Nigella sativa Encapsulated Nano-Scaffolds and Their Bioactivity Significance
Mahfoozur Rahman, Sarwar Beg, Mazin A. Zamzami, Hani Choudhry, Aftab Ahmad, Khalid S. Alharbi in Biomarkers as Targeted Herbal Drug Discovery, 2022
Alcoholic extract of N. sativa is a strong antidepressant. Moreover, the anxiolytic activity was demonstrated with the increase in serotonin (5-HT) and decrease in hydroxyindole acetic acid (5-HIAA) levels in the rat brain. The increased level of 5-HT in rats improved learning and memory capacity and augmented the tryptophan levels. The neuroprotective effects were due to the antioxidant, free radical scavenging and anti-inflammatory capacities of N. sativa. It may also act as anticonvulsant (Ahmad et al., 2013). The results of thymoquinone rich fraction nanoemulsion (TQRFNE), thymoqui-none nanoemulsion (TQNE), and the conventional emulsion were studied on the high fat or cholesterol diet (HFCD) fed rats. Various proteins and enzymes levels such as amyloid-β (Aβ) generation; amyloid-β precursor protein (APP) processing, γ-secretases of presenilin 1 (PSEN1), β-secretase 1 (BACE1), and presenilin 2 (PSEN2), Aβ degradation; Aβ transportation; insulin-degrading enzyme (IDE), receptor for advanced glycation end products (RAGE) and low-density lipoprotein receptor-related protein 1 (LRP1) was estimated in brain tissues. TQRFNE were found to reduce the brain Aβ fragment length 1-40 and 1-42 (Aβ40 and Aβ42) levels, which could further improve the AD pathogenesis (Ismail et al., 2017).
Benzodiazepines as anxiolytics
Adam Doble, Ian L Martin, David Nutt in Calming the Brain: Benzodiazepines and related drugs from laboratory to clinic, 2020
In the treatment of sleep disorders with hypnotic benzodiazepines, it is desirable to achieve rapidly a high level of receptor occupation, which will then decrease during the night. In contrast to the treatment of anxiety disorders, it is important to achieve constant levels of receptor occupation to maintain anxiolysis throughout the day. The onset of action of the drug is not an issue in this indication, indeed, transient peaks of high receptor occupation should be avoided in order to limit excess sedation. For these reasons, the individual benzodiazepines used in the treatment of anxiety disorders have grown to be different from those used as hypnotics. For anxiety, compounds with longer elimination half-lives are preferred, whereas for sleep induction, short half-life drugs are favoured (see Chapter 8). The principal benzodiazepines used as anxiolytics include diazepam, chlordiazepoxide, clonazepam, lorazepam, alprazolam and oxazepam.
Mental III Health in Primary Care
Andrew Stevens, James Raftery, Jonathan Mant, Sue Simpson in Health Care Needs Assessment, 2018
The effectiveness (shown in RCTs) of the major groups of drugs used in the treatment of mental ill health in general practice is summarised below. Antidepressants are effective, at least when used in recommended doses, although there remains controversy over the relative cost-effectiveness of different classes of drugs. Antidepressants are most effective in severe episodes of depression. Concern over the adequacy of primary care prescribing with respect to both dose and duration is regularly highlighted in research. Some practitioners advocate low-dose prescribing. However, robust evidence for its effectiveness is lacking (seeAppendix 1).160Antipsychotic drugs are effective for the treatment of initial episodes of psychosis, for maintenance of remission and for the treatment of relapse.Mood stabilising drugs, such as lithium and carbabazepine, are effective in bipolar disorder.Anxiolytics, predominantly benzodiazepines, are useful in the very short-term treatment of anxiety disorders or as short-term hypnotics (see Appendix 2).
Pharmacological Treatment of Generalised Anxiety Disorder: Current Practice and Future Directions
Published in Expert Review of Neurotherapeutics, 2023
Harry A. Fagan, David S. Baldwin
Beyond the neurotransmitters discussed above, several additional neurotransmitter systems have been implicated in the neurobiology of GAD and other anxiety disorders based on animal models of anxiety disorders, molecular genetic studies, and preclinical studies in human volunteers [83]. These include the neurotransmitter glutamate and various neuropeptides including neuropeptide Y (NPY), tachykinins, corticotropin-releasing factor (CRF), oxytocin, orexin, and endocannabinoids [83,84]. The influence of the immune system and pro-inflammatory mechanisms have also been implicated in the pathophysiology of anxiety disorders, including GAD [85]. Below we discuss recent and ongoing developments to develop novel anxiolytics based either on alternate serotonergic or GABAergic modulation, through modulation of glutamate or neuropeptides, and through modulation of the immune system.
Early outcomes, associated factors and predictive values of clinical outcomes of tandospirone in generalized anxiety disorder: a post-hoc analysis of a randomized, controlled, multicenter clinical trial
Published in Current Medical Research and Opinion, 2023
Yi Fu, Jian Lin Ji, Shen Xun Shi, Hai Yin Zhang, Guo Zhen Lin, Ying Li Zhang, Xiuli Li, Wen Yuan Wu
At present, GAD treatment is mainly based on medication. Commonly used anxiolytic drugs in the clinic include anxiolytics (benzodiazepines and 5-HT1A receptor partial agonists) and antidepressants with anxiolytic effects. 5-HT1A receptor partial agonists mainly produce anxiolytic effects by regulating 5-HT function. Tandospirone is a representative 5-HT1A receptor partial agonist. In vitro and in vivo studies have shown that tandospirone is mainly metabolized by cytochrome P450 (CYP) 3A4. In vivo, tandospirone is metabolized to 1-(2-pyrimidine) -piperazine by CYP3A4. Trials have demonstrated the anxiolytic effects of tandospirone7,8. The currently approved indications of tandospirone in China are anxiety caused by various neuroses, including GAD, essential hypertension, peptic ulcer and other physical diseases. The recommended dose of tandospirone is 30-60 mg/d9. Several national and international guidelines have recommended 5-HT1A receptor partial agonists for the first-line treatment of anxiety disorders, especially GAD10–12. Tandospirone is highly effective and safe, and represents a more promising drug for clinical application compared with traditional anti-anxiety drugs13–15.
The effects of listening to lullabies and self-selected music at home on prenatal stress and anxiety in nulliparous pregnant women: A randomized-controlled study
Published in Health Care for Women International, 2023
Nazlı Baltacı, Özlem Doğan Yüksekol, Emine Koç, Mihriban Ulucan
It has been reported that antenatal anxiety and stress negatively affect maternal and fetal health, and are associated with premature birth, low birth weight, small for gestational age (Grigoriadis et al., 2018), postpartum depression, low breastfeeding probability (Grigoriadis et al., 2019), low prenatal attachment (Chang et al., 2015; Nagle-Yang et al., 2019), weak fetal neurological and cognitive development, serious cognitive and emotional problems in young children (Corbijn van Willenswaard et al., 2017; Lin et al., 2019). Commonly used anxiolytics can cause premature birth and low birth weight of the baby (Lin et al., 2019). Therefore, musical interventions can be used integratively in antenatal care, follow-up and treatment stages to alleviate anxiety and stress during pregnancy.
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