Antianxiety Agents

Abstract

Anxiety is a complex and prevalent cluster of psychiatric disorders consisting of generalized anxiety disorder, panic disorder, social phobia, obsessive‐compulsive disorder, posttraumatic stress disorder, and specific phobias. These conditions are most commonly treated with benzodiazepines, buspirone, and serotonin reuptake inhibitors, all of which fall some way short of the ideal anxiolytic. The clinical applications, side effects, and drug metabolism of these medications are discussed. A multitude of neurotransmitter systems are implicated to a greater or lesser degree in the complex underlying neurobiology and physiology of anxiety, including GABA, serotonin, norepinephrine, glutamate, as well as neuropeptides such as CCK, CRF, and NPY. The increasing understanding of the roles of each neurobiological pathway provides a platform for medicinal chemistry efforts in anxiolytic research. The structure‐activity relationships of current medications and newer, investigational compounds interacting with these systems are discussed, as well as the future prospects for the development of improved anxiolytics.