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Personalized Clinical Approaches to Anxiety Disorders

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Anxiety Disorders

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1191))

Abstract

Anxiety disorders (ADs) are common psychiatric disorders, with a lifetime prevalence estimated at 33.7% in epidemiological studies. ADs are associated with serious disability and severe impairment in quality of life. Although several treatments [e.g. selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs), pregabalin, tricyclic antidepressants and benzodiazepines and/or cognitive-behaviour therapy (CBT)] are recommended, a large number of patients (i.e. from 30 to 70%) do not achieve complete remission. According to the novel paradigm of personalized medicine, the search of possible predictors of both disease vulnerability and treatment response might be the best way to prevent more accurately disease risk and to tailor the most effective treatment for each individual. Although a growing body of studies have proposed several endophenotypes/markers (i.e. neurochemical, neuroimaging, physiological, genetic and epigenetic endophenotypes/markers) as possible predictors of ADs susceptibility and/or treatment response, findings are not robust enough to be considered acceptable to incorporate in the clinical practice. In order to obtain more reliable results, larger studies with a multimodal approach, based on a combination of different biomarkers, are needed.

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Conflicts of Interest

Dr. Charles B. Nemeroff’s disclosures are as follows:

Dr. Nemeroff has received funding from NIH and the Stanley Medical Research Institute; he has served as a consultant to Bracket (Clintara), Gerson Lehrman Group Healthcare and Biomedical Council, Fortress Biotech, Sunovion Pharmaceuticals, Janssen Research and Development, Magstim, Navitor Pharmaceuticals, Intra-Cellular Therapies, Takeda, Taisho Pharmaceutical and Xhale; he has served on the boards of directors for the American Foundation for Suicide Prevention, Gratitude America and the Anxiety Disorders Association of America; he is a stockholder in AbbVie, Antares, Bracket Intermediate Holding Corp., Celgene, OPKO Health, Seattle Genetics and Xhale; he serves on the scientific advisory boards of the American Foundation for Suicide Prevention, the Anxiety Disorders Association of America, the Brain and Behavior Research Foundation, Bracket (Clintara), the Laureate Institute for Brain Research, RiverMend Health, Skyland Trail and Xhale; he reports income sources or equity of $10,000 or more from American Psychiatric Publishing, Bracket (Clintara), CME Outfitters, Takeda and Xhale; he has patents on a method and devices for transdermal delivery of lithium (US 6,375,990B1) and a method of assessing antidepressant drug therapy via transport inhibition of monoamine neurotransmitters by ex vivo assay (US 7,148,027B2).

Dr. Giampaolo Perna’s disclosures are as follows:

Giampaolo Perna has received funding from Cariplo Foundation. He has served in the scientific advisor board of Medibio Ltd and has served as consultant for Lundbeck and Pfizer.

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Authors and Affiliations

  1. Department of Biomedical Sciences, Humanitas University, Milan, Italy

    Giampaolo Perna, Erika Sangiorgio & Daniela Caldirola

  2. Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, Como, Italy

    Giampaolo Perna, Alessandra Alciati, Erika Sangiorgio & Daniela Caldirola

  3. Humanitas Clinical and Research Center, Milan, Italy

    Alessandra Alciati

  4. Institute for Early Life Adversity Research, University of Texas Dell Medical School in Austin, Austin, TX, USA

    Charles B. Nemeroff

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  1. College of Medicine, Korea University, Gyeonggido, Korea (Republic of)

    Yong-Ku Kim

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Perna, G., Alciati, A., Sangiorgio, E., Caldirola, D., Nemeroff, C.B. (2020). Personalized Clinical Approaches to Anxiety Disorders. In: Kim, YK. (eds) Anxiety Disorders. Advances in Experimental Medicine and Biology, vol 1191. Springer, Singapore. https://doi.org/10.1007/978-981-32-9705-0_25

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