RESUMO
The medicinal properties of resveratrol have garnered increasing attention from researchers. Extensive data have been accumulated on its use in treating cardiovascular diseases, immune system disorders, cancer, neurological diseases, and behavioral disorders. The protective mechanisms of resveratrol, particularly in anxiety-related stress disorders, have been well documented. However, less attention has been given to the side effects of resveratrol. This review explores not only the mechanisms underlying the anxiolytic effects of resveratrol but also the mechanisms that may lead to increased anxiety following resveratrol treatment. Understanding these mechanisms is crucial for enhancing the efficacy of resveratrol in managing anxiety disorders associated with stress and PTSD.
Assuntos
Ansiolíticos , Transtornos de Ansiedade , Ansiedade , Resveratrol , Resveratrol/farmacologia , Humanos , Ansiolíticos/farmacologia , Ansiolíticos/uso terapêutico , Animais , Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/tratamento farmacológico , Estresse Psicológico/tratamento farmacológico , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológicoAssuntos
Ansiolíticos , Coriorretinopatia Serosa Central , Humanos , Coriorretinopatia Serosa Central/diagnóstico , Coriorretinopatia Serosa Central/tratamento farmacológico , Ansiolíticos/uso terapêutico , Masculino , Feminino , Adulto , Tomografia de Coerência Óptica/métodos , Ansiedade/tratamento farmacológico , Angiofluoresceinografia/métodos , Depressão/tratamento farmacológico , Pessoa de Meia-Idade , Acuidade Visual , Fundo de Olho , Transtornos de Ansiedade/tratamento farmacológico , Resultado do TratamentoAssuntos
Transtornos de Ansiedade , Maconha Medicinal , Tramadol , Cloridrato de Venlafaxina , Humanos , Tramadol/uso terapêutico , Cloridrato de Venlafaxina/uso terapêutico , Transtornos de Ansiedade/tratamento farmacológico , Maconha Medicinal/uso terapêutico , Adulto , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Masculino , Analgésicos Opioides/uso terapêutico , Analgésicos Opioides/efeitos adversos , FemininoRESUMO
BACKGROUND: Anxiety and depression cause major detriment to the patient, family, and society - particularly in treatment-resistant (TR) cases, which are highly prevalent. TR prevalence may be due to current diagnoses being based not on biological measures but on symptom lists that suffer from clinical subjectivity, variation in symptom presentation, and comorbidity. AIMS: Goal-conflict-specific rhythmicity (GCSR) measured using the Stop-Signal Task (SST) may provide the first neural biomarker for an anxiety process and disorder. This GCSR has been validated with selective drugs for anxiety. So, we proposed that GCSR could differ between TR and non-TR individuals and do so differently between those diagnoses normally sensitive to selective anxiolytics and those not. METHODS: We recorded electroencephalograms (EEG) from 20 TR participants (4 GAD, 5 SAD and 11 MDD) and 24 non-TR participants (4 GAD, 5 SAD and 15 Comorbid GAD/MDD (GMD)) while they performed the SST. RESULTS: There was significant positive GCSR in all groups except the GAD-TR group. GAD-TR lacked GCSR in the low-frequency range. However, TR had little effect in SAD or MDD/GMD populations with apparent increases not decreases. CONCLUSIONS: Overall, these results suggest that GAD may occur in two forms: one resulting from excessive GCSR and so being drug sensitive, and the other resulting from some other mechanism and so being TR. In SAD and MDD groups, heightened GCSR could be a consequence rather than the cause, driven by mechanisms that are normally more sensitive to non-selective panicolytic antidepressants.
