Update on treatments for anxiety-related disorders

Abstract

Purpose of reviewThis review examines recent evidence that informs the treatment of anxiety-related disorders.Recent findingsIn addition to selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and benzodiazepines, agomelatine has demonstrated efficacy in treating generalized anxiety disorder (GAD). Other novel products, such as ketamine, psilocybin and cannabidiol, are in the process of gathering evidence in support of the treatment of anxiety disorders. In psychological therapy, various psychological treatments for anxiety disorders, such as mindfulness-based intervention, acceptance and commitment therapy, psychodynamic therapy, emotion-focused therapy and dialectical behavioural therapy, have been tried. Still, most therapies have not proven superior to cognitive behavioural therapy (CBT). In very preliminary findings: Repetitive transcranial magnetic stimulation (rTMS) was effective in GAD; transcranial direct current stimulation (tDCS) was effective for social anxiety disorder (SAD) and GAD and augmented exposure therapy for specific fears. Internet and mobile-based interventions have comparable efficacy to face-to-face therapy.SummaryPharmacotherapy of anxiety disorders is expanding to novel products. Despite trying other psychological therapies for anxiety disorders, most therapies were comparable to but not superior to CBT. rTMS and tDCS were also used and show early promise for GAD, but further studies are needed. Most internet or mobile app based psychological therapies were based on CBT, and some can be considered as alternatives to in-person face-to-face therapy.

Neuropharmacological Effects of the Dichloromethane Extract from the Stems of Argemone ochroleuca Sweet (Papaveraceae) and Its Active Compound Dihydrosanguinarine

“…The findings showed that the AOE exerted its anxiolytic and antidepressant actions through the possible participation of the GABAergic and noradrenergic systems, respectively. An impairment in the noradrenergic system is involved in developing depression and anxiety [ 35 ]. Imipramine, desipramine, protriptyline, and others are antidepressant drugs that act through the noradrenergic system.…”

“…Imipramine, desipramine, protriptyline, and others are antidepressant drugs that act through the noradrenergic system. Lofepramine, a noradrenaline uptake inhibitor, is used to decrease the number of panic attacks [ 35 , 36 ]. The noradrenergic system is a therapeutic target for anxiety and depression [ 35 , 36 ].…”

“…Lofepramine, a noradrenaline uptake inhibitor, is used to decrease the number of panic attacks [ 35 , 36 ]. The noradrenergic system is a therapeutic target for anxiety and depression [ 35 , 36 ].…”

Anxiolytic effects of Chrysanthemum morifolium Ramat Carbonisata-based carbon dots in mCPP-induced anxiety-like behavior in mice: a nature-inspired approach

“…Alterations in serotonin 5-HT levels have been shown to substantially impact anxiety-related behaviors ( Riedel et al, 2002 ; Pobbe et al, 2011 ; Zangrossi and Graeff, 2014 ), while SSRIs have emerged as first-line therapy for anxiety (H. J. Lee and Stein, 2023 ). SNRIs, also employed as first-line clinical agents, imply an effect of NE on mood.…”

Editorial: Case reports in anxiety and stress

“…Response to standard pharmacological or psychological treatments in anxiety and stress-related disorders is often unsatisfactory ( 5 , 6 , 33 ). Non-invasive neurostimulation methods, such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) have shown preliminary evidence of efficacy in anxiety disorders and PTSD ( 34 ). Chang et al describe the successful use of accelerated theta-burst rTMS, applied over the dorsolateral prefrontal cortices (DLPFC), in a patient with treatment-resistant PTSD occurring in the context of emotional and physical abuse.…”