Titre du document / Document title

The functional anatomy, neurochemistry, and pharmacology of anxiety

Auteur(s) / Author(s)

NINAN P. T. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Emory University School of Medicine, Atlanta, Ga, ETATS-UNIS

Résumé / Abstract

The functional anatomy of anxiety involves amygdala-based neurocircuits with critical reciprocal connections to the medial prefrontal cortex. Traumatic experiences leave emotional imprints involving the amygdala, with facilitated fear-conditioned associations involving declarative memory traces. Avoidance conditioning is an additional component. An understanding of the functional anatomy of anxiety allows for a new perspective on the various anxiety disorders. The neurotransmitters involved in these circuits are reviewed for their relevance to the pharmacologic choices in the treatment of anxiety. Potent serotonin reuptake inhibitors appear to have superior efficacy in many of the anxiety disorders, with indications that norepinephrine reuptake inhibitors have an advantage in severe forms of major depression. Medications with dual effects-blocking reuptake of both serotonin and norepinephrine (e.g., clomipramine and venlafaxine XR)-have superior benefits in achieving remission in major depression and GAD. These medications may also offer a faster onset of action and theoretically superior benefits in patients with comorbid anxiety disorder and major depression.

Revue / Journal Title

The Journal of clinical psychiatry. Supplement 

Source / Source

Congrès
Depression/Anxiety Working Group Conference, Dallas, Tex. , ETATS-UNIS (30/01/1999)
1999, vol. 60, n^o 22 (36 p.)  (48 ref.), pp. 12-17

Langue / Language

Anglais

Editeur / Publisher

Physicians Postgraduate Press, Memphis, TN, ETATS-UNIS  (1986) (Revue)

Mots-clés anglais / English Keywords

Depression ; Anxiety disorder ; Pathophysiology ; Amygdala ; Neurotransmission ; Prefrontal cortex ; Emotion emotionality ; Declarative memory ; Cognition ; Treatment ; Chemotherapy ; Tranquillizer ; Psychotropic ; Reuptake inhibitor ; Serotonin ; Norepinephrine ; Mechanism of action ; Treatment efficiency ; Brain (vertebrata) ; Central nervous system ; Review ; Human ; Mood disorder ;

Mots-clés français / French Keywords

Etat dépressif ; Trouble anxieux ; Physiopathologie ; Amygdale ; Neurotransmission ; Cortex préfrontal ; Emotion émotivité ; Mémoire déclarative ; Cognition ; Traitement ; Chimiothérapie ; Tranquillisant ; Psychotrope ; Inhibiteur recapture ; Sérotonine ; Noradrénaline ; Mécanisme action ; Efficacité traitement ; Encéphale ; Système nerveux central ; Article synthèse ; Homme ; Trouble humeur ;

Mots-clés espagnols / Spanish Keywords

Estado depresivo ; Trastorno ansiedad ; Fisiopatología ; Amígdala ; Neurotransmisión ; Corteza prefrontal ; Emoción emotividad ; Memoria declarativa ; Cognición ; Tratamiento ; Quimioterapia ; Tranquilizante ; Psicotropo ; Inhibidor recaptura ; Serotonina ; Noradrenalina ; Mecanismo acción ; Eficacia tratamiento ; Encéfalo ; Sistema nervioso central ; Artículo síntesis ; Hombre ; Trastorno humor ;

Localisation / Location

INIST-CNRS, Cote INIST : 9069 S, 35400008089998.0020