Assuntos
Transtornos de Ansiedade , Biomarcadores , Transtorno Depressivo Maior , Eletroencefalografia , Humanos , Adulto , Masculino , Feminino , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/fisiopatologia , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/fisiopatologia , Pessoa de Meia-Idade , Adulto Jovem , Objetivos , Transtorno Depressivo Resistente a Tratamento/tratamento farmacológico , Ansiedade/tratamento farmacológico , Fobia Social/tratamento farmacológico , Fobia Social/fisiopatologia , Conflito PsicológicoRESUMO
BACKGROUND: People with mental health conditions were potentially more vulnerable than others to the neuropsychiatric effects of the COVID-19 pandemic and the global efforts taken to contain it. The aim of this multinational study was to examine the changes in psychotropic drug prescribing during the pandemic among people with depressive and anxiety disorders. METHODS: This study included electronic medical records and claims data from nine databases in six countries (France, Germany, Italy, the UK, South Korea, and the USA) of patients with a diagnosis of depressive or anxiety disorders between 2016 and 2021. The outcomes were monthly prevalence rates of antidepressant, antipsychotic, and anxiolytic drug prescribing. The associations between the pandemic and psychotropic drug prescribing were examined with interrupted time series analyses for the total sample and stratified by sex and age group. People with lived experience were not involved in the research and writing process. FINDINGS: Between Jan 1, 2016 and Dec 31, 2020, an average of 16 567 914 patients with depressive disorders (10 820 956 females [65·31%] and 5 746 958 males [34·69%]) and 15 988 451 patients with anxiety disorders (10 688 788 females [66·85%] and 5 299 663 males [33·15%]) were identified annually. Most patients with depressive disorders and anxiety disorders were aged 45-64 years. Ethnicity data were not available. Two distinct trends in prescribing rates were identified. The first pattern shows an initial surge at the start of the pandemic (eg, antipsychotics among patients with depressive disorders in MDCD_US (rate ratio [RR] 1·077, 95% CI 1·055-1·100), followed by a gradual decline towards the counterfactual level (RR 0·990, 95% CI 0·988-0·992). The second pattern, observed in four databases for anxiolytics among patients with depressive disorders and two for antipsychotics among patients with anxiety disorders, shows an immediate increase (eg, antipsychotics among patients with anxiety disorders in IQVIA_UK: RR 1·467, 95% CI 1·282-1·675) without a subsequent change in slope (RR 0·985, 95% CI 0·969-1·003). In MDCD_US and IQVIA_US, the anxiolytic prescribing rate continued to increase among patients younger than 25 years for both disorders. INTERPRETATION: The study reveals persistently elevated rates of psychotropic drug prescriptions beyond the initial phase of the pandemic. These findings underscore the importance of enhanced mental health support and emphasise the need for regular review of psychotropic drug use among this patient group in the post-pandemic era. FUNDING: University Grants Committee, Research Grants Council, The Government of the Hong Kong Special Administrative Region.
Assuntos
Transtornos de Ansiedade , COVID-19 , Transtorno Depressivo , Psicotrópicos , Humanos , Masculino , Feminino , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/epidemiologia , Adulto , Pessoa de Meia-Idade , COVID-19/epidemiologia , COVID-19/psicologia , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/epidemiologia , Psicotrópicos/uso terapêutico , Idoso , Adulto Jovem , Prescrições de Medicamentos/estatística & dados numéricos , Antidepressivos/uso terapêutico , Ansiolíticos/uso terapêutico , Adolescente , Padrões de Prática Médica/estatística & dados numéricos , Antipsicóticos/uso terapêutico , Alemanha/epidemiologia , República da Coreia/epidemiologia , Reino Unido/epidemiologia , SARS-CoV-2RESUMO
Obesity impacts mental health greatly. Psychological factors may influence the effectiveness of its treatment. This study aimed to compare symptoms of generalised anxiety disorder and depression among adult women across different weight categories. The study sample comprised 1105 adult women. The computer-assisted web interview (CAWI) utilising the seven-item Generalised Anxiety Disorders Scale (GAD-7) and the nine-item Patient Health Questionnaire (PHQ-9) was used. Both GAD-7 and PHQ-9 scores correlated positively with BMI (r = 0.121, p < 0.001 and r = 0.173, p < 0.001, respectively) and negatively with age (r = -0.106, p < 0.001 and r = -0.103, p < 0.001, respectively). Patients undergoing treatment with semaglutide scored lower for both anxiety symptoms (8.71 ± 6.16, p = 0.013) and depression symptoms (9.76 ± 6.37, p = 0.013). Women who underwent bariatric surgery screened less frequently for anxiety (8.03 ± 6.27, p = 0.002) but not for depression. An interdisciplinary approach involving mental health professionals within the therapeutic team can comprehensively address factors contributing to obesity development and treatment outcomes. Further investigation of semaglutide's use is needed due to the promising evidence suggesting a positive effect on decreasing the severity of depression and anxiety symptoms to assess the direct or indirect character of this influence.
