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Xia M, Xu X, Chen C, Wu H, Xu RA, Wang C. Quantitative investigation of drug-drug interaction between bergenin and vilazodone in rats through UPLC-MS/MS assay. BMC Chem 2024; 18:89. [PMID: 38702755 PMCID: PMC11067167 DOI: 10.1186/s13065-024-01203-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024] Open
Abstract
In this study, we firstly established and verified a method by ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) for the analysis of vilazodone and its metabolite M10 in rat plasma, then this method was used to explore the pharmacokinetics of vilazodone and M10 present or absence of 80 mg/kg bergenin in rats. Protein precipitation with acetonitrile was used to prepare the samples in this research. The mobile phase for liquid chromatography was consisted of 0.1% formic acid aqueous solution and acetonitrile. Brexpiprazole was used as the internal standard (IS), and the multiple reaction monitoring (MRM) mode was used for detection. The verification items required by the US Food and Drug Administration (FDA) guidelines such as selectivity, sensitivity, linearity, stability, recovery and matrix effect of this method were all met the standards. Besides, rats were used to explore the drug-drug interaction between vilazodone and bergenin, which were divided into two groups, and separately gavaged with the same-volume of carboxymethyl cellulose sodium (CMC-Na) solution and 80 mg/kg bergenin, respectively. The results showed that bergenin significantly affected the metabolism of vilazodone. It suggested that there was a potential drug-drug interaction between bergenin and vilazodone in rats. In clinical application, we should pay attention to the dose of vilazodone when in combination with bergenin.
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Affiliation(s)
- Mengming Xia
- The Affiliated LiHuiLi Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Xinhao Xu
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chaojie Chen
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hualu Wu
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ren-Ai Xu
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Changlv Wang
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
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2
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Mordeno IG, Gallemit IMJS, Dinding DLL. To Leave is to Die a Little: Assessing the Symptom Structure of Separation Anxiety Disorder in Left-Behind Emerging Adults. Psychiatr Q 2023:10.1007/s11126-023-10024-z. [PMID: 37058269 DOI: 10.1007/s11126-023-10024-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2023] [Indexed: 04/15/2023]
Abstract
The literature on separation anxiety disorder (SAD) presented two contentious issues relating to its assessment. First, studies are scarce in assessing the symptom structure of DSM-5 SAD among the adult population. Second, the accuracy in assessing the severity of SAD through measuring the intensity of disturbance and the frequency of occurrence of symptoms is yet to be studied. To address these limitations, the present study aimed to: (1) examine the latent factor structure of the newly developed separation anxiety disorder symptom severity inventory (SADSSI); (2) evaluate the necessity of using frequency or intensity formats through comparison of differences in the latent level; and (3) investigate SAD latent class analysis. Utilizing 425 left-behind emerging adults (LBA), the findings showed that a general factor with two dimensions (i.e., response formats) measuring frequency and intensity symptom severity separately has excellent fit and good reliability. Finally, the latent class analysis yielded a three-class solution best fitting to the data. Overall, the data provided evidence for the psychometric soundness of SADSSI as an assessment tool for separation anxiety symptoms among LBA.
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Affiliation(s)
- Imelu G Mordeno
- Department of Professional Education, Mindanao State University, Iligan Institute of Technology, Iligan City, Philippines.
- Department of Professional Education, College of Education, MSU-Iligan Institute of Technology, Andres Bonifacio Ave, Tibanga, Iligan City, 9200, Philippines.
