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Anxiety treatment: Updated options

https://doi.org/10.21518/ms2025-130

Abstract

Generalized anxiety disorder and other anxiety spectrum disorders constitute the category of the most common mental disorders. Three lines of pharmacological therapy are used in the treatment of anxiety disorders: 1) selective serotonin reuptake inhibitors (SSRI) and serotonin and norepinephrine reuptake inhibitors (SNRI); 2) benzodiazepines; 3) antipsychotics. Along with SSRI and SNRI, other groups of antidepressants are used in the treatment of anxiety disorders, and other drugs with anxiolytic properties, such as pregabalin, are being considered as alternatives to benzodiazepines. Drugs in each of the three categories are characterized by both advantages and disadvantages that limit their clinical use, which determines the need to find new treatments for anxiety disorders. One of the most modern and promising treatments for generalized anxiety disorder is Aviandr, which was designated AVN-101 and CD-008-0045 at the stages of development and initial testing. The efficacy and safety of Aviandr in the treatment of generalized anxiety disorder has been proven by the results of randomized controlled trials; in addition, the effectiveness of the drug in improving the condition of patients who have suffered from acute coronavirus infection has been noted. In addition to its anxiolytic effect, Aviandr shows the ability to reduce depressive symptoms and exhibits a number of other additional effects. A notable feature of Aviandr, which gives it advantages over traditional treatments for generalized anxiety disorder with comparable effectiveness, is the absence of daytime sleepiness, which often occurs when benzodiazepines are prescribed, and the side effects that are typical for SSRI.

About the Authors

Yu. P. Sivolap
Peoples’ Friendship University of Russia named after Patrice Lumumba
Russian Federation

Yury P. Sivolap - Dr. Sci. (Med.), Professor of the Department of Psychiatry, Psychotherapy and Psychosomatic Pathology, Faculty of Continuing Medical Education.

6, Miklukho-Maklai St., Moscow, 117198



A. A. Portnova
Research and Clinical Center of Pediatric Psychoneurology
Russian Federation

Anna A. Portnova - Dr. Sci. (Med.), Chief Researcher.

74, Michurinsky Prospekt, Moscow, 119602



References

1. Zlomuzica A, Kodzaga I, Piovesan K, Lipp A. Treating anxiety comorbidity: Lessons from exposure generalization studies. Behav Brain Res. 2025:481:115409. https://doi.org/10.1016/j.bbr.2024.115409.

2. Black DW, Andreasen NC. Introductory Textbook of Psychiatry. 6th ed. Arlington: American Psychiatric Publishing; 2014. 760 p. Available at: https://evirtual.upra.ao/examples/biblioteca/content/files/psi_donald%20w.%20black,%20nancy%20c.%20andreasen%20-%20introductory%20textbook%20of%20psychiatry-american%20psychiatric%20publishing%20%282014%29.pdf.

3. Bandelow B, Michaelis S, Wedekind D. Treatment of anxiety disorders. Dialogues Clin Neurosci. 2017;19(2):93–107. https://doi.org/10.31887/DCNS.2017.19.2/bbandelow.

4. Hood SD, Odufowora-Sita O, Briere JB, Lucchino M, Khrouf F, Olewinska E et al. Systematic review and network meta-analysis of agomelatine for the treatment of generalized anxiety disorder in adult patients. Int Clin Psychopharmacol. 2025;40(2):62–74. https://doi.org/10.1097/YIC.0000000000000551.

5. Flint AJ. Generalised anxiety disorder in elderly patients: epidemiology, diagnosis and treatment options. Drugs Aging. 2005;22(2):101–114. https://doi.org/10.2165/00002512-200522020-00002.

6. Baldwin DS, Waldman S, Allgulander C. Evidence-based pharmacological treatment of generalized anxiety disorder. Int J Neuropsychopharmacol. 2011;14(5):697–710. https://doi.org/10.1017/S1461145710001434.

7. Stahl SM. Don’t ask, don’t tell, but benzodiazepines are still the leading treatments for anxiety disorder. J Clin Psychiatry. 2002;63(9):756–757. https://doi.org/10.4088/jcp.v63n0901.

8. Penninx BWJH, Pine DS, Holmes EA, Reif A. Benzodiazepines for the longterm treatment of anxiety disorders? – Authors’ reply. Lancet. 2021;398(10295):120. https://doi.org/10.1016/S0140-6736(21)00931-4.

