytic effect of the potent and systemically active metabotropic glutamate subtype 5 (mGlu5) receptor antagonist 2-methyl-6-(phenylethynyl)pyridine (MPEP) in rodents. Here, we present evidence for the anxiolytic activity of a novel mGlu5 receptor antagonist, 3-[(2-methyl-1,3-thiazol-4-yl)ethynyl]pyridine (MTEP), in rats and compare its profile to the benzodiazepine receptor agonist diazepam. MTEP occupied mGlu5 receptors in a dose-dependent manner with essentially full receptor occupancy at the highest dose tested (10 mg/kg, i.p.). At doses appropriate for mGlu5 receptor-mediated effects, MTEP significantly reduced fear-potentiated startle and increased punished responding in a modified Geller-Seifter conflict model consistent with an anxiolytic-like profile. In both models, the magnitude of the anxiolytic-like response was similar to that seen with diazepam. In contrast, MTEP decreased unpunished responding to a lesser extent than diazepam and had no effect on rotarod performance when administered either alone or in combination with ethanol. Repeated dosing with MTEP in this model eliminated the increase in punished responding observed with acute dosing. The present results suggest that mGlu5 receptor antagonists lack the side effects seen with benzodiazepines, such as sedation and ethanol interaction, and provide insight into a possible role for mGlu5 receptor antagonists in the modulation of mood disorders.

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Section: Discussionmentioning

confidence: 99%

The Behavioral Profile of the Potent and Selective mGlu5 Receptor Antagonist 3-[(2-methyl-1,3-thiazol-4-yl)ethynyl]pyridine (MTEP) in Rodent Models of Anxiety

Busse

Brodkin

Tattersall

et al. 2004

Neuropsychopharmacol

155

112

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“…In der Behandlung der GAD können Antidepressiva eingesetzt werden. Entsprechende Untersuchungen liegen für trizyklische Antidepressiva, SSRI und Venlafaxin vor [Ballenger, 1999;Roerig, 1999;Rickles et al, 1993Rickles et al, , 2000Davidson et al, 1999;Gelenberg et al, 2000;Pollack et al, 2001;Rocca et al, 1997]. Die Datenlage zur Psychotherapie der GAD ist, verglichen mit den Fortschritten, die in der psychotherapeutischen Behandlung anderer Angsterkrankungen wie z.B.…”

Section: Hintergrundunclassified

Wirksamkeit der kognitiven Verhaltenstherapie bei generalisierten Angsterkrankungen – Ergebnisseder Berliner KVT-GAD-Studie

Bär¹,

Zubrägel²,

Ahrens³

2002

Verhaltenstherapie

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Effectiveness of the Cognitive Behavior Therapy in the Treatment of Generalized Anxiety Disorders – Results of the Berlin GAD-KVT-Study Background: In recent years generalized anxiety disorders (GAD) have become a focus of clinical research. There is some empirical evidence that cognitive behavior therapy (CBT) is an effective treatment. But the available studies have some shortcomings which do not allow generalizations to treatment under routine conditions. Method: In a multicenter controlled clinical trial supported by the Deutsche Forschungsgemeinschaft, efficacy of manual-guided CBT was studied in cooperation with behavior therapists who work in private practice. The design and methodology of the study adhere to the same rules as are valid in pharmacotherapy trials. Patients treated with CBT (TA) were compared with those of a waiting contact group (KKG). Because the control group patients were also treated with CBT after the waiting period (TB), a validation of treatment results has been possible. 72 outpatients (age 18–65 years, HAM-A ≧ 18, GAD according to DSM-IV, no co-morbid axis-I or axis-II disorders, no co-medication) were included and randomized into the study arms. Results: In TA HAM-A showed a reduction pre-post of 10.64 (39.6%) and STAI state of 7.96 (15.1%). In TB (those patients with delayed start of therapy) the reduction in the HAM-A was 12.08 (56.9%) and in the STAI state 6.62 (13.5%). In KKG the reduction was 1.22 (5.3%) in the HAM-A and 1.63 (3.2%) in the STAI state. Differences between TA or TB and KKG were statistically highly significant. Conclusion: The data show that manual-guided CBT is effective in GAD. Results are statistically significant and clinically meaningful. The study also shows that multicenter trials are also feasible in psychotherapy research.

