Pharmacological treatment of Generalised Anxiety Disorder: current practice and future directions
Pharmacological treatment of Generalised Anxiety Disorder: current practice and future directions
Introduction: Generalized Anxiety Disorder (GAD) is a common psychiatric condition, characterized by the presence of general apprehensiveness and excessive worry. Current management consists of a range of pharmacological and psychological treatments. However, many patients do not respond to first-line pharmacological treatments and novel anxiolytic drugs are being developed. Areas covered: In this review, the authors first discuss the diagnostic criteria and epidemiology of GAD. The effective pharmacological treatments for GAD and their tolerability are addressed. Current consensus guidelines for treatment of GAD are discussed, and maintenance treatment, the management of treatment resistance, and specific management of older adults and children/adolescents are considered. Finally, novel anxiolytics under development are discussed, with a focus on those which have entered clinical trials. Expert opinion: A range of effective treatments for GAD are available, particularly duloxetine, escitalopram, pregabalin, quetiapine, and venlafaxine. There is a limited evidence base to support the further pharmacological management of patients with GAD who have not responded to initial treatment. Although many novel anxiolytics have progressed to clinical trials, translation from animal models has been mostly unsuccessful. However, the potential of several compounds including certain psychedelics, ketamine, oxytocin, and agents modulating the orexin, endocannabinoid, and immune systems merits further study.
GAD, generalised anxiety disorder, novel anxiolytics, pharmacological treatment, pharmacothreraphy, pharmacotherapy, Generalized Anxiety Disorder
535-548
Fagan, Harry
b1cc5180-6929-4e27-8cae-1d123fdd0b6a
Baldwin, David
1beaa192-0ef1-4914-897a-3a49fc2ed15e
15 May 2023
Fagan, Harry
b1cc5180-6929-4e27-8cae-1d123fdd0b6a
Baldwin, David
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Fagan, Harry and Baldwin, David
(2023)
Pharmacological treatment of Generalised Anxiety Disorder: current practice and future directions.
Expert Review of Neurotherapeutics, 23 (6), .
(doi:10.1080/14737175.2023.2211767).
Abstract
Introduction: Generalized Anxiety Disorder (GAD) is a common psychiatric condition, characterized by the presence of general apprehensiveness and excessive worry. Current management consists of a range of pharmacological and psychological treatments. However, many patients do not respond to first-line pharmacological treatments and novel anxiolytic drugs are being developed. Areas covered: In this review, the authors first discuss the diagnostic criteria and epidemiology of GAD. The effective pharmacological treatments for GAD and their tolerability are addressed. Current consensus guidelines for treatment of GAD are discussed, and maintenance treatment, the management of treatment resistance, and specific management of older adults and children/adolescents are considered. Finally, novel anxiolytics under development are discussed, with a focus on those which have entered clinical trials. Expert opinion: A range of effective treatments for GAD are available, particularly duloxetine, escitalopram, pregabalin, quetiapine, and venlafaxine. There is a limited evidence base to support the further pharmacological management of patients with GAD who have not responded to initial treatment. Although many novel anxiolytics have progressed to clinical trials, translation from animal models has been mostly unsuccessful. However, the potential of several compounds including certain psychedelics, ketamine, oxytocin, and agents modulating the orexin, endocannabinoid, and immune systems merits further study.
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GAD paper revision FINAL copy 28-4-23
- Accepted Manuscript
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Pharmacological Treatment of Generalised Anxiety Disorder Current Practice and Future Directions
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More information
Accepted/In Press date: 4 May 2023
e-pub ahead of print date: 15 May 2023
Published date: 15 May 2023
Additional Information:
Funding Information:
The authors are planning to initiate a study investigating the anxiolytic effect of an orexin receptor antagonist in healthy volunteers. In February 2023, an application for complete funding of this study and provision of an orexin receptor antagonist (daridorexant) was requested from Idorsia Pharmaceuticals Ltd, through their Investigator Sponsored Study (ISS) program. At the time of submission, no decision had been made. DS Baldwin has acted as an advisor to Idorsia Pharmaceuticals Ltd (no honorarium sought or paid) and is a Medical Patron of Anxiety UK. He is also the current president of the British Association for Psychopharmacology. HA Fagan is also supported to carry out this work through an Academic Clinical Fellowship, funded by the National Institute of Health and Care Research (NIHR), the United Kingdom (Award reference: ACF-2022-26-003).
Publisher Copyright:
© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
Keywords:
GAD, generalised anxiety disorder, novel anxiolytics, pharmacological treatment, pharmacothreraphy, pharmacotherapy, Generalized Anxiety Disorder
Identifiers
Local EPrints ID: 477298
URI: http://eprints.soton.ac.uk/id/eprint/477298
ISSN: 1473-7175
PURE UUID: 2c538cf9-8e1c-40ee-8360-089bc9a9eaa8
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Date deposited: 02 Jun 2023 16:37
Last modified: 17 Mar 2024 02:41
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Author:
Harry Fagan
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