Understanding the Neurobiology of Comorbidity in Anxiety Disorders

CNS Spectrums ◽  
2006 ◽  
Vol 11 (S12) ◽  
pp. 13-20 ◽  
Author(s):  
David J. Nutt ◽  
Dan J. Stein
Keyword(s):  
Anxiety Disorders ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Reuptake Inhibitors ◽  
Response To Treatment ◽  
Selective Serotonin ◽  
Anxiety And Depression ◽  
Brain Pathology ◽  
Receptor Function ◽  
Similarities And Differences

AbstractAnxiety and depression are common disorders that frequently co-exist. Both disorders show good response to antidepressants, especially the selective serotonin reuptake inhibitors. Some suggest that these disorders are variants of the same underlying brain pathology. This review examines the similarities and differences between anxiety and depression in terms of the known neurobiological etiologic mechanisms as well as their biological underpinnings and response to treatment. Sufficient and significant differences between these disorders support the view that they are independent entities. Shared abnormalities in the 5HT1A receptor function, for example, may help explain some of the comorbidity.

scholarly journals Efficacy of selective serotonin reuptake inhibitors and adverse events: Meta-regression and mediation analysis of placebo-controlled trials

2016 ◽  
Vol 208 (2) ◽  
pp. 114-119 ◽  
Author(s):  
Michael Barth ◽  
Levente Kriston ◽  
Swaantje Klostermann ◽  
Corrado Barbui ◽  
Andrea Cipriani ◽  
...  
Keyword(s):  
Adverse Events ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Reuptake Inhibitors ◽  
Response To Treatment ◽  
Selective Serotonin ◽  
Controlled Trials ◽  
Regression Analyses ◽  
Double Blind ◽  
Meta Regression

BackgroundIt has been suggested that the efficacy of antidepressants has been overestimated in clinical trials owing to unblinding of drug treatments by adverse events.AimsTo investigate the association between adverse events and the efficacy of selective serotonin reuptake inhibitors (SSRIs).MethodThe literature was searched to identify randomised, double-blind, placebo-controlled trials of SSRIs in the treatment of major depression. Efficacy outcomes were response to treatment and change in depressive symptoms. Reporting of adverse events was used as an indicator of tolerability. Random effects meta-analyses were used to calculate pooled estimates. Meta-regression analyses were performed to investigate the association between adverse events and efficacy. Potential mediation was investigated with the Baron & Kenny approach.ResultsA total of 68 trials (n = 17 646) were included in the analyses. In meta-analysis SSRIs were superior to placebo in terms of efficacy (odds ratio, OR = 1.62, 95% CI 1.51–1.72). More patients allocated to SSRIs reported adverse events than did patients receiving placebo (OR = 1.73, 95% CI 1.58–1.89). Meta-regression analyses did not find an association between adverse events and efficacy (P = 0.439). There was no indication of adverse events mediating the effect of SSRI treatment.ConclusionsOur results do not support, but also do not unequivocally disprove, the hypothesis that adverse events lead to an overestimation of the effect of SSRIs over placebo.

Overview of Diagnosis and Drug Treatments of Anxiety Disorders

CNS Spectrums ◽  
2005 ◽  
Vol 10 (1) ◽  
pp. 49-56 ◽  
Author(s):  
David J. Nutt
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Drug Treatments ◽  
The Common

AbstractAnxiety disorders are common and often disabling. They fall into five main categories: panic disorder, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder and posttraumatic stress disorder, each of which have characteristic symptoms and cognitions. All anxiety disorders respond to drugs and psychological treatments. This review will focus on drug treatments. Recent research has emphasized the value of antidepressants especially the selective serotonin reuptake inhibitors, benzodiazepines, and related sedative-like compounds. The common co-existence of depression with all of the anxiety disorders means that the selective serotonin reuptake inhibitors are now generally considered to be the first-line treatments but the benzodiazepines have some utility especiaRy in promoting sleep and working acutely to reduce extreme distress.

Sign in / Sign up

Export Citation Format

Share Document