Abstract
Psychopharmacological advances in the last decade have contributed to the treatment of anxiety and depression in a number of ways. These developments have modified the conceptual framework of the biological understanding of these conditions and have led to a differentiation of subgroups of patients within the broad diagnostic categories of anxiety and depression. These more specific sub-categories are based for the most part on differences in treatment response. Psychopharmacology has also led to changes in nosology, the development of laboratory diagnostic tools, methods of response prediction and to the use of more neurochemically specific therapeutic agents. In addition to these advances, drug developments have resulted in the use of chemicals which, while maintaining initial therapeutic objectives, have fewer of the adverse effects which limited the use of the earlier compounds. In this chapter, an attempt will be made to review these developments of the last few years.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Akindele, M. O., Evans, J. I., & Oswald, I. (1970). Monoamine oxidase inhibitors, sleep and mood. Electroencephalogram and Clinical Neurophysiology, 29, 47–56.
Asberg, M., Bertilsson, K., & Tuck, D. (1972). Indolamine metabolites in the cerebrospinal fluid of depressed patients before and during treatment with nortriptyline. Clinical and Pharmacological Therapy, 14, 277–286.
Asberg, M., Thoren, P., & Traskman, L. (1976). Serotonin depression: A biochemical subgroup within the affective disorders? Science, 191, 478–480.
Belmaker, R. H. (1981). Receptors, adenylate cyclase, depression, and lithium. Biological Psychiatry, 16, 333–350.
Bond, A. J., & Lader, M. H. (1981). Comparative effects of diazepam and buspirone on subjective feelings, psychological tests and the EEG. International Pharmacopsychiatry, 16, 212–220.
Braestrup, C., Nielsen, M., & Olsen, C. E. (1980). Urinary and brain carboline-3-carboxylates as potent inhibitors of brain benzodiazepine receptors. Proceedings of the National Academy of Science U.S.A., 77, 2288–2292.
Carroll, B. J. (1983). Biologic markers and treatment response. Journal of Clinical Psychiatry, 44, 30–40.
Charney, D. S., Heninger, G. R., Sternberg, D. E., Hafstad, K. M., Giddings, S., & Landis, D. H. (1982). Adrenergic receptor sensitivity in depression — Effects of Clonidine in depressed patients and healthy subjects. Archives of General Psychiatry, 39, 290–294.
Chouinard, G., Young, S. N., & Annable, L. (1983). Antimanic effect of clonazepam. Biological Psychiatry, 18, 451–466.
Claycomb, J. B. (1978). Endogenous anxiety: Implications for nosology and treatment. Journal of Clinical Psychiatry, 44, 19–22.
Colello, G. D., Hockenbery, D. M., Bosmann, H. B., Fuchs, S., & Folkers, K. (1978). Competitive inhibition of benzodiazepine binding by fractions from porcine brain. Proceedings of the National Academy of Science, 75, 6319–6323.
Cooper, A. J., & Datta, S. R. (1980). A placebo controlled evaluation of L-tryptophan in depression in the elderly. Canadian Journal of Psychiatry, 25, 386–390.
Coppen, A. (1967). The biochemistry of affective disorders. British Journal of Psychiatry, 113, 1237–1264.
Costa, E., & Guidotti, A. (1979). Molecular mechanisms in the receptor action of benzodiazepines. Annual Review of Pharmacology and Toxicology, 19, 531–545.
de Montigny, C., Grunberg, F., Mayer, A., & Deschenes, J. P. (1981). Lithium induces rapid relief of depression in tricyclic antidepressant drug non-responders. British Journal of Psychiatry, 138, 252–256.
Drimmer, E. J., Gitlin, M. J., & Gwirtsman, H. E. (1983). Desipramine and methylphenidate combination treatment for depression: Case report. American Journal of Psychiatry, 140, 241–242.
Emerson, T. R., Pare, C.M.B., Turner, P., & Hathaway, N. R. (1981). The use of a beta blocker (Acebutolol, “Sectral”) and a benzodiazepine (Diazepam) in the treatment of anxiety. Current Therapeutic Research, 29, 693–703.
Fabre, L. F., & Napoliello, M. J. (1981). An open dose-finding study of melperone in nonpsychotic outpatients with anxiety. Current Therapeutic Research, 30, 427–433.
Feighner, J. P. (1980). Pharmacology: New antidepressants. Psychiatric Annals, 10, 388–395.