Assuntos
Transtornos de Ansiedade , Depressão , Obesidade , Humanos , Feminino , Adulto , Obesidade/psicologia , Obesidade/tratamento farmacológico , Pessoa de Meia-Idade , Transtornos de Ansiedade/tratamento farmacológico , Depressão/tratamento farmacológico , Polônia , Fármacos Antiobesidade/uso terapêutico , Peptídeos Semelhantes ao Glucagon/uso terapêutico , Ansiedade/tratamento farmacológico , Questionário de Saúde do Paciente , Adulto Jovem , Cirurgia Bariátrica , Índice de Massa Corporal , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: This study aimed to 1) examine how psychopharmacotherapy and mindfulness-based stress reduction (MBSR) influence absenteeism and job performance among individuals with anxiety disorders and 2) compare the effectiveness of these treatments in improving work performance. METHODS: Adults (N = 67) with a primary anxiety disorder were recruited to participate in the study. Participants were randomized to escitalopram, a common treatment for anxiety disorders, or MBSR. Absenteeism and job performance were measured with the Health and Work Performance (HPQ) questionnaire prior to treatment and at the week 24 follow up. RESULTS: At week 24, individuals in the escitalopram arm and the MBSR arm showed significant improvements in partial days of missed work due to mental/physical health problems from baseline (1.00 [0.00-2.50] to 0.00 [0.00 = 1.00], p = .034 and 0.00 [0.00-2.00] to 0.00 [0.00 = 1.00], p = .001, respectively). In the MBSR arm only, job performance increased from baseline to week 24 (65.00 [50.00-80.00] to 75.00 [67.50-82.50], p = .017). None of the outcome variables significantly varied by group at baseline or week 24. CONCLUSIONS: Our study finds evidence that MBSR improves work performance equivalently to SSRI medication among individuals with anxiety disorders. Given the limitations of SSRIs, MBSR should be considered as an alternative to individuals who desire improved anxiety symptoms and work outcomes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03522844.
Assuntos
Absenteísmo , Transtornos de Ansiedade , Escitalopram , Meditação , Desempenho Profissional , Humanos , Masculino , Feminino , Adulto , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/terapia , Pessoa de Meia-Idade , Escitalopram/uso terapêutico , Atenção Plena/métodos , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Resultado do Tratamento , Citalopram/uso terapêuticoRESUMO
OBJECTIVE: To study the effectiveness and the quality of life impact of the mobile application Zdorovye.ru in people with subclinical and clinical anxiety disorder (AD). MATERIAL AND METHODS: 200 patients with more than 7 points on the Hospital Anxiety and Depression Scale (HADS) were included. Participants were randomized into two groups: experimental one (EG, n=133) - to receive standard treatment with temgicoluril (Adaptol), 500 mg (Olainfarm JSC, Latvia) and the Zdorovye.ru application; control group (CG, n=52) - standard treatment with temgicoluril (Adaptol). RESULTS: There were a significant decrease in the HADS-A score, PSS-10 score and an increase in the visual analog scale EQ-5D score in both groups after 3 months of treatment (p<0.001). Clinical improvement was noticeable after 1.5 months in EG group: a decrease in HADS-A scores (p=0.001) and in tension and stress on PSS-10 subscales (p<0.001) were noted. This effect was not observed in the CG. After 3 months, all participants noted an improvement in quality of life (p<0.001), without a statistically significant difference between groups (p=0.233). The application left a positive impression on users and doctors - most respondents rated it as useful and clear. CONCLUSION: Taking temgicoluril (Adaptol) for 3 months led to symptoms decrease and the quality of life and well-being improvement in patients with AD. Using the mobile application Zdorovye.ru in conjunction with drug therapy made it possible to achieve a clinical effect earlier, in 1.5 months.