| | - I Marie Joy S Gallemit
- School of Graduate Studies, College of Education, Mindanao State University, Iligan Institute of Technology, Iligan City, Philippines
| | - Dame Lent L Dinding
- Department of Psychology, Mindanao State University, Marawi City, Philippines
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3
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Bandelow B, Allgulander C, Baldwin DS, Costa DLDC, Denys D, Dilbaz N, Domschke K, Eriksson E, Fineberg NA, Hättenschwiler J, Hollander E, Kaiya H, Karavaeva T, Kasper S, Katzman M, Kim YK, Inoue T, Lim L, Masdrakis V, Menchón JM, Miguel EC, Möller HJ, Nardi AE, Pallanti S, Perna G, Rujescu D, Starcevic V, Stein DJ, Tsai SJ, Van Ameringen M, Vasileva A, Wang Z, Zohar J. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders - Version 3. Part I: Anxiety disorders. World J Biol Psychiatry 2023; 24:79-117. [PMID: 35900161 DOI: 10.1080/15622975.2022.2086295] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
AIM This is the third version of the guideline of the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Posttraumatic Stress Disorders (published in 2002, revised in 2008). METHOD A consensus panel of 33 international experts representing 22 countries developed recommendations based on efficacy and acceptability of available treatments. In total, 1007 RCTs for the treatment of these disorders in adults, adolescents, and children with medications, psychotherapy and other non-pharmacological interventions were evaluated, applying the same rigorous methods that are standard for the assessment of medications. RESULT This paper, Part I, contains recommendations for the treatment of panic disorder/agoraphobia (PDA), generalised anxiety disorder (GAD), social anxiety disorder (SAD), specific phobias, mixed anxiety disorders in children and adolescents, separation anxiety and selective mutism. Selective serotonin reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are first-line medications. Cognitive behavioural therapy (CBT) is the first-line psychotherapy for anxiety disorders. The expert panel also made recommendations for patients not responding to standard treatments and recommendations against interventions with insufficient evidence. CONCLUSION It is the goal of this initiative to provide treatment guidance for these disorders that has validity throughout the world.
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Affiliation(s)
- Borwin Bandelow
- Department of Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany
| | | | - David S Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Daniel Lucas da Conceição Costa
- Department and Institute of Psychiatry, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Damiaan Denys
- Afdeling Psychiatrie, Universitair Medische Centra, Amsterdam, The Netherlands
| | - Nesrin Dilbaz
- Psikiyatri Uzmanı, Üsküdar Üniversitesi Tıp Fakültesi Psikiyatri ABD, İstanbul, Turkey
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Elias Eriksson
- Department of Pharmacology, University of Gothenburg, Gothenburg, Sweden
| | - Naomi A Fineberg
- School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, United Kingdom
| | | | | | - Hisanobu Kaiya
- Department of Psychiatry, Kyoto Prefactual Medical College, Kyoto, Japan
| | - Tatiana Karavaeva
- V. M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health, Federal State Budgetary Institution of Higher Education, St. Petersburg State Pediatric Medical University, St. Petersburg, Russia
| | - Siegfried Kasper
- Clinical Division of General Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Martin Katzman
- S.T.A.R.T. Clinic, Toronto, Canada.,Adler Graduate Professional School, Toronto, Canada.,Department of Psychiatry, Northern Ontario School of Medicine, Thunder Bay, Canada.,Department of Psychology, Lakehead University, Thunder Bay, Canada
| | - Yong-Ku Kim
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Korea
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| | - Leslie Lim
- Department of Psychiatry, Singapore General Hospital, Bukit Merah, Singapore
| | - Vasilios Masdrakis
- First Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, University of Barcelona, Cibersam, Barcelona, Spain
| | - Euripedes C Miguel
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Hans-Jürgen Möller
- Department of Psychiatry and Psychotherapy, University of München, Munich, Germany
| | - Antonio E Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Stefano Pallanti
- Istituto die Neuroscienze, University of Florence, Firenze, Italy
| | - Giampaolo Perna
- Department of Biological Sciences, Humanitas University Pieve Emanuele, Milano, Italy
| | - Dan Rujescu
- Clinical Division of General Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Vladan Starcevic
- Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, University of Sydney, Sydney, Australia
| | - Dan J Stein
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Michael Van Ameringen
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Anna Vasileva
- V. M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health, I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russia
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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4
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Garakani A, Murrough JW, Freire RC, Thom RP, Larkin K, Buono FD, Iosifescu DV. Pharmacotherapy of Anxiety Disorders: Current and Emerging Treatment Options. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2021; 19:222-242. [PMID: 34690588 PMCID: PMC8475923 DOI: 10.1176/appi.focus.19203] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
