New Anxiety Treatments

Any given year, according to the National Institute of Mental Health, 40 million Americans suffer from anxiety disorders. Although effective treatments exist, many patients do not respond well to treatment. Researchers B W Dunlop and J Banja note in the Journal of Medical Ethics that 40 to 70 percent of patients report relief from symptoms, and only 20 to 47 percent report total absence of symptoms. New treatment options could help address the often devastating effects of anxiety disorders.

Transcranial Magnetic Stimulation

• Transcranial magnetic stimulation (TMS) is a method for stimulating brain neurons using magnetic fields. Early results show decreased symptoms in patients with post-traumatic stress disorder compared to treatment without TMS. TMS, still unproven, holds promise since it involves no surgery or even electrode implant, and few side effects.

Guided Internet Therapy

• Guided internet therapy (GIT) uses internet-assisted communication and tasks to do online what had been one in person using cognitive-behavior therapy (techniques to identify negative thoughts, or cognitions, and behaviors and replace them with positive ones). GIT appears equally effective as face-to-face therapy for panic disorder and post-traumatic stress disorder.

Virtual Reality Therapy

• Virtual reality therapy, a means of computer simulation, offers a new twist to methods of "exposure therapy." Exposure therapy involves gradually exposing a patient to the object or situation that induces anxiety in a controlled setting. Virtual reality therapy, sometimes with a head-mounted display and computer images that respond to body movements, has been shown to be at least as effective as other exposure therapies for panic disorders and specific phobias. It has advantages over exposure therapy where conditions or cost make direct exposure expensive or impractical (e.g. treating soldiers returning from war, or flight anxiety).

Metacognitive Therapy

• Metacognitive therapy, unlike traditional cognitive-behavior therapy (CBT), targets thoughts about anxiety itself rather than external events or physical symptoms in patients with generalized anxiety disorder. As this disorder develops, two types of negative views about worry (metacognitions) develop: about the uncontrollability of worry, and about dangerous physical, psychological, or social consequences of worry (real or imagined). Metacognitive therapy combined with CBT can better relieve symptoms and aid recovery than CBT alone.

Extinction Retention

• Extinction retention in this context refers to the gains from treatment that is retained from each exposure during exposure therapy. Exposure therapy may be enhanced if extinction retention can be maximized. D-cycloserine, a chemical thought to aid extinction retention, has been shown to be effective for treating obsessive-compulsive disorder and specific phobias in conjunction with cognitive-behavioral therapy.

New Medications

• The anti-convulsant neurontin (gabapentin) has some demonstrated effectiveness for treating panic disorder and social anxiety disorder; but manipulation of research by the manufacturer calls results in to question. Also, the Food and Drug Administration has issued a warning for neurontin for possible increase in suicidal thoughts.

  Pregabalin, marketed as Lyrica, has been approved by Euroean Union Licensing for treatment of generalized anxiety disorder. Still, it is not considered a first choice for treatment and only recommended in cases of patients who do not respond to other medications.

  Pinoldol, a beta-blocker, shows effectiveness treating panic disorder in patients who did not respond to SSRIs.