Assuntos
Transtornos de Ansiedade , Aplicativos Móveis , Qualidade de Vida , Humanos , Feminino , Masculino , Adulto , Transtornos de Ansiedade/tratamento farmacológico , Pessoa de Meia-Idade , Resultado do Tratamento , Ansiolíticos/uso terapêutico , Ansiolíticos/administração & dosagemRESUMO
OBJECTIVE: To investigate the efficacy and safety of Aviandr in the treatment of anxiety in patients with adjustment disorders after COVID-19. MATERIAL AND METHODS: A multicenter prospective open-label study included 109 patients of both sexes aged 18 to 65 years (70 women, 39 men, average age - 41.4±13.18 years) with a leading complaint of anxiety (Hamilton scale score, HAM-A ≥18 - ≤24), which arose after acute coronavirus infections. Clinical manifestations had to meet the diagnostic criteria F43.2 ICD-10. The drug Aviander was prescribed 20 mg 2 times a day for 4 weeks. At the end of taking the drug, patients were monitored for another 1 week (a delayed follow-up visit). Psychopathological, statistical and parametric research methods were used using standardized HAM-A, Montgomery-Asberg scales (MADRS), visual analog asthenia scale (VASH-A), Sheehan Disability Scale (SDS), digital character substitution test (DSST), general clinical impression scale (CGI). RESULTS: Data from 109\110 patients were analyzed to evaluate efficacy\safety. Aviandr was administered 20 mg 2 times daily for 4 weeks. Patients were followed for 1 week (delayed follow-up visit) at the end of treatment. Reducing the intensity of anxiety on the HAM-A scale was - 14.2±4.92 or 69.4±22.66% by the end of treatment. The response rate to therapy (responders are patients with a decrease in the total score on the HAM-A ≥50%) was 83.49%. Remission was achieved (sum of HAM-A scores ≤7) by the end of treatment 68.81% of patients, and 79.8% of patients at the follow-up visit. Significant changes were obtained on the MADRS, VAS-A, SDS and DSST scales. According CGI 45.9% of patients had «much improved¼ and 43.1% of patients had «very much improved¼ by the end of treatment; 58.7% of patients had «much improved¼ and of 33.9% patients had «very much improved¼ at the follow-up visit. 38 adverse events were reported in 27 (24.55%) patients during the study. A definite association with study drug was reported between 5 mild adverse events in 4 (3.64%) patients. No subjects withdrew from the study due to an adverse event. Positive dynamics (reduction of anxiety symptoms, decrease in asthenia) persisted after discontinuation of the study drug. No cases of withdrawal syndrome were observed. CONCLUSION: According to the results of the study, the anxiolytic, antidepressant, antiasthenic and pro-cognitive effects of Aviandr were observed. An increase in the social activity of patients was observed.
Assuntos
COVID-19 , Humanos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , COVID-19/complicações , COVID-19/psicologia , Estudos Prospectivos , Idoso , Adulto Jovem , Resultado do Tratamento , Transtornos de Adaptação/tratamento farmacológico , Adolescente , Ansiedade/tratamento farmacológico , Ansiedade/etiologia , SARS-CoV-2 , Transtornos de Ansiedade/tratamento farmacológico , Ansiolíticos/uso terapêutico , Ansiolíticos/efeitos adversosRESUMO
BACKGROUND: Women with menopausal transition (MT) have an elevated risk of experiencing common mental health diagnoses (CMHD: depression or anxiety). There is no recent data comparing the rate, and treatment, of CMHD between men and women. METHODS: In this population-based study, incidence rates (IR) per 100 person-years-at-risk (PYAR) for men and women ≥45 years registered with an UK primary care practice between 2010 and 2021 were estimated. Incidence rate ratios (IRR) with 95 % confidence intervals (CIs) of CMHD were estimated using men as a reference. We measured first prescriptions for psychotropic medications received within 12 months after CMHD. For selective serotonin reuptake inhibitors (SSRIs) /selective norepinephrine reuptake inhibitors (SNRIs), we measured the IR of prescribing per 100 PYAR, by 10-year bands. Proportion of SSRIs/SNRIs prescribing was estimated per 100 persons. RESULTS: Rates of anxiety and depressive disorders were 1.68 and 1.69 per 100 PYAR in women aged 45-54 years-old compared to 0.91 and 1.20 per 100 PYAR in men, with IRR of 1.84 (95 % CI 1.72-1.97) and 1.44 (1.35-1.53) respectively. SSRIs/SNRIs were the most prescribed medication; in 2021, IRs for SSRIs/SNRIs were 13.4 per 100 PYAR in both sexes. In 2021, the proportion of SSRIs/SNRIs prescribing was 50.67 per 100 women and 41.91 per 100 men. LIMITATIONS: MT is assumed based on women's age as menopause onset is rarely recorded in primary care databases. CONCLUSIONS: Women ≥45 years experienced more CMHD compared to men, especially 45-54 years-olds, which coincides with MT. The proportion of SSRIs/SNRIs prescribing was higher in women.