Feighner, J. P., Merideth, C. H., & Hendrickson, G. A. (1982). A double-blind comparison of buspirone and diazepam in outpatients with generalized anxiety disorder. Journal of Clinical Psychiatry, 43(12), (Sec. 2), 103–108.
Fontaine, R., Annable, L., Chouinard, G., & Ogilvie, R. I. (1983). Bromazepam and diazepam in generalized anxiety: A placebo-controlled study with measurement of drug plasma concentrations. Journal of Clinical Psychopharmacology, 3(2), 80–87.
Friedmann, C. T. H., Davis, L. J., Ciccone, P. E., & Rubin, R. T. (1980). Phase II double-blind controlled study of a new anxiolytic, Fenobam (McN-3377) vs. placebo. Current Therapeutic Research, 27(2), 144–151.
Garcia-Sevilla, J. A., Zis, A. P., Hollingsworth, P. J., Greden, J. F., & Smith, C. B. (1981). Platelet 2-adrenergic receptors in major depressive disorder — Binding of tritiated Clonidine before and after tricyclic antidepressant drug treatment. Archives of General Psychiatry, 38, 1327–1333.
Gelenberg, A. J., Wojcik, J. D., Gibson, C. J., & Wurtman, R. J. (1982). Tyrosine for depression. Journal of Psychiatric Research, 17, 175–180.
Gelenberg, A. J., Wojcik, J. D., Growdon, J. H., Sved, A. F., & Wurtman, R. J. (1980). Tyrosine for the treatment of depression. American Journal of Psychiatry, 137, 622–623.
Goldberg, H. L., & Finnerty, R. (1982). Comparison of buspirone in two separate studies. Journal of Clinical Psychiatry, 43(12) (Sec. 2), 87–91.
Goldberg, I. K. (1980). L-tyrosine in depression. The Lancet, 364.
Goodwin, F. K., Prange, A. J., Jr., Post, R. M., Muscettola, G., & Lipton, M. A. (1982). Potentiation of antidepressant effects by L-triiodothyronine in tricyclic nonresponders. American Journal of Psychiatry, 139, 24–38.
Greenblatt, D. J., Shader, R. I., Harmatz, J. S., Franke, K., & Koch-Weser, J. (1977). Absorption rate, blood concentrations, and early response to oral chlordiazepoxide. American Journal of Psychiatry, 134, 559–562.
Haefely, W., Pole, P., Pieri, L., Schaffner, R., & Laurent, J. P. (1983). Neuropharmacology of benzodiazepines: Synaptic mechanisms and neural basis of action. In E. Costa (Ed.), The benzodiazepines: From molecular biology to clinical practice. New York: Raven Press.
Itoh, H., Takahashi, R., & Miura, S. (1980). Alprazolam, a new type anxiolytic in neuroleptic patients — — A pilot study. International Pharmacopsychiatry, 15, 344–349.
Janke, W., & Netter, P. (1983). Anxiolytic effects of drugs: Approaches, methods and problems. Neuropsychobiology, 9, 33–40.
Jimerson, D. C., Post, R. M., Stoddard, F. J., Gillin, J. C., & Bunney, W. E. (1980). Preliminary trial of the noradrenergic agonist Clonidine in psychiatric patients. Biological Psychiatry, 15, 45–57.
Kaneko, M., Kumashiro, H., Takahashi, Y., & Hoshino, Y. (1979). L-5-HTP treatment and serum 5-HT level after L-5-HTP loading on depressed patients. Neuropsychobiology, 5, 232–240.
Kathol, R. G., Noyes, R. Jr., Slymen, D. J., Crowe, R. R., Clancy, J., & Kerber, R. E. (1980). Propranolol in chronic anxiety disorders — A controlled study. Archives of General Psychiatry, 37, 1361–1365.
Kelwala, S., Jones, D., & Sitaram, N. (1983). Monoamine metabolites as predictors of antidepressant response: A critique. Progress in Neuropsychopharmacology & Biological Psychiatry, 7, 229–240.
Klaiber, E. L., Broverman, D. M., Vogel, W., & Kobayashi, T. (1979). Estrogen therapy for severe persistent depression in women. Archives of General Psychiatry, 36, 550–554.
Klein, D. F. (1964). Delineation of two drug responsive anxiety syndromes. Psychopharmacologia, 5, 397–408.
Klein, D. F., Davis, J. M. (1969). Diagnosis and drug treatment of psychiatric disorders. Baltimore: Williams & Wilkins.
Kolasa, K., Fusi, R., Garattini, S., Consolo, S., & Ladinsky, H. (1982). Neurochemical effects of buspirone, a novel psychotropic drug, on the central cholinergic system. Journal of Pharmacy and Pharmacology, 34, 314–317.
