Introduction: Major Depressive Disorder (MDD) and General Anxiety Disorder (GAD) significantly contribute to the global burden of disease. Vilazodone, a combined serotonin reuptake inhibitor and 5-HT1A partial agonist, is an approved therapy for the treatment of MDD and which has been further investigated for GAD.
Areas covered: This article covers the pharmacokinetics and pharmacodynamics of vilazodone and provides an evaluation of the clinical usefulness of vilazodone for the treatment of MDD and anxiety disorders. A literature search was performed using PubMed/MEDLINE, Web of Science and the Cochrane Library.
Expert opinion: Studies have shown that vilazodone is significantly superior to placebo. However, vilazodone cannot as yet be recommended as a first-line treatment option for MDD as it is unclear whether the drug’s dual mechanism of action provides greater efficacy than prevailing treatment options. Moreover, more phase IV studies are needed to establish its efficacy and long-term safety in larger and more diverse populations. Although vilazodone may have an additional advantage for the treatment of anxiety symptoms in MDD, here also additional studies are required to confirm its efficacy over and above SSRI alternatives and other antidepressant treatments. Therefore, presently, vilazodone should be considered as a second- or third-line treatment option for MDD and GAD. 相似文献
Abstract: We observed a case of withdrawal after abrupt discontinuation of mianserin. A 41-year-old woman was treated according to a diagnosis of depression, which was her 6th episode. Mianserin 30 mg/day, etizolam 1 mg/day and flunitrazepam 1 mg/day were administered. When the patient discontinued taking the drugs by herself because of subsiding of these symptoms, severe panic anxiety appeared. This panic anxiety was not relieved by taking etizolam and flunitrazepam again, but subsided rapidly by the re-administration of mianserin 30 mg/day, and because of that the depressive symptom also disappeared. From these experiences panic anxiety seemed to be a withdrawal symptom, and involvement of the noradrenergic system in panic anxiety as well as serotonergic system was suggested. 相似文献
Anxiety disorders are common in Parkinson's disease (PD). However, the risk of PD among people with anxiety has not been examined in a prospective cohort study. We examined this relation prospectively within the Health Professionals Follow-Up Study, a cohort of US male health professionals. In 1988, anxiety was assessed using the Crown-Crisp phobic anxiety index in 35,815 men without PD, stroke, or cancer at baseline. There were 189 incident cases of PD during 12 years of follow-up. After adjusting for age, smoking, and caffeine intake, the relative risk of PD among men with the highest level of anxiety (Crown-Crisp index scores of 4 and above) was 1.5 (95% CI = 1.0-2.1; P-trend = 0.01) compared to men with the lowest level of anxiety. This positive association persisted after excluding cases of PD with onset in the first 2 years of follow-up. Use of anxiolytic medication was also associated with an elevated risk of PD (RR= 1.6; 95% CI = 0.9-3.1), but adjusting for this potential confounder did not materially affect the association between anxiety and risk of PD. Our results suggest that anxiety is a risk factor for PD. Whether this association is causal or the result of shared underlying biology remains a question. 相似文献
Video feedback has been shown to increase performance estimates on the part of speech anxious individuals (R. M. Rapee & K. Hayman, 1996). The present experiment tested a video feedback condition against 2 control conditions. A possible moderator of video feedback effects, the degree to which participants underrated their initial speech, was also tested, as was the possibility of mediation of video feedback's effects by increases in self-efficacy. Participants were 90 speech anxious undergraduate students. Although video feedback showed transitory effects across the sample as a whole, the effect was consistently positive for participants who highly underrated their first speech. Self-efficacy was an important predictor of change in self-perception of performance, but was not a mediator of video feedback's effects. 相似文献
The objective of the study was to evaluate the presence of psychopathology in fibromyalgia patients compared with a control group of other rheumatologic patients with pain. Forty-nine fibromyalgia patients and 33 control patients were interviewed blinded, using standardized psychometric scales. Pain was scored on a visual analogue scale. Fibromyalgia patients scored significantly higher than the controls on the Bech-Rafaelsen Melancholia Scale, the Atypical Depression Scale and the Hamilton Anxiety Rating Scale. On the Newcastle Depression Scale there was no difference. In both groups a correlation was found between pain score and psychometric scoring. The fibromyalgia patients scored significantly higher on pain than the controls. After correcting for this difference, the fibromyalgia patients still scored higher on anxiety and depression. 相似文献
Self-assessment scales have long been used in psychiatric research even if their validity has often been questioned, one reason being poor the concordance of expert ratings. In clinical practice the use of rating scales is restricted, since they are considered to be time-consuming and perhaps even to disrupt the clinician's rapport with the patient. In the present study, a self-assessment scale, the CPRS Self-rating Scale for Affective Syndromes (CPRS-S-A), was constructed by re-phrasing in a self-rating format 19 items from the original Comprehensive Psychopathological Rating Scale (CPRS) and covering depression, anxiety and obsessional symptoms. In a group of 30 patients with depression syndromes and anxiety syndromes, the CPRS-S-A and the original CPRS were both used on 2 occasions. The patient's Global Assessment of Functioning scores ranged from 30 to 76 (mean 58), which suggests a moderate severity of illness, as does the fact that the majority were outpatients. There was a high degree of concordance between the instruments for most items and for the scores on the subscales for both diagnostic groups (i.e., the Montgomery-Åsberg Depression Rating Scale and the Brief Anxiety Scale, which are both subscales drawn from the CPRS). The time taken to complete the CPRS-S-A varied from 5 to 30 min (mean 19 min for depressive and 16 min for anxiety patients on the first occasion, 13 min for both groups on the second), and the self-rating procedure was readily accepted by both groups of patients. The CPRS-S-A would thus seem to be a promising instrument for quantitative rating of symptoms in ambulatory patients, both in clinical practice and in research. 相似文献