Assuntos
Menopausa , Psicotrópicos , Inibidores Seletivos de Recaptação de Serotonina , Inibidores da Recaptação de Serotonina e Norepinefrina , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Inibidores da Recaptação de Serotonina e Norepinefrina/uso terapêutico , Psicotrópicos/uso terapêutico , Reino Unido/epidemiologia , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/epidemiologia , Idoso , Fatores Sexuais , Incidência , Padrões de Prática Médica/estatística & dados numéricosRESUMO
BACKGROUND: Blinding is thought to minimise expectancy effects and biases in double-blind randomised-controlled trials (RCTs). However, whether blinding integrity should be assessed and reported remains debated. Furthermore, it is unknown whether blinding failure influences the outcome of RCTs in anxiety disorders. We carried out a systematic review to understand whether blinding integrity is assessed and reported in anxiolytic RCTs. A secondary aim was to explore whether blinding integrity is associated with treatment efficacy. METHOD: Our protocol was pre-registered (PROSPERO CRD42022328750). We searched electronic databases for placebo-controlled, randomised trials of medication in adults with generalised and social anxiety disorders, and in panic disorder, from 1980. We extracted data regarding blinding integrity and treatment efficacy. Risk of bias was assessed with the Cochrane risk of bias tool. Where possible, we subsequently calculated Bang's Blinding Index, and assessed the association between blinding integrity and treatment effect size. RESULTS: Of the 247 RCTs that met inclusion criteria, we were able to obtain assessments of blinding integrity from nine (3.64%). Overall, blinding failed in five of these trials (55.56%), but blinding was intact in 80% of placebo arms. We found a significant association between reduced blinding integrity among assessors and increased treatment effect size (betas < -1.30, p's < 0.001), but this analysis involved only four studies of which two were outlying studies. In patients, we saw a non-significant trend where reduced blinding integrity in the placebo groups was associated with increased treatment efficacy, which was not present in active medication arms. [Correction added on 19 August 2024, after first online publication: Results of the RCTs and its assessment of blinding integrity have been updated.] CONCLUSION: Consistent with work in other psychiatric disorders, blinding integrity is rarely reported in anxiolytic RCTs. Where it is reported, blinding appears to often fail. We found signals that suggest unblinding of clinician assessors (driven by two studies with complete unblinding), and of patients in placebo arms, might be associated with larger treatment effect sizes. We recommend that data regarding blinding integrity, along with the reasons patients and assessors offer for their beliefs regarding group allocation, are systematically collected in RCTs of anxiolytic treatment.
Assuntos
Ansiolíticos , Transtornos de Ansiedade , Humanos , Ansiolíticos/uso terapêutico , Transtornos de Ansiedade/tratamento farmacológico , Método Duplo-Cego , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do TratamentoRESUMO
BACKGROUND: Women with gynecologic disorders requiring a hysterectomy often have co-existing psychiatric diagnoses. A change in the dispensing pattern of antidepressant (AD) and antianxiety (AA) medications around the time of hysterectomy may be due to improvement in gynecologic symptoms, such as pelvic pain and abnormal bleeding, or the emotional impact of the hysterectomy. Unfortunately, these dispensing patterns before and after hysterectomy are currently undescribed. OBJECTIVES: To model the dispensing patterns of AD and AA medications over time among women with psychiatric disorders before and after benign hysterectomy for endometriosis and uterine fibroids; and to characterize clusters of patients with various dispensing behaviors based on these patterns. DESIGN: Retrospective cohort study. METHODS: This is a study of women who underwent a benign hysterectomy using data from the Merative MarkertScan® Research Databases (Ann Arbor, MI, USA). Inclusion criteria were reproductive-aged women (18-50 years), diagnosis of at least one mood or anxiety disorder, and at least one dispensing of AD or AA medications. We measured monthly adherence and persistence of AD/AA medication use over 12 months after hysterectomy. Group-based-trajectory modeling (GBTM) was used to identify trajectory groups of monthly AD/AA medication dispensing over the study period. Multinomial logistic regression was used to identify factors independently associated with individual dispensing trajectory patterns. RESULTS: For a total of 11,607 patients, 6 dispensing trajectory groups were identified during the study period: continuously high (27.0%), continuously moderate (21.9%), continuously low (17.9%), low-to-high (10.0%), moderate-to-low (9.8%), and low-to-moderate (13.4%). Compared with the continuously high group, younger age, no history of a mood disorder, and uterine fibroids were clinical predictors of low dispensing. The discontinuation rate at 3 months after hysterectomy was higher at 88.6% in the continuously low group and at 66.5% in the continuously low-to-moderate group. CONCLUSIONS: This study demonstrates that GBTM identified six distinct trajectories of AD/AA medication dispensing in the perioperative period. Trajectory models could be used to identify specific dispensing patterns for targeting interventions.