Lader, M. (1979). Anxiety reduction and sedation: Psychophysiological theory. British Journal of Clinical Pharmacology, 7, 99S-105S.
Lader, M., & Petursson, H. (1981). Benzodiazepine derivatives — Side effects and dangers. Biological Psychiatry, 16, 1195–1201.
Lader, M., & Petursson, H. (1983). Rational use of anxiolytic/sedative drugs. Drugs, 25, 514–528.
Langer, G., Aschauer, H., Koinig, G., Resch, F., & Schonbeck, G. (1983). The TSH-response to TRH: A possible predictor of outcome to antidepressant and neuroleptic treatment. Progress in Neuropsychopharmacology & Biological Psychiatry, 7, 335–342.
Lapierre, Y. D. (1983). New antidepressant drugs. Journal of Clinical Psychiatry, 44, 41–44.
Lapierre, Y.D., & Oyewumi, L.K. (1982). Fenobam, another anxiolytic? Current Therapeutic Research, 31, 95–101.
Leonard, B. E. (1980). Pharmacological properties of some “second generation” antidepressant drugs. Neuropharmacology, 19, 1175–1183.
Lloyd, K. J., Farley, I. J., Deck, J. H. N., et al., (1974). Serotonin and 5-hydroxyindoleacetic acid in discrete areas of the brainstem of suicide victims and control patients. Advances in Biochemistry & Psychopharmacology, 11, 387–397.
Maas, J. W. (1975). Biogenic amines and depression: Biochemical and pharmacological separation of two types of depression. Archives of General Psychiatry, 32, 1357–1361.
Maas, J. W., Koslow, S. H., Katz, M. M., Bowden, C. L., Gibbons, R. L., Stokes, P. E., Robins, E., & Davis, J. M. (1984). Pretreatment neurotransmitter metabolite levels and response to tricyclic antidepressant drugs. American Journal of Psychiatry, 141, 1159–1171.
Mann, J., Peselow, E. D., Snyderman, S., & Gershon, S. (1980). D-phenyla-lanine in endogenous depression. American Journal of Psychiatry, 137, 1611–1612.
Meltzer, H. Y. (1983). The effect of buspirone on prolactin and growth hormone secretion in man. Archives of General Psychiatry, 40, 1099–1102.
Mendels, J. (1976). Lithium in the treatment of depression. American Journal of Psychiatry, 133(4), 373–378.
Mohler, H., & Okada, T. (1977). Benzodiazepine receptor: Demonstration in the central nervous system. Science, 198, 849–851.
Mohler, H., Pole, P., Sumin, R., Pieri, L., & Kettler, R. (1979). Nicotinamide is a brain constituent with benzodiazepine-like actions. Nature, 278, 563–565.
Nies, A., Robinson, D. S., Bartlett, D., & Lambourn, M. R. (1977). M.A.O. inhibitors in clinical practice: Principles based on recent research. Psychopharmacological Bulletin, 13, 54–55.
Oppenheim, G. (1983). Estrogen in the treatment of depression: Neuropharmacological mechanisms. Biological Psychiatry, 18, 721–725.
Pare, C. M. B. (1979). Monoamine oxidase inhibitors in resistant depression. International Psychopharmacopsychiatry, 14, 101–109.
Pecknold, J. C., McClure, D. J., & Appeltauer, L. (1980). Fenobam in anxious out-patients. Current Therapeutic Research, 27, 119–123.
Peet, M., & Coppen, A. (1980). Lithium treatment and prophylaxis in unipolar depression. Psychosomatics, 21, 303–313.
Prange, A. J., Wilson, I. C., Robon, A. M., & Lipton, M. (1969). Enhancement of imipramine antidepressant activity by thyroid hormone. American Journal of Psychiatry, 126, 457–469.
Quitkin, F. M., Rabkin, J. G., Ross, D., & McGrath, P. J. (1984). Duration of antidepressant drug treatment — What is an adequate trial? Archives of General Psychiatry, 41, 238–245.
Ravaris, C. L., Robinson, D. S., Ives, J. O., Nies, A., & Bartlett, D. (1980). Phenelzine and amitriptyline in the treatment of depression — A comparison of present and past studies. Archives of General Psychiatry, 37, 1075–1080.
Sachar, E. J., Hellman, L., & Fukushima, D. K. (1970). Cortisol production in depressive illness. A clinical and biochemical clarification. Archives of General Psychiatry, 23, 289–298.