(Appeared originally in Frontiers in Psychiatry 2020 Dec 23; 11:595584)
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5
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Ruiz-García A, Jiménez Ó, Resurrección DM, Ferreira M, Reis-Jorge J, Fenollar-Cortés J. Portuguese validation of the Adult Separation Anxiety-Questionnaire (ASA-27). PLoS One 2021; 16:e0248149. [PMID: 33690669 PMCID: PMC7946201 DOI: 10.1371/journal.pone.0248149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 02/22/2021] [Indexed: 11/20/2022] Open
Abstract
Adult separation anxiety disorder (ASAD) is characterized by developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached. Despite the high rates of this diagnosis among Portuguese adults, there is a lack of measures to assess it. In this study, we assessed the psychometric properties of a Portuguese adaptation of the Adult Separation Anxiety questionnaire (ASA-27) on a sample of 267 adults (72.7% women) aged 18–80 years (M = 40.5, SD = 13.1). Factor structure, internal consistency, and convergence validity were examined. This study confirmed the single-factor structure of the Portuguese version of ASA-27. Consistency was high for the total sample (ω = .92) and by gender (ω = .93 and 92, men and women groups, respectively). The scale was positively related to the Portuguese version of State-Trait Anxiety Inventory (STAI) (r = .57, p< .001, for both State and trait anxiety scales) and Composite Codependency Scale total score (r = .29, p< .001). In addition, the ASA-27 total score showed incremental validity in the explanation of anxiety measured by STAI. In conclusion, results show that the Portuguese version of the ASA-27 is a reliable and valid measure of ASAD.
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Affiliation(s)
| | - Óliver Jiménez
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, Universidad de Málaga, Málaga, Spain
| | | | - Marco Ferreira
- Instituto Superior de Educação e Ciências, ISEC Lisboa, Lisboa, Portugal
| | - José Reis-Jorge
- Instituto Superior de Educação e Ciências, ISEC Lisboa, Lisboa, Portugal
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6
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Schiele MA, Domschke K. [Separation anxiety disorder]. DER NERVENARZT 2020; 92:426-432. [PMID: 33319254 DOI: 10.1007/s00115-020-01037-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/16/2020] [Indexed: 11/25/2022]
Abstract
In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) separation anxiety disorder has been included in the chapter on anxiety disorders, thereby removing the age of onset restriction that previously required first onset during childhood or adolescence. Separation anxiety disorder has a lifetime prevalence of 4.8% and onset often occurs after the age of 18 years. Despite the high prevalence, separation anxiety disorder is often underdiagnosed and subsequently remains untreated. This narrative review summarizes the etiology, clinical features, diagnostic criteria as well as important differential diagnostic aspects, common comorbidity profiles and treatment implications of separation anxiety disorder. Furthermore, relevant implications for everyday practice and future perspectives for treatment and research are discussed.
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Affiliation(s)
- M A Schiele
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstraße 5, 79104, Freiburg, Deutschland.
| | - K Domschke
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstraße 5, 79104, Freiburg, Deutschland
- Center for Basics in NeuroModulation, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
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7
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Schiele MA, Bandelow B, Baldwin DS, Pini S, Domschke K. A neurobiological framework of separation anxiety and related phenotypes. Eur Neuropsychopharmacol 2020; 33:45-57. [PMID: 32046934 DOI: 10.1016/j.euroneuro.2020.01.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/25/2019] [Accepted: 01/22/2020] [Indexed: 01/09/2023]
Abstract
In the DSM-5, separation anxiety disorder (SAD) is newly classified in the chapter on anxiety, renewing research efforts into its etiology. In this narrative review, we summarize the current literature on the genetic, endocrine, physiological, neural and neuropsychological underpinnings of SAD per se, SAD in the context of panic disorder, separation anxiety symptoms, and related intermediate phenotypes. SAD aggregates in families and has a heritability of ~43%. Variants in the oxytocin receptor, serotonin transporter, opioid receptor µ1, dopamine D4 receptor and translocator protein genes have all been associated with SAD. Dysregulation of the hypothalamus-pituitary-adrenal axis, dysfunctional cortico-limbic interaction and biased cognitive processing seem to constitute further neurobiological markers of separation anxiety. Hypersensitivity to carbon dioxide appears to be an endophenotype shared by SAD, panic disorder and anxiety sensitivity. The identification of biological risk markers and its multi-level integration hold great promise regarding the prediction of SAD risk, maintenance and course, and in the future may allow for the selection of indicated preventive and innovative, personalized therapeutic interventions.