Dispensing patterns of antidepressant and antianxiety medications for psychiatric disorders after benign hysterectomy in reproductive-aged women: Results from the group-based trajectory modelingWomen with gynecologic disorders often have coexisting psychiatric diagnoses. A change in the dispensing pattern of antidepressant and antianxiety medications may be due to improvement in gynecologic symptoms or the emotional impact of the hysterectomy. However, static measures, such as the proportion of days covered or medication possession ratio, may not adequately predict meaningful dispensing patterns. Using the group-based trajectory modeling, 6 distinct patterns of medication dispensing over the perioperative periods of women with benign hysterectomy are identified and therefore used to assess how certain clinical characteristics influence these dispensing patterns. This study concludes that trajectory modeling may be a more appropriate approach to investigating dispensing patterns among women with preexisting psychiatric conditions.
Assuntos
Ansiolíticos , Antidepressivos , Histerectomia , Humanos , Feminino , Adulto , Estudos Retrospectivos , Antidepressivos/uso terapêutico , Pessoa de Meia-Idade , Ansiolíticos/uso terapêutico , Leiomioma/cirurgia , Leiomioma/tratamento farmacológico , Adulto Jovem , Endometriose/cirurgia , Endometriose/tratamento farmacológico , Adolescente , Adesão à Medicação/estatística & dados numéricos , Transtornos de Ansiedade/tratamento farmacológico , Estudos de CoortesRESUMO
Anxiety disorders are prevalent chronic psychological disease with complex pathogenic mechanisms. Current anxiolytics have limited efficacy and numerous side effects in many anxiety patients, highlighting the urgent need for new therapies. Recent research has been focusing on nutritional supplements, particularly amino acids, as potential therapies for anxiety disorders. Among these, L-Cysteine plays a crucial role in various biological processes. L-Cysteine exhibits antioxidant properties that can enhance the antioxidant functions of the central nervous system (CNS). Furthermore, metabolites of L-cysteine, such as glutathione and hydrogen sulfide have been shown to alleviate anxiety through distinct molecular mechanisms. Long-term administration of L-Cysteine has anxiolytic, antidepressant, and memory-improving effects. L-Cysteine depletion can lead to increased oxidative stress in the brain. This review delves into the potential mechanisms of L-Cysteine and its main products, glutathione (GSH) and hydrogen sulfide (H2S) in the management of anxiety and related diseases.
Assuntos
Transtornos de Ansiedade , Cisteína , Suplementos Nutricionais , Cisteína/farmacologia , Humanos , Transtornos de Ansiedade/tratamento farmacológico , Animais , Ansiolíticos/farmacologia , Ansiolíticos/uso terapêutico , Sulfeto de Hidrogênio/metabolismo , Sulfeto de Hidrogênio/farmacologia , Sulfeto de Hidrogênio/uso terapêutico , Glutationa/metabolismo , Antioxidantes/farmacologia , Antioxidantes/administração & dosagem , Estresse Oxidativo/efeitos dos fármacosRESUMO
ABSTRACT: Anxiety comorbidity in bipolar disorder (BD) is important and thus significantly affects the course of BD and its outcomes. The treatment of generalized anxiety disorder comorbid with BD involves certain challenges, as antidepressant medications, which are standard in the treatment of anxiety disorder, have the risk of shifting to manic episodes and rapid cycling. In this case report, the response to agomelatine treatment in generalized anxiety disorder comorbid with bipolar 1 disorder was evaluated.