Schatzberg, A. F., Orsulak, P. J., Rosenbaum, A. H., Maruta, T., Kruger, E. R., Cole, J. O., & Schildkraut, J. J. (1982). Toward a biochemical classification of depressive disorders, V: Heterogeneity of unipolar depressions. American Journal of Psychiatry, 139, 471–475.
Schildkraut, J. J. (1965). The catecholamine hypothesis of affective disorders: A review of supporting evidence. American Journal of Psychiatry, 122, 509–522.
Seppala, T., Aranko, K., Mattila, M. J., & Shrotriya, R. C. (1982). Effects of alcohol on buspirone and lorazepam actions. Clinical Pharmacological Therapy, 32, 201–207.
Shader, R. I., & Greenblatt, P. J. (1977). Clinical implications of benzodiazepine pharmacokinetics. American Journal of Psychiatry, 134(6), 652–656.
Sheehan, D. V. (1984). Delineation of anxiety and phobic disorders responsive to monoamine inhibitors: Implications for classification. Journal of Clinical Psychiatry, 45 (Sec. 2), 29–36.
Sheehan, D. V., Ballenger, J., & Jacobsen, C. (1980). Treatment of endogenous anxiety with phobic, hysterical, and hypochondriacal symptoms. Archives of General Psychiatry, 37, 51–59.
Sheehan, D. V., Coleman, J. H., Greenblatt, D. J., Jones, K. J., Levine, P. H., Orsulak, P. J., Peterson, M., Schildkrant, J. J., Uzogara, E., & Watkins, D. (1984). Biochemical correlates of panic attacks with agoraphobia and their response to a new treatment. Journal of Clinical Psychopharmacology, 4, 66–75.
Sheehan, D. V., & Sheehan, K. H. (1982). The classification of anxiety and hysterical states. Part II. Toward a more heuristic classification. Journal of Clinical Psychopharmacology, 2, 386–393.
Shopsin, B., & Waters, B. (1980). The pharmacotherapy of major depressive syndrome. Part I: Treatment of acute depression. Psychosomatics, 21, 542–556.
Smith, C. B., Hollingsworth, P. J., Garcia-Sevilla, J. A., & Zis, A. P. (1983). Platelet alpha2 adrenoreceptors are decreased in number after antidepressant therapy. Progress in Neuropsycho-pharmacology & Biological Psychiatry, 7, 241–247.
Spitzer, R. L., & Williams, J. B. W. (1982). Hysteroid Dysphoria: An unsuccessful attempt to demonstrate its syndromal validity. American Journal of Psychiatry, 139(10), 1286–1291.
Sulser, F. (1983). Deamplification of noradrenergic signal transfer by antidepressants: A unified catecholamine-serotonin hypothesis of affective disorders. Psychopharmacological Bulletin, 19, 300–304.
Targum, S. D. (1983). The application of serial neuroendocrine challenge studies in the management of depressive disorder. Biological Psychiatry, 18, 3–19.
Taylor, D. P., Riblet, L. A., Stanton, H. C., Eison, A. S., Eison, M. S., Temple, D. L. Jr. (1982). Dopamine and antianxiety activity. Pharmacological & Biochemical Behavior, 17, 25–35.
Tyrer, P. J., & Lader, M. H. (1974). Physiological response to propranolol and diazepam in chronic anxiety. British Journal of Clinical Pharmacology, 1, 387–390.
Van Hiele, L. J. (1980). 5-hydroxytryptophan in depression: The first substitution therapy in psychiatry? Neuropsychobiology, 6, 230–240.
Van Praag, H. M. (1980). Central monoamine metabolism in depressions. II. Catecholamines and related compounds. Comprehensive Psychiatry, 21, 44–54.
Wharton, R. N., Perei, J. M., Dayton, P. G., & Malitz, S. (1971). A potential clinical use for methylphenidate (Ritalin) with tricyclic antidepressants. American Journal of Psychiatry, 127, 1619–1625.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1986 Plenum Press, New York
About this chapter
Cite this chapter
Lapierre, Y.D. (1986). New Approaches to the Pharmacological Treatment of Anxiety and Depression. In: Shaw, B.F., Segal, Z.V., Vallis, T.M., Cashman, F.E. (eds) Anxiety Disorders. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-5254-9_13
Download citation
DOI: https://doi.org/10.1007/978-1-4684-5254-9_13
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4684-5256-3
Online ISBN: 978-1-4684-5254-9
eBook Packages: Springer Book Archive