P1vital CNS Experimental Medicine : ANXIETY OVERVIEW

'Anxiety' part of a self portrait by artist Terry Miles READ MORE:

The mechanisms underlying the anxiety disorders (including generalised anxiety disorder, panic disorder, obsessive compulsive disorder and phobia) are not well understood. Anxiety disorders affect an estimated 73 million people worldwide and two pharmacological approaches to therapy are in routine clinical use. These are modulation of GABAA function by benzodiazepines and enhancement of serotonergic function by 5-HT1A receptor partial agonists (e.g. buspirone) and selective serotonin reuptake inhibitors (SSRIs).

The currently available therapies in these classes each have significant shortcomings. Use of benzodiazepines, which are highly effective anxiolytics with a rapid onset of action, is restricted by concerns over side effects, particularly their liability to induce drug dependence. By contrast the serotonergic compounds, which are generally thought to be free from dependence liability, are often less efficacious and may require 4-6 weeks of treatment to attain clinical efficacy. Delay in onset may lead to compliance failure.

The clinical need therefore is for an anxiolytic with rapid efficacy but devoid of benzodiazepine-like side effects, particularly dependence liability. There is considerable potential for Experimental Medicine models to be used to select the best compounds for expensive late stage trials.