Abstract
Serotonin reuptake inhibitors and benzodiazepines are evidence-based pharmacological treatments for Anxiety Disorders targeting serotonin and GABAergic systems, respectively. Although clearly effective, these medications fail to improve anxiety symptoms in a significant proportion of patients. New insights into the glutamate system have directed attention toward drugs that modulate glutamate as potential alternative treatments for anxiety disorders. Here we summarize the current understanding of the potential role of glutamate neurotransmission in anxiety disorders and highlight specific glutamate receptors that are potential targets for novel anxiety disorder treatments. We also review clinical trials of medications targeting the glutamate system in DSM-5 anxiety disorders. Understanding the role of the glutamate system in the pathophysiology of anxiety disorder may aid in developing novel pharmacological agents that are effective in treating anxiety disorders.
Highlights
Anxiety disorders affect ∼18% of adults making them one of the most common psychiatric disorders [1]
This review aims to summarize the characteristics and potential pharmacological targets of the glutamate system
2 week follow up Liebowitz Social Anxiety Scale (LSAS), after 1 dose VAS-Anxiety
Summary
Anxiety disorders affect ∼18% of adults making them one of the most common psychiatric disorders [1]. The Diagnostic Statistical Manual 5 (DSM-5) lists separation anxiety, generalized anxiety disorder (GAD), social anxiety disorder (SAD), specific phobia, panic disorder, and agoraphobia under the anxiety disorders [2]. Co-morbidity of anxiety disorders with other psychiatric disorders is associated with a more chronic, treatment resistant course and with elevated suicide risk [3, 4]. Patients with anxiety disorders have increased risk of substance abuse and certain medical disorders such as hypertension and irritable bowel syndrome [5]. The high prevalence of anxiety as a primary or comorbid disorder and its significant functional disability result in a high personal, social and economic cost [6]
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