9. Tibrewal P, Looi JCL, Allison S, Bastiampillai T. Benzodiazepines for the longterm treatment of anxiety disorders? Lancet. 2021;398(10295):119–120. https://doi.org/10.1016/S0140-6736(21)00934-X.

10. Dubovsky SL, Marshall D. Benzodiazepines Remain Important Therapeutic Options in Psychiatric Practice. Psychother Psychosom. 2022;91(5):307–334. https://doi.org/10.1159/000524400.

11. Gomez AF, Barthel AL, Hofmann SG. Comparing the efficacy of benzodiazepines and serotonergic anti-depressants for adults with generalized anxiety disorder: a meta-analytic review. Expert Opin Pharmacother. 2018;19(8):883–894. https://doi.org/10.1080/14656566.2018.1472767.

12. Beyer C, Currin CB, Williams T, Stein DJ. Meta-analysis of the comparative efficacy of benzodiazepines and antidepressants for psychic versus somatic symptoms of generalized anxiety disorder. Compr Psychiatry. 2024;132:152479. https://doi.org/10.1016/j.comppsych.2024.152479.

13. DeBattista C, Schatzberg AF. Schatzberg’s Manual of Clinical Psychopharmacology. 10th ed. Washington: American Psychiatric Association Publishing; 2024. 866 p. https://doi.org/10.1176/appi.books.9798894551289.

14. Nelles PA, Singewald N, Sperner-Unterweger B, Hüfner K. The “conflict avoidance theory of inflammation-induced anxiety” (CATIA): A psychoneuroimmunologic hypothesis. Med Hypotheses. 2025;196:111580. https://doi.org/10.1016/j.mehy.2025.111580.

15. Sah A, Singewald N. The (neuro)inflammatory system in anxiety disorders and PTSD: Potential treatment targets. Pharmacol Ther. 2025;269:108825. https://doi.org/10.1016/j.pharmthera.2025.108825.

16. Garakani A, Murrough JW, Freire RC, Thom RP, Larkin K, Frank D et al. Pharmacotherapy of Anxiety Disorders: Current and Emerging Treatment Options. Front Psychiatry. 2020;11:595584. https://doi.org/10.3389/fpsyt.2020.595584.

17. Ivashchenko AA, Morozova MA, Vostokova NV, Beniashvily AG, Bukhanovskaya OA, Burminskiy DS et al. Safety and efficacy of aviandr in patients with generalized anxiety disorder: A multicenter, randomized, double-blind, placebo-controlled, dose-finding, pilot study. J Psychiatr Res. 2021;143:436–444. https://doi.org/10.1016/j.jpsychires.2021.10.008.

18. Morozova MA, Safarova TP, Gluskina LYa, Penchul NA, Kasimova LN, Zaiarnaia II et al. A Double-Blind, Placebo-Controlled Study of the Efficacy and Safety of Aviandr® in the Treatment of Generalized Anxiety Disorder. Current Therapy of Mental Disorders. 2024;(3):2–16. (In Russ.) Available at: https://ctmd.psypharma.ru/index.php/ctmd/article/view/488.

19. Parfenov VA. Aviandr is a new original drug for treating anxiety. Neurology, Neuropsychiatry, Psychosomatics. 2024;16(4):98–102. (In Russ.) https://doi.org/10.14412/2074-2711-2024-4-98-102.

20. Medvedev VE, Kotova OV, Akarachkova ES, Belyaev AA, Parshakova ES. Generalized anxiety disorder: anatomical and functional features of the brain. Aviandr – new possibilities of therapy. Sovremennaya Terapiya v Psikhiatrii i Nevrologii. 2024;(2):5–11. (In Russ.) Available at: https://logospress.ru/image/catalog/STPN/STPN-2024/02-2024/STPN_2-2024_St2.pdf.

21. Popova VB, Antonova EA, Hlyabova PM, Rodyukova IS, Alpenidze DN, Drozdova YV et al. Efficacy and safety of Aviandr in the treatment of anxiety in patients with adjustment disorders after COVID-19. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2024;124(7):131–138. (In Russ.) https://doi.org/10.17116/jnevro2024124071131.


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For citations:


Sivolap YP, Portnova AA. Anxiety treatment: Updated options. Meditsinskiy sovet = Medical Council. 2025;(3):111-116. (In Russ.) https://doi.org/10.21518/ms2025-130

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ISSN 2079-701X (Print)
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