A precision medicine approach to pharmacological adjuncts to extinction: A call to broaden research

King, Gabrielle; Baker, Kathryn D.; Bisby, Madelyne A.; Chan, Diana; Cowan, Caitlin S. M.; Stylianakis, Anthea A.; Zimmermann, Kelsey S.; Richardson, Rick

doi:10.1007/s00213-018-4999-0

Cited by 6Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMemory and Neural MechanismsNeurotransmitter Receptor Influence on Behavior

A precision medicine approach to pharmacological adjuncts to extinction: A call to broaden research

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King, Gabrielle, Baker, Kathryn D., Bisby, Madelyne A., Chan, Diana, Cowan, Caitlin S. M., Stylianakis, Anthea A., Zimmermann, Kelsey S., Richardson, Rick·2019·Psychopharmacology

DOI 10.1007/s00213-018-4999-0

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Abstract

There is a pressing need to improve treatments for anxiety. Although exposure-based therapy is currently the gold-standard treatment, many people either do not respond to this therapy or experience a relapse of symptoms after treatment has ceased. In recent years, there have been many novel pharmacological agents identified in preclinical research that have potential as adjuncts for exposure therapy, yet very few of these are regularly integrated into clinical practice. Unfortunately, the robust effects observed in the laboratory animal often do not translate to a clinical population. In this review, we discuss how age, sex, genetics, stress, medications, diet, alcohol, and the microbiome can vary across a clinical population and yet are rarely considered in drug development. While not an exhaustive list, we have focused on these factors because they have been shown to influence an individual's vulnerability to anxiety and alter the neurotransmitter systems often targeted by pharmacological adjuncts to therapy. We argue that for potential adjuncts to be successfully translated from the lab to the clinic empirical research must be broadened to consider how individual difference factors will influence drug efficacy.

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The benefit of DCS-augmented EBT seems to be reduced in patients receiving antidepressants.
“Furthermore, the benefit of DCS-augmented EBT seems to be reduced in patients receiving antidepressants (King et al., 2018;Otto et al., 2016).”
From Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders (2019) · cites this paper as King et al., 2018

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Authors: King, G., Baker, K. D., Bisby, M. A., Chan, D., Cowan, C. S. M., Stylianakis, A. A., Zimmermann, K. S., & Richardson, R.
Affiliations: UNSW Sydney (AU)
University College Cork (IE)
Corresponding author: King, Gabrielle
ORCID: Baker, Kathryn D.
Bisby, Madelyne A.
Cowan, Caitlin S. M.
Stylianakis, Anthea A.
Zimmermann, Kelsey S.
Richardson, Rick
Venue: Psychopharmacology
Publisher: Springer Science and Business Media LLC
Published: 2018-08-16
Volume: 236
Issue: 1
Pages: 143-161
ISSN: 0033-3158 (ISSN-L)
1432-2072
DOI: 10.1007/s00213-018-4999-0
OpenAlex: W2886849746
Cited by: 6
References: 258
Citations by year: 2022: 1 · 2020: 1 · 2019: 4
FWCI: 0.20
Type: journal article
Language: en
Open access: green
hdl.handle.net
Licence: cc-by-nc-nd
www.springer.com/tdm (tdm)
Locations: Psychopharmacology (publishedVersion)
PubMed (publishedVersion)
UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Keywords: precision medicine, extinction, anxiety disorders, exposure therapy, individual differences, sex differences, age effects, genetic factors, stress, diet, alcohol, gut microbiota, translational research, drug development, neurotransmitter systems
MeSH terms: Drug Development, Animals, Anxiety, Brain, Extinction, Psychological, Humans, Anti-Anxiety Agents, Neurotransmitter Agents, Precision Medicine

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A precision medicine approach to pharmacological adjuncts to extinction: A call to broaden research

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