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Affiliation(s)
- Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Borwin Bandelow
- Department of Psychiatry and Psychotherapy, University Medical Centre Göttingen, Germany
| | - David S Baldwin
- Clinical and Experimental Sciences, University of Southampton, Faculty of Medicine, Southampton, United Kingdom; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Stefano Pini
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Germany.
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8
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Bandelow B. Current and Novel Psychopharmacological Drugs for Anxiety Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:347-365. [PMID: 32002937 DOI: 10.1007/978-981-32-9705-0_19] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Anxiety disorders, including panic disorder/agoraphobia (PDA), generalized anxiety disorder (GAD), social anxiety disorder (SAD), and others, are the most prevalent mental disorders. In this paper, recommendations are given for the psychopharmacological treatment of these disorders which are based on comprehensive treatment guidelines, meta-analyses, and systematic reviews of available randomized controlled studies. Anxiety disorders can effectively be treated with psychotherapy, pharmacotherapy, or a combination of both. First-line drugs are the selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Benzodiazepines are not recommended for routine use due to their possible addiction potential. Other treatment options include the calcium modulator pregabalin, tricyclic antidepressants, buspirone, moclobemide, and others. Drug treatment can be combined with psychological treatments. Novel treatment strategies include medications that act on GABA, glutamate, and other neurotransmitter systems. After remission, medications should be continued for 6 to 12 months.
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Affiliation(s)
- Borwin Bandelow
- Department of Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany.
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9
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Garakani A, Murrough JW, Freire RC, Thom RP, Larkin K, Buono FD, Iosifescu DV. Pharmacotherapy of Anxiety Disorders: Current and Emerging Treatment Options. Front Psychiatry 2020; 11:595584. [PMID: 33424664 PMCID: PMC7786299 DOI: 10.3389/fpsyt.2020.595584] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/13/2020] [Indexed: 12/20/2022] Open
Abstract
Anxiety disorders are the most prevalent psychiatric disorders and a leading cause of disability. While there continues to be expansive research in posttraumatic stress disorder (PTSD), depression and schizophrenia, there is a relative dearth of novel medications under investigation for anxiety disorders. This review's first aim is to summarize current pharmacological treatments (both approved and off-label) for panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), and specific phobias (SP), including selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), azapirones (e.g., buspirone), mixed antidepressants (e.g., mirtazapine), antipsychotics, antihistamines (e.g., hydroxyzine), alpha- and beta-adrenergic medications (e.g., propranolol, clonidine), and GABAergic medications (benzodiazepines, pregabalin, and gabapentin). Posttraumatic stress disorder and obsessive-compulsive disorder are excluded from this review. Second, we will review novel pharmacotherapeutic agents under investigation for the treatment of anxiety disorders in adults. The pathways and neurotransmitters reviewed include serotonergic agents, glutamate modulators, GABAergic medications, neuropeptides, neurosteroids, alpha- and beta-adrenergic agents, cannabinoids, and natural remedies. The outcome of the review reveals a lack of randomized double-blind placebo- controlled trials for anxiety disorders and few studies comparing novel treatments to existing anxiolytic agents. Although there are some recent randomized controlled trials for novel agents including neuropeptides, glutamatergic agents (such as ketamine and d-cycloserine), and cannabinoids (including cannabidiol) primarily in GAD or SAD, these trials have largely been negative, with only some promise for kava and PH94B (an inhaled neurosteroid). Overall, the progression of current and future psychopharmacology research in anxiety disorders suggests that there needs to be further expansion in research of these novel pathways and larger-scale studies of promising agents with positive results from smaller trials.
