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Generalized Anxiety Disorder
Published in Stephen M. Stahl, Bret A. Moore, Anxiety Disorders: A Guide for Integrating Psychopharmacology and Psychotherapy, 2013
Joseph E. Comaty, Claire Advokat
Although current pharmacological and behavioral GAD treatments leave much room for improvement, efforts to address therapeutic limitations continue. One study reported positive results on the HAM-A, and an excellent safety profile, with an experimental drug, ocinaplon, that is a positive allosteric modulator of the GABAA receptor (Czobor, Skolnick, Beer, & Lippa, 2010). A reexamination of opioids in the neurobiology of anxiety has recently been proposed (Colasanti, Rabiner, Lingford-Hughes, & Nutt, 2011). Similarly, a recent neurobiological analysis of fear extinction discusses the relevance of this behavioral paradigm to the anxiety disorders (Graham & Milad, 2011). Clearly, the need for more effective methods of treating generalized anxiety disorder is recognized and new developments are in progress.
Pharmacological Treatment of Generalised Anxiety Disorder: Current Practice and Future Directions
Published in Expert Review of Neurotherapeutics, 2023
Harry A. Fagan, David S. Baldwin
Non-benzodiazepine hypnotics (or ‘Z-drugs’) are GABAA receptor positive allosteric modulators that fall within one of the several different chemical classes to benzodiazepines. Several have specific affinity to particular sub-units of the GABAA receptor. Non-benzodiazepines are widely used in psychiatric practice as hypnotics but have largely failed to enter clinical practice for the treatment of anxiety disorders. A single small RCT that assessed the pyrazolopyrimidine ocinaplon in GAD found greater efficacy than placebo, but due to adverse effects in phase 3 trials, its development was subsequently discontinued [52].