scholarly journals The role of beta-adrenolytic drugs in treating anxiety disorders

2018 ◽  
Vol 19 (3) ◽  
pp. 209-224
Author(s):  
Żaneta Brudkowska ◽  
Małgorzata Tomczyk ◽  
Katarzyna Jusiak ◽  
Hanna Karakuła-Juchnowicz ◽  
Ewa Rudnicka-Drożak
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Clinical Trials ◽  
Anxiety Disorders ◽  
Posttraumatic Stress ◽  
Randomized Clinical Trials ◽  
Stress Disorder ◽  
Therapeutic Potential ◽  
Beta Blockers ◽  
Panic Attacks ◽  
Pubmed Database

Summary Introduction: Beta blockers are mainly used in treating cardiovascular diseases. However, it has been observed that these drugs have also an anxiolytic potential. Over the years, a number of clinical trials have been conducted aimed at determining the effectiveness of beta blockers in treating anxiety disorders. The aim of the article: The main objective of the article is to present the significance and position of adrenolytic drugs in the pharmacotherapy of anxiety disorders on the basis of available literature. Moreover, the authors also decided to take into account the data from current research results, considering the problem of side effects of using adrenolytic drugs - especially the controversial reports on their effect on the development of affective disorders. Method: An analysis was conducted of articles from Medline/PubMed database, selected on the basis of the following key words: anxiety disorders, beta blockers, adrenolytic drugs, as well as on the basis of their dates of publication: 1960-2017. In order to conduct a reliable and complete review of literature, the authors decided to include works from quite an extended period of time. The articles included in the review were published in Polish and English. Results: The review of articles concerning the treatment of anxiety disorders clearly suggests that propranolol is effective in reducing the frequency of panic attacks and the tendency for avoidance behavior in patients with agoraphobia. Other studies report on potential benefits in terms of early interventional prevention and treating posttraumatic stress disorder with propranolol. However, there is lack of randomized clinical trials concerning the therapeutic effect of other adrenolytic drugs in treating anxiety disorders. Early research works reported that (mainly lipophilic) beta blockers may have a depressogenic effect; however, the latest studies have not confirmed it. The contemporary research on the therapeutic potential of beta blockers in treating anxiety disorders is insufficient. What seems to be most promising, however, are reports concerning the desirable effects of using adrenolytic drugs in treating posttraumatic stress disorder, which implicates the necessity of conducting further research verifying the validity of their application.

Combination Pharmacotherapy and Psychotherapy for the Treatment of Major Depressive and Anxiety Disorders

2015 ◽  
Author(s):  
Cindy J. Aaronson ◽  
Gary Katzman ◽  
Rachel L. Moster
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Posttraumatic Stress ◽  
Obsessive Compulsive Disorder ◽  
Randomized Clinical Trials ◽  
Stress Disorder ◽  
Obsessive Compulsive ◽  
Major Depressive ◽  
Compulsive Disorder

Clinical wisdom and intuition suggest that when treating major depression and/or anxiety disorders, combining two documented efficacious treatments such as antidepressants and psychotherapy would improve outcome. However, the data do not completely support this conclusion. This chapter reviews randomized clinical trials comparing combined pharmacotherapy and psychotherapy with monotherapy for the treatment of major depressive disorder, panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder, generalized anxiety disorder, and social anxiety disorder in adults. Although DSM-V no longer categorizes posttraumatic stress disorder and obsessive-compulsive disorder as anxiety disorders, the authors continue to include them in this chapter.

scholarly journals Scaling Up: Multisite Open-Label Clinical Trials of MDMA-Assisted Therapy for Severe Posttraumatic Stress Disorder

2021 ◽  
pp. 002216782110236
Author(s):  
Julie B. Wang ◽  
Jessica Lin ◽  
Leah Bedrosian ◽  
Allison Coker ◽  
Ilsa Jerome ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Clinical Trials ◽  
Posttraumatic Stress ◽  
Clinical Supervision ◽  
Stress Disorder ◽  
The United States ◽  
Health Condition ◽  
Open Label ◽  
Adverse Health Outcomes ◽  
Ptsd Symptom Severity

Background: Posttraumatic stress disorder (PTSD) is a debilitating mental health condition associated with serious adverse health outcomes and functional impairment. Previous MDMA–assisted therapy (MDMA-AT) studies have shown promising results in single site studies. Two open-label studies tested this modality in multisite clinical trials to assess the feasibility of scaling this manualized therapy across 14 North American sites. Method: Cotherapist dyads were trained in the manualized MDMA-AT protocol and administered three experimental sessions 3 to 5 weeks apart among participants with severe PTSD. Cotherapist dyads were provided clinical supervision and evaluated for protocol adherence by centralized raters. Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) assessed change in symptoms severity. Results: Adherence rating scores were high across cotherapist dyads ( M = 95.08%, SD = 3.70%) and sites ( M = 95.23%, SD = 2.20%). CAPS-5 scores decreased following 3 MDMA-AT sessions at 18 weeks post baseline (Δ M = −29.99, Δ SD = 13.45, p < .0001, n = 37, Cohen’s d = 2.2, confidence interval [1.97, 2.47]). MDMA was well tolerated. Conclusions: These findings corroborate previous results that MDMA-AT can achieve significant improvements in PTSD symptom severity and demonstrate scalability of manualized therapy across clinic sites in the United States and Canada.

Intrusive Thoughts in Posttraumatic Stress Disorder

2002 ◽  
Vol 16 (2) ◽  
pp. 127-143 ◽  
Author(s):  
Sherry A. Falsetti ◽  
Jeannine Monnier ◽  
Joanne L. Davis ◽  
Heidi S. Resnick
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Treatment Outcome ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Intrusive Thoughts ◽  
Panic Attacks ◽  
Trauma Survivors ◽  
Multiple Channel ◽  
Assessment And Treatment ◽  
Behavioral Treatments

This article reviews the literature on prevalence, associated features, assessment, and treatment of intrusive symptoms associated with posttraumatic stress disorder (PTSD). Research indicates that among trauma survivors, intrusive thoughts and imagery are quite common and distressing. It appears that early intrusions may be predictive of long-term distress and that avoidance and suppression can maintain intrusions. The treatment outcome literature for PTSD indicates that current cognitive behavioral treatments are effective in reducing intrusions. New data from a recent treatment outcome study for PTSD with comorbid panic attacks, using Multiple Channel Exposure Therapy, also suggest that this treatment is effective in significantly reducing intrusions.

scholarly journals Pharmacotherapy of Anxiety Disorders: Current and Emerging Treatment Options

2020 ◽  
Vol 11 ◽  
Author(s):  
Amir Garakani ◽  
James W. Murrough ◽  
Rafael C. Freire ◽  
Robyn P. Thom ◽  
Kaitlyn Larkin ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Posttraumatic Stress ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Stress Disorder ◽  
Controlled Trials ◽  
Beta Adrenergic ◽  
Adrenergic Agents ◽  
Compulsive Disorder

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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