Antianxiety medications for the treatment of complex agoraphobia: pharmacological interventions for a behavioral condition

Giampaolo Perna1-3, Silvia Dacc&ograve;2, Roberta Menotti2, Daniela Caldirola21Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, the Netherlands; 2Department of Clinical Neuroscience, San Benedetto Hospital, Her...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Perna G, Dacc&ograve; S, Menotti R, Caldirola D
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/8dbcfc5c308b419b93df62df99ca8375
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:8dbcfc5c308b419b93df62df99ca8375
record_format	dspace
spelling	oai:doaj.org-article:8dbcfc5c308b419b93df62df99ca83752021-12-02T01:18:45ZAntianxiety medications for the treatment of complex agoraphobia: pharmacological interventions for a behavioral condition1176-63281178-2021https://doaj.org/article/8dbcfc5c308b419b93df62df99ca83752011-10-01T00:00:00Zhttp://www.dovepress.com/antianxiety-medications-for-the-treatment-of-complex-agoraphobia-pharm-a8500https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Giampaolo Perna1-3, Silvia Dacc&ograve;2, Roberta Menotti2, Daniela Caldirola21Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, the Netherlands; 2Department of Clinical Neuroscience, San Benedetto Hospital, Hermanas Hospitalarias, Albese con Cassano, Como, Italy; 3Department of Psychiatry and Behavioral Sciences, Leonard M Miller School of Medicine, University of Miami, Miami, FL, USABackground: Although there are controversial issues (the &quot;American view&quot; and the &quot;European view&quot;) regarding the construct and definition of agoraphobia (AG), this syndrome is well recognized and it is a burden in the lives of millions of people worldwide. To better clarify the role of drug therapy in AG, the authors summarized and discussed recent evidence on pharmacological treatments, based on clinical trials available from 2000, with the aim of highlighting pharmacotherapies that may improve this complex syndrome.Methods: A systematic review of the literature regarding the pharmacological treatment of AG was carried out using MEDLINE, EBSCO, and Cochrane databases, with keywords individuated by MeSH research. Only randomized, placebo-controlled studies or comparative clinical trials were included.Results: After selection, 25 studies were included. All the selected studies included patients with AG associated with panic disorder. Effective compounds included selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, selective noradrenergic reuptake inhibitors, and benzodiazepines. Paroxetine, sertraline, citalopram, escitalopram, and clomipramine showed the most consistent results, while fluvoxamine, fluoxetine, and imipramine showed limited efficacy. Preliminary results suggested the potential efficacy of inositol; D-cycloserine showed mixed results for its ability to improve the outcome of exposure-based cognitive behavioral therapy. More studies with the latter compounds are needed before drawing definitive conclusions.Conclusion: No studies have been specifically oriented toward evaluating the effect of drugs on AG; in the available studies, the improvement of AG might have been the consequence of the reduction of panic attacks. Before developing a &quot;true&quot; psychopharmacology of AG it is crucial to clarify its definition. There may be several potential mechanisms involved, including fear-learning processes, balance system dysfunction, high light sensitivity, and impaired visuospatial abilities, but further studies are warranted.Keywords: panic, anxiety, avoidance, pharmacological treatment, drug therapyPerna GDacc&ograve; SMenotti RCaldirola DDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2011, Iss Issue 1, Pp 621-637 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Perna G Dacc&ograve; S Menotti R Caldirola D Antianxiety medications for the treatment of complex agoraphobia: pharmacological interventions for a behavioral condition
description	Giampaolo Perna1-3, Silvia Dacc&ograve;2, Roberta Menotti2, Daniela Caldirola21Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, the Netherlands; 2Department of Clinical Neuroscience, San Benedetto Hospital, Hermanas Hospitalarias, Albese con Cassano, Como, Italy; 3Department of Psychiatry and Behavioral Sciences, Leonard M Miller School of Medicine, University of Miami, Miami, FL, USABackground: Although there are controversial issues (the &quot;American view&quot; and the &quot;European view&quot;) regarding the construct and definition of agoraphobia (AG), this syndrome is well recognized and it is a burden in the lives of millions of people worldwide. To better clarify the role of drug therapy in AG, the authors summarized and discussed recent evidence on pharmacological treatments, based on clinical trials available from 2000, with the aim of highlighting pharmacotherapies that may improve this complex syndrome.Methods: A systematic review of the literature regarding the pharmacological treatment of AG was carried out using MEDLINE, EBSCO, and Cochrane databases, with keywords individuated by MeSH research. Only randomized, placebo-controlled studies or comparative clinical trials were included.Results: After selection, 25 studies were included. All the selected studies included patients with AG associated with panic disorder. Effective compounds included selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, selective noradrenergic reuptake inhibitors, and benzodiazepines. Paroxetine, sertraline, citalopram, escitalopram, and clomipramine showed the most consistent results, while fluvoxamine, fluoxetine, and imipramine showed limited efficacy. Preliminary results suggested the potential efficacy of inositol; D-cycloserine showed mixed results for its ability to improve the outcome of exposure-based cognitive behavioral therapy. More studies with the latter compounds are needed before drawing definitive conclusions.Conclusion: No studies have been specifically oriented toward evaluating the effect of drugs on AG; in the available studies, the improvement of AG might have been the consequence of the reduction of panic attacks. Before developing a &quot;true&quot; psychopharmacology of AG it is crucial to clarify its definition. There may be several potential mechanisms involved, including fear-learning processes, balance system dysfunction, high light sensitivity, and impaired visuospatial abilities, but further studies are warranted.Keywords: panic, anxiety, avoidance, pharmacological treatment, drug therapy
format	article
author	Perna G Dacc&ograve; S Menotti R Caldirola D
author_facet	Perna G Dacc&ograve; S Menotti R Caldirola D
author_sort	Perna G
title	Antianxiety medications for the treatment of complex agoraphobia: pharmacological interventions for a behavioral condition
title_short	Antianxiety medications for the treatment of complex agoraphobia: pharmacological interventions for a behavioral condition
title_full	Antianxiety medications for the treatment of complex agoraphobia: pharmacological interventions for a behavioral condition
title_fullStr	Antianxiety medications for the treatment of complex agoraphobia: pharmacological interventions for a behavioral condition
title_full_unstemmed	Antianxiety medications for the treatment of complex agoraphobia: pharmacological interventions for a behavioral condition
title_sort	antianxiety medications for the treatment of complex agoraphobia: pharmacological interventions for a behavioral condition
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/8dbcfc5c308b419b93df62df99ca8375
work_keys_str_mv	AT pernag antianxietymedicationsforthetreatmentofcomplexagoraphobiapharmacologicalinterventionsforabehavioralcondition AT daccampograves antianxietymedicationsforthetreatmentofcomplexagoraphobiapharmacologicalinterventionsforabehavioralcondition AT menottir antianxietymedicationsforthetreatmentofcomplexagoraphobiapharmacologicalinterventionsforabehavioralcondition AT caldirolad antianxietymedicationsforthetreatmentofcomplexagoraphobiapharmacologicalinterventionsforabehavioralcondition
_version_	1718403149837893632

Antianxiety medications for the treatment of complex agoraphobia: pharmacological interventions for a behavioral condition

Ejemplares similares