New research into anxiety disorders – Part I
Nearly one in five Americans has been diagnosed with some form of anxiety disorder. These range from panic attacks and post-traumatic stress disorder to social phobias and obsessive-compulsive disorders. Anti-anxiety drugs or antidepressants can curb symptoms that interfere with day-to-day life. And these drugs are big business. In 2013, Americans filled 48 million prescriptions for the benzodiazepine drug alprazolam (Xanax). Patients also picked up 27 million prescriptions for sertraline (Zoloft), an antidepressant drug that also helps some people with anxiety.
Yet, while many people do find relief in these drugs, they don’t work for everyone. Benzodiazepines can interfere with normal thinking and induce drowsiness. They also can be highly addictive, so doctors are reluctant to prescribe them for people with a history of substance abuse. Zoloft and other selective serotonin reuptake inhibitors (SSRIs) also don’t work for everyone. They can cause nausea, jitters, insomnia, suicidal thoughts, and loss of libido. However, researchers are teasing out another option for reducing anxiety. When stress kicks in, so would this experimental drug.
“By targeting specific enzymes,” said neuroscientist J. Megan Gray, “we can minimize side effects.” Researchers from Calgary to Southern California are investigating the inner struggle between one brain chemical that keeps stress in check and another that is part of the body’s fight or flight response. Many of these investigators talked about their latest findings during the November 2014 Society for Neuroscience conference in Washington, D.C.
The brains of humans and some animals naturally synthesize endocannabinoids; molecules that help regulate functions including appetite, mood and response to stress. An ample supply of endocannabinoids keeps anxiety under control, and this is the function that Gray and her colleagues at the Hotchkiss Brain Institute at the University of Calgary want to boost.
When something stressful happens — a deadline approaches or travel plans go awry — the fight or flight response floods the brain with corticotropin-releasing hormone (CRH). It degrades endocannabinoids and turns anxiety on. That’s like releasing the parking brake when a car is parked on a hill. The new drug would boost the level of endocannabinoids in the brain, creating a buffer against CRH’s action. Endocannabinoids and the active compounds in marijuana both bind to the same brain receptors, which is why some people self-medicate by smoking marijuana.
“Often, if you go to a medical marijuana place and tell them you have anxiety, they’ll give you marijuana,” said James Lim, a neuroscientist at the University of California-Irvine. The problem is that cannabis also contains many other chemicals, including harmful tars that complicate the reaction. If researchers can design an endocannabinoid-boosting compound that is simpler, said Gray, “we can better understand what people are exposing themselves to.”
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