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“…36,37 A eficácia da venlafaxina seria similar à da buspirona. 38 De um modo geral, a dose diária de 150 mg foi associada a uma melhora em vários critérios, embora uma dose menor (75 mg/ dia) tenha apresentado algum efeito, e a dose de 225 mg/dia tenha mostrado resultados mais consistentes. O efeito ansiolítico pode ser observado a partir da primeira ou segunda semanas, dependendo do critério empregado.…”

Section: Inibidores Seletivos Da Recaptação De Serotonina E Noradrenaunclassified

Tratamento farmacológico do transtorno de ansiedade generalizada: perspectivas futuras

Andreatini

Boerngen-Lacerda

Filho

2001

Rev. Bras. Psiquiatr.

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KeywordsO presente artigo apresenta uma visão atualizada e ampla do tratamento farmacológico do transtorno de ansiedade generalizada (TAG). São revistos os medicamentos com eficácia comprovada em estudos controlados e atualmente disponíveis na clínica (benzodiazepínicos, buspirona, antidepressivos, betabloqueadores, antipsicóticos e extrato de kava-kava). A seguir, baseados nesses dados, propõe-se um algoritmo de tratamento do TAG. São apresentadas as principais linhas de pesquisa de novos fármacos ansiolíticos, descrevendo os principais achados clínicos e pré-clínicos. Transtornos da ansiedade. Farmacoterapia. Modelos animais.This article presents an updated and broad perspective of the pharmacological treatment of generalized anxiety disorder (GAD). Medications proven to be efficacious in controlled studies and available in the clinic setting were reviewed (benzodiazepines, buspirone, antidepressives, beta-blocking agents, antipsychotics and kavakava extract). From this data, an algorithm for GAD treatment is proposed. In addition, the main research lines on new anxiolytic drugs and their stage of clinical or pre-clinical development are presented.Anxiety disorders. Pharmacotherapy. Animal models.Atualização abordagens que estão em fase de pesquisas pré-clínicas ou clínicas pré-comercialização. Quanto às pesquisas pré-clínicas, serão apresentados resultados, obtidos em modelos animais de ansiedade, das drogas atualmente em estudo, como possíveis alternativas futuras para o tratamento do TAG. Visão geral dos modelos animais de ansiedadeUm fator limitante na pesquisa da ansiedade é a ausência de análogos no animal. Em decorrência da ansiedade ser um conceito que descreve um estado subjetivo, ela é considerada uma característica humana. Por isso, na melhor das hipóteses, ela pode ser apenas modelada e não reproduzida em animais. 2Modelos animais de ansiedade úteis devem: (1) reproduzir características comportamentais e patológicas da síndroma de ansiedade; (2) permitir investigação de mecanismos neurobiológicos que não são facilmente estudados no homem; e (3) permitir avaliação confiável de agentes ansiolíticos, assim como identificar efeitos ansiogênicos de drogas e toxinas. Uma grande variedade de modelos animais de ansiedade tem sido validada farmacologicamente usando os ansiolíticos clássicos benzodiazepínicos, que apresentam início de efeito rápido. Além disso, esses agentes tem sido usados como padrão de comparação com agentes novos propostos como efetivos para controle da ansiedade. Entretanto, vários transtornos de ansiedade são resistentes ao tratamento com benzodiazepínicos, e esse fato, além de mostrar a relevância da pesquisa de novos agentes, demonstra que a utilização apenas dos benzodiazepínicos como validação farmacológica dos modelos animais não é adequada. Ou melhor, pode-se questionar que a maioria dos modelos animais avalia fenômenos que são modificados pelos benzodiazepínicos, e não a "ansiedade" propriamente dita. Uma estratégia recente consiste no desenvolvimento de novos modelos e...

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Efficacy, Safety, and Tolerability of Venlafaxine Extended Release and Buspirone in Outpatients With Generalized Anxiety Disorder

Cited by 255 publications

References 0 publications

The Behavioral Profile of the Potent and Selective mGlu5 Receptor Antagonist 3-[(2-methyl-1,3-thiazol-4-yl)ethynyl]pyridine (MTEP) in Rodent Models of Anxiety

The Behavioral Profile of the Potent and Selective mGlu5 Receptor Antagonist 3-[(2-methyl-1,3-thiazol-4-yl)ethynyl]pyridine (MTEP) in Rodent Models of Anxiety

Wirksamkeit der kognitiven Verhaltenstherapie bei generalisierten Angsterkrankungen – Ergebnisseder Berliner KVT-GAD-Studie

Tratamento farmacológico do transtorno de ansiedade generalizada: perspectivas futuras

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