Glutamate and anxiety disorders.
Anxiety disorders are among the most prevalent psychiatric disorders, but they represent a particular challenge for treatment. The standard first-line treatments, including antidepressants, benzodiazepines, and buspirone, result in significant response rates for a majority of patients; however, unfavorable side effect profiles or risk for dependency for particular agents might limit their use by anxious patients, who often have low thresholds for medication discontinuation. Novel pharmacologic agents that modulate particular receptors, ion channels, or transporters relevant to glutamatergic neurotransmission may represent a new approach to the treatment of anxiety disorders, with generally more favorable side effect profiles. Although the role of glutamate in the pathophysiology of anxiety disorders is still being elucidated, the use of these agents in treatment of anxiety disorders and commonly comorbid conditions such as substance abuse and mood disorders will continue to increase.
Amiel
Jonathan M
JM
Columbia University Department of Psychiatry, New York State Psychiatric Institute, New York, NY 10032, USA. jma2106@columbia.edu
Mathew
Sanjay J
SJ
D014151:Anti-Anxiety Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy* / Q000503:physiopathology; D001921:Brain / Q000187:drug effects / Q000503:physiopathology; D004311:Double-Blind Method; D018683:Excitatory Amino Acid Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018698:Glutamic Acid / Q000378:metabolism*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D018091:Receptors, AMPA / Q000187:drug effects / Q000502:physiology; D018092:Kainic Acid Receptors / Q000187:drug effects / Q000502:physiology; D018094:Receptors, Metabotropic Glutamate / Q000187:drug effects / Q000502:physiology; D016194:Receptors, N-Methyl-D-Aspartate / Q000187:drug effects / Q000502:physiology
D014151:Anti-Anxiety Agents; D000927:Anticonvulsants; D018683:Excitatory Amino Acid Agents; D018698:Glutamic Acid; D018091:Receptors, AMPA; D018092:Kainic Acid Receptors; D018094:Receptors, Metabotropic Glutamate; D016194:Receptors, N-Methyl-D-Aspartate