Serotonin norepinephrine reuptake inhibitors (SNRIs) in anxiety disorders: A comprehensive review of their clinical efficacy

Research output: Contribution to journalArticle

Abstract

Anxiety disorders are common psychiatric conditions that typically require long-term treatment. This review summarizes current knowledge of the pharmacological treatment of anxiety disorders with serotonin norepinephrine reuptake inhibitors (SNRIs) with specific emphasis on the findings of recent randomized clinical trials and relevant neurobiological investigations. It is now well established that gabaergic, noradrenergic and serotonergic systems play a critical role in the pathophysiology of anxiety disorders, abnormalities in these systems being related to structural and functional alterations in specific brain areas such as the amygdala, prefrontal cortex, locus coeruleus and hippocampus, as repeatedly shown by neuroimaging studies. SNRIs selectively inhibit norepinephrine and serotonin reuptake and have shown to be efficacious and generally well tolerated treatments in patients with anxiety disorders, with some potential clinical advantages over selective serotonin reuptake inhibitors (SSRIs), which are considered by many to represent first-line pharmacological treatments in patients with anxiety disorders. Anxiety disorders are characterized by a typically chronic course, high rates of comorbidity and frequent partial response to standard treatments, and the increasing use of SNRIs reflects currently unmet clinical need, in terms of overall response, remission rates and treatment tolerability.

Original languageEnglish
Pages (from-to)17-29
Number of pages13
JournalHuman Psychopharmacology
Volume25
Issue number1
DOIs
Publication statusPublished - 2010

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Anxiety Disorders
Therapeutics
Pharmacology
Locus Coeruleus
Serotonin Uptake Inhibitors
Amygdala
Prefrontal Cortex
Neuroimaging
Psychiatry
Serotonin and Noradrenaline Reuptake Inhibitors
Comorbidity
Hippocampus
Serotonin
Norepinephrine
Randomized Controlled Trials
Brain

Keywords

  • Anxiety disorders (ADs)
  • Selective serotonin reuptake inhibitors (SSRIs)
  • Serotonin norepinephrine reuptake inhibitors (SNRIs)

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Neurology
  • Pharmacology (medical)

Cite this

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