Assuntos
Acetamidas , Transtornos de Ansiedade , Transtorno Bipolar , Humanos , Acetamidas/uso terapêutico , Masculino , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/complicações , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/complicações , Adolescente , Resultado do Tratamento , Antidepressivos/uso terapêutico , NaftalenosRESUMO
ABSTRACT: Previous studies have found that anxiety disorders may increase the incidence of atrial fibrillation (AF). More and more studies have shown that α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPARs) are involved in the occurrence and development of cardiovascular diseases. However, the role of AMPARs in AF associated with anxiety disorder remains unclear. The aim of this study was to investigate the effect of AMPARs on AF susceptibility in rats with anxiety disorder and its possible mechanism. The anxiety disorder rat model was established by unpredictable empty bottle stimulation and was treated with AMPARs agonist and antagonist. Our results showed that AMPARs antagonist treatment significantly reduced sympathetic activity, improved heart rate variability, shortened action potential duration, prolonged effective refractory period, reduced AF induction rate, and improved cardiac electrical remodeling and the expression of inflammatory factors. In addition, inhibition of AMPARs reduced the phosphorylation of IκBα and p65. Our experimental results suggest that inhibition of AMPARs can reduce autonomic remodeling, improve atrial electrical remodeling, and suppress myocardial inflammation, which provides a potential therapeutic strategy for the treatment of AF associated with anxiety disorder.
Assuntos
Transtornos de Ansiedade , Fibrilação Atrial , Modelos Animais de Doenças , Átrios do Coração , Ratos Sprague-Dawley , Receptores de AMPA , Animais , Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/metabolismo , Masculino , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/metabolismo , Transtornos de Ansiedade/fisiopatologia , Átrios do Coração/efeitos dos fármacos , Átrios do Coração/fisiopatologia , Átrios do Coração/metabolismo , Átrios do Coração/patologia , Receptores de AMPA/metabolismo , Remodelamento Atrial/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Mediadores da Inflamação/metabolismo , Potenciais de Ação/efeitos dos fármacos , Fosforilação , Transdução de Sinais , Sistema Nervoso Simpático/fisiopatologia , Sistema Nervoso Simpático/efeitos dos fármacos , Sistema Nervoso Simpático/metabolismo , Fator de Transcrição RelA/metabolismo , Ratos , Anti-Inflamatórios/farmacologia , Período Refratário Eletrofisiológico/efeitos dos fármacos , Inibidor de NF-kappaB alfa/metabolismoRESUMO
OBJECTIVE: Recovery from a COVID-19 infection can lead to post-COVID-19 condition (PCC), which causes a multitude of debilitating symptoms that negatively affect an individual's health-related quality of life, including depressive and anxiety symptoms. We aim to examine the mediatory effects of anxiety on depressive symptoms in persons with PCC receiving vortioxetine. METHODS: We performed a post-hoc analysis of a randomized, double-blinded, placebo-controlled clinical trial investigating vortioxetine treatment on cognitive functioning in persons with PCC. Anxiety and depressive symptoms were measured by the 7-Item Generalized Anxiety Disorder (GAD-7) Scale and the 16-Item Quick Inventory of Depressive Symptomatology (QIDS-SR-16), respectively. RESULTS: Based on data of 147 participants, GAD-7 scores were significantly positively associated with QIDS-SR-16 scores (ß=0.038, 95 % CI [0.029,0.047], p < 0.001). After adjusting for covariates, a significant group (χ2=176.786, p < 0.001), time (χ2=8.914, p = 0.003), and treatment x time x GAD-7 score interaction (χ2=236.483, p < 0.001) effect was observed. Vortioxetine-treated participants had a significant difference in overall change in depressive symptoms (mean difference=-3.15, SEM=0.642, 95 % CI [-4.40,-1.89], p < 0.001). CONCLUSION: Anxiety symptoms were significantly associated with depressive symptoms in persons with PCC. Antidepressant efficacy on ameliorating depressive symptoms is dependent on improving anxiety symptoms, underscoring significant implications in improving treatment efficacy and patient quality of life.