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Affiliation(s)
- Amir Garakani
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Silver Hill Hospital, New Canaan, CT, United States.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - James W Murrough
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Rafael C Freire
- Department of Psychiatry and Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Robyn P Thom
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Kaitlyn Larkin
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Frank D Buono
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Dan V Iosifescu
- Clinical Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States.,Department of Psychiatry, New York University School of Medicine, New York, NY, United States
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10
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Sartori SB, Singewald N. Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders. Pharmacol Ther 2019; 204:107402. [PMID: 31470029 DOI: 10.1016/j.pharmthera.2019.107402] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/19/2019] [Indexed: 12/24/2022]
Abstract
Current medication for anxiety disorders is suboptimal in terms of efficiency and tolerability, highlighting the need for improved drug treatments. In this review an overview of drugs being studied in different phases of clinical trials for their potential in the treatment of fear-, anxiety- and trauma-related disorders is presented. One strategy followed in drug development is refining and improving compounds interacting with existing anxiolytic drug targets, such as serotonergic and prototypical GABAergic benzodiazepines. A more innovative approach involves the search for compounds with novel mechanisms of anxiolytic action using the growing knowledge base concerning the relevant neurocircuitries and neurobiological mechanisms underlying pathological fear and anxiety. The target systems evaluated in clinical trials include glutamate, endocannabinoid and neuropeptide systems, as well as ion channels and targets derived from phytochemicals. Examples of promising novel candidates currently in clinical development for generalised anxiety disorder, social anxiety disorder, panic disorder, obsessive compulsive disorder or post-traumatic stress disorder include ketamine, riluzole, xenon with one common pharmacological action of modulation of glutamatergic neurotransmission, as well as the neurosteroid aloradine. Finally, compounds such as D-cycloserine, MDMA, L-DOPA and cannabinoids have shown efficacy in enhancing fear-extinction learning in humans. They are thus investigated in clinical trials as an augmentative strategy for speeding up and enhancing the long-term effectiveness of exposure-based psychotherapy, which could render chronic anxiolytic drug treatment dispensable for many patients. These efforts are indicative of a rekindled interest and renewed optimism in the anxiety drug discovery field, after decades of relative stagnation.
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Affiliation(s)
- Simone B Sartori
- Institute of Pharmacy, Department of Pharmacology and Toxicology, Center for Molecular Biosciences Innsbruck (CMBI), Leopold Franzens University Innsbruck, Innsbruck, Austria
| | - Nicolas Singewald
- Institute of Pharmacy, Department of Pharmacology and Toxicology, Center for Molecular Biosciences Innsbruck (CMBI), Leopold Franzens University Innsbruck, Innsbruck, Austria.
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11
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Avedisova AS, Arkusha IA, Zakharova KV. [Separation anxiety disorder in adults - a new diagnostic category]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:66-75. [PMID: 30499500 DOI: 10.17116/jnevro201811810166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Anxiety separation disorder (SAD) became the subject of increased attention of researchers in recent decades. DSM-5 and project of ICD-11 allow us to treat this disorder as an independent nosological unit without attachment to age. The review provides information on the prevalence, clinical manifestations and diagnosis of SAD in adults, summarizes information on the etiopathogenesis, relations to other psychiatric disorders, and highlights the lack of modern therapeutic approaches to SAD. The purpose of this review is to raise the level of knowledge about SAD and its new positioning in classification systems.
