Current And Future Anxiolytics Flashcards
What are the current types of anxiolytics used in treatment
SSRI’s
SNRI’s
MOAI’s
TCA’s
5-HT1a receptor agonist
Which drug is used only in GAD
Buspirone
5-HT1a receptor
What does a delay in therapeutic effect suggest
Secondary neuro-adaptation
Describe how 5-HT1aRs are presented in anxiety
Located pre/post synaptically
Decreased 5-HT1aR binding in prefrontal cortex, amygdala and raphe nucleus
How do glucocorticoids alter expression of 5-HT receptors
Chronic stress (cortisol) = decrease 5-HT1a expression
Removal of cortisol = increase 5-HT1a expression
Whats the difference between 5-HT1aRs and 5-HT2cRs
1a = inhibitory -> decrease in 5-HT binding in anxiety
2c = excitatory -> evidence of being responsible for anxiety
What happens when activation of 5-HT2cRs in amygdala is blocked
Decrease in excitatory activity in amygdala
= release less CRF
= reduce activation of striatum, LC and hypothalamus
= reduced response to stress
How does stress affect CRF levels
Increase in CRF mRNA
What affect does reduced activation have on the hypothalamus on the HPA axis
Decrease activation of HPA axis
What adrenoreceptor is dysfunctional in people with anxiety
A2-adrenoreceptor
What other benefits to SSRI’s have
Can help with neurogenesis by promoting new positive emotional associations
Describe the role of SRRIs on 5-HT2c R’s in amygdala
Activation of 5-HT2c Rs is blocked in amygdala
Decrease in excitatory activity in amygdala
Less CRF releases
Reduced activation of striatum, LC and hypothalamus
Whats the effect of chronic SSRI’s on HPA axis
Reduce activation of hypothalamus
= decrease of activation of HPA axis
How is chronic SSRI related to fear extinction
Increase gene expression of brain derived neurotrophic factor
Facilitates relearning emotional responses
Neurogenesis/ dendritic regrowth