Assuntos
Ansiedade , COVID-19 , Depressão , Vortioxetina , Humanos , Vortioxetina/farmacologia , Vortioxetina/uso terapêutico , Masculino , Feminino , Pessoa de Meia-Idade , Ansiedade/tratamento farmacológico , Depressão/tratamento farmacológico , Depressão/etiologia , Método Duplo-Cego , Adulto , COVID-19/complicações , COVID-19/psicologia , Qualidade de Vida , Transtornos de Ansiedade/tratamento farmacológico , Idoso , Antidepressivos/uso terapêutico , Antidepressivos/farmacologiaRESUMO
The gut microbiome is a vast, variable, and largely unexplored component of human biology that sits at the intersection of heritable and environmental factors, and represents a rich source of novel chemistry that is already known to be compatible with the human body. This alone would make it a promising place to search for new therapeutics, but recent work has also identified gut microbiome abnormalities in patients with a number of psychiatric disorders, including anxiety disorders-suggesting that not only treatments, but cures may lie therein. Here, we'll discuss two known "para-endogenous" anxiolytics-γ-hydroxybutyrate and the neurosteroid allopregnanolone-which have recently been discovered to be produced by the microbiome.
Assuntos
Ansiolíticos , Microbioma Gastrointestinal , Humanos , Ansiolíticos/farmacologia , Ansiolíticos/uso terapêutico , Microbioma Gastrointestinal/efeitos dos fármacos , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/microbiologia , Transtornos de Ansiedade/metabolismo , Pregnanolona/uso terapêutico , Pregnanolona/farmacologia , Animais , Ansiedade/tratamento farmacológico , Ansiedade/microbiologiaRESUMO
Anxiety disorders are chronic, disabling psychiatric disorders, and there is a growing medical need for the development of novel pharmacotherapeutic agents showing improved efficacy and an improved side effect profile as compared with the currently prescribed anxiolytic drugs. In the course of the search for next-generation anxiolytics, neuropeptide receptors have garnered interest as potential therapeutic targets, underscored by pivotal roles in modulating stress responses and findings from animal studies using pharmacological tools. Among these neuropeptide receptors, the type 1 receptor for melanin-concentrating hormone (MCH1), which has been demonstrated to be involved in an array of physiological processes, including the regulation of stress responses and affective states, has gained attraction as a therapeutic target for drugs used in the treatment of psychiatric disorders, including anxiety disorders. To date, a plethora of MCH1 antagonists have been synthesized, and studies using MCH1 antagonists and genetically manipulated mice lacking MCH1 have revealed that the blockade of MCH1 produces anxiolytic-like effects across diverse rodent paradigms. In addition, MCH1 antagonists have been demonstrated to show a rapid onset of antidepressant-like effects; therefore, they may be effective for conditions commonly encountered in patients with anxiety disorders, which is an advantage for anxiolytic drugs. Notably, MCH1 antagonists have not manifested the undesirable side effects observed with the currently prescribed anxiolytics. All these preclinical findings testify to the potential of MCH1 antagonists as novel anxiolytics. Although there are still issues that need to be resolved prior to the initiation of clinical trials, such as elucidating the precise neuronal mechanisms underlying their anxiolytic effects and exploring pertinent biomarkers that can be used in clinical trials, MCH1 blockade appears to be an attractive way to tackle anxiety disorders.
Assuntos
Ansiolíticos , Transtornos de Ansiedade , Animais , Ansiolíticos/farmacologia , Ansiolíticos/uso terapêutico , Humanos , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/metabolismo , Receptores do Hormônio Hipofisário/antagonistas & inibidores , Receptores do Hormônio Hipofisário/metabolismo , CamundongosRESUMO
Most cases of anxiety are currently treated with either benzodiazepines or serotonin reuptake inhibitors. These drugs carry with them risks for a multitude of side effects, and patient compliance suffers for this reason. There is thus a need for novel anxiolytics, and among the most compelling prospects in this vein is the study of the TAARs. The anxiolytic potential of ulotaront, a full agonist at the human TAAR1, is currently being investigated in patients with generalized anxiety disorder. Irrespective of whether this compound succeeds in clinical trials, a growing body of preclinical literature underscores the relevance of modulating the TAARs in anxiety. Multiple behavioral paradigms show anxiolytic-like effects in rodents, possibly due to increased neurogenesis and plasticity, in addition to a panoply of interactions between the TAARs and other systems. Crucially, multiple lines of evidence suggest that the TAARs, particularly TAAR1, TAAR2, and TAAR5, are expressed in the extended amygdala and hippocampus. These regions are central in the actuation of anxiety, and are particularly susceptible to neurogenic and neuroplastic effects which the TAARs are now known to regulate. The TAARs also regulate the dopamine and serotonin systems, both of which are implicated in anxiety. Ligands of the TAARs may thus constitute a new class of anxiolytics.