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Affiliation(s)
- A S Avedisova
- Serbsky National Medical Research Centre for Psychiatry and Narcology of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - I A Arkusha
- Serbsky National Medical Research Centre for Psychiatry and Narcology of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - K V Zakharova
- Serbsky National Medical Research Centre for Psychiatry and Narcology of the Ministry of Health of the Russian Federation, Moscow, Russia
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12
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Stuivenga M, Giltay EJ, Cools O, Roosens L, Neels H, Sabbe B. Evaluation of vilazodone for the treatment of depressive and anxiety disorders. Expert Opin Pharmacother 2018; 20:251-260. [PMID: 30475091 DOI: 10.1080/14656566.2018.1549542] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Major Depressive Disorder (MDD) and General Anxiety Disorder (GAD) significantly contribute to the global burden of disease. Vilazodone, a combined serotonin reuptake inhibitor and 5-HT1A partial agonist, is an approved therapy for the treatment of MDD and which has been further investigated for GAD. Areas covered: This article covers the pharmacokinetics and pharmacodynamics of vilazodone and provides an evaluation of the clinical usefulness of vilazodone for the treatment of MDD and anxiety disorders. A literature search was performed using PubMed/MEDLINE, Web of Science and the Cochrane Library. Expert opinion: Studies have shown that vilazodone is significantly superior to placebo. However, vilazodone cannot as yet be recommended as a first-line treatment option for MDD as it is unclear whether the drug's dual mechanism of action provides greater efficacy than prevailing treatment options. Moreover, more phase IV studies are needed to establish its efficacy and long-term safety in larger and more diverse populations. Although vilazodone may have an additional advantage for the treatment of anxiety symptoms in MDD, here also additional studies are required to confirm its efficacy over and above SSRI alternatives and other antidepressant treatments. Therefore, presently, vilazodone should be considered as a second- or third-line treatment option for MDD and GAD.
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Affiliation(s)
- Mirella Stuivenga
- a Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences , University of Antwerp, Belgium; University Psychiatric Hospital Duffel , Duffel , Belgium
| | - Erik J Giltay
- a Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences , University of Antwerp, Belgium; University Psychiatric Hospital Duffel , Duffel , Belgium.,b Department of Psychiatry , Leiden University Medical Center (LUMC) , Leiden , The Netherlands
| | - Olivia Cools
- a Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences , University of Antwerp, Belgium; University Psychiatric Hospital Duffel , Duffel , Belgium
| | - Laurence Roosens
- c Toxicological Center, Department of Pharmaceutical Sciences , University of Antwerp , Antwerp , Belgium
| | - Hugo Neels
- c Toxicological Center, Department of Pharmaceutical Sciences , University of Antwerp , Antwerp , Belgium
| | - Bernard Sabbe
- a Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences , University of Antwerp, Belgium; University Psychiatric Hospital Duffel , Duffel , Belgium
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13
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Matthies S, Schiele MA, Koentges C, Pini S, Schmahl C, Domschke K. Please Don't Leave Me-Separation Anxiety and Related Traits in Borderline Personality Disorder. Curr Psychiatry Rep 2018; 20:83. [PMID: 30155649 DOI: 10.1007/s11920-018-0951-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW In light of the apparent symptomatic resemblance of separation anxiety disorder (SAD) symptoms on the one hand and abandonment fears, anxiousness, and separation insecurity central to borderline personality disorder (BPD) on the other hand, a comprehensive overview of separation anxiety and related traits in BPD is provided. RECENT FINDINGS Epidemiological, environmental, psychological, and neurobiological data connecting BPD to separation events, feelings of loneliness, insecure attachment styles, dimensional separation anxiety as well as SAD per se suggest a partly shared etiological pathway model underlying BPD and SAD. Differential diagnostic aspects and implications for treatment are discussed, highlighting separation anxiety as a promising transdiagnostic target for specific psychotherapeutic and pharmacological treatment approaches in BPD. This innovative angle on cross-disorder symptomatology might carry potential for novel preventive and therapeutic avenues in clinical practice by guiding the development of interventions specifically targeting separation anxiety and attachment-related issues in BPD.
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Affiliation(s)
- Swantje Matthies
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstrasse 5, D-79104, Freiburg, Germany
| | - Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstrasse 5, D-79104, Freiburg, Germany
| | - Christa Koentges
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstrasse 5, D-79104, Freiburg, Germany
| | - Stefano Pini
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstrasse 5, D-79104, Freiburg, Germany.
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Strawn JR, Dobson ET. Individuation for a DSM-5 disorder: Adult separation anxiety. Depress Anxiety 2017; 34:1082-1084. [PMID: 29211944 DOI: 10.1002/da.22703] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 10/30/2017] [Indexed: 01/07/2023] Open
Affiliation(s)
- Jeffrey R Strawn
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH, USA.,Department of Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Eric T Dobson
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH, USA
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