Drug mechanisms in anxiety

Abstract

The most common and successful therapyfor the majority of patients suffering from anxiety is treatment with benzodiazepines (BZDs). The problem of drug-induced dependency following treatment with these drugs may be avoided by developing more selective and specific BZD compounds, such as 2,3-substituted BZDs. Alternative approaches to the treatment of anxiety include the following: (i) antidepressants such as the selective serotonin reuptake inhibitors (SSRIs), which are active in treating most anxiety disorders, including GAD; (ii) metabotropic glutamate (mGluR2) receptor agonists, which negatively modulate glutamate neurotransmission, and CRF antagonists, which have been proposed to exhibit anxiolytic properties; (iii) 5-HT1A receptor agonists which have demonstrated anxiolytic effects in clinical studies, although preclinical studies have reported weak or variable effects; (iv) 5-HT moduline antagonists, as well as 5-HT2C receptor antagonists, which may have anxiolytic properties; and, finally, (v) other approaches which are under investigation, including CCK2 antagonists.