employee
International Society "Stress under Control" (Vice-President)
employee
M.F. Vladimirsky State Medical University (Associate Professor of the Psychiatry Course)
employee
employee
Moscow Regional Scientific Research Clinical Institute named after M.F. Vladimirsky (Head of the Psychiatry Course)
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employee
CSCSTI 76.29
Anxiety disorders (AD) are the most common among mental disorders. Anxiety, somatic symptoms, and sleep disorders are characteristic features. Currently, according to various estimates, AD affects from 7.3 % to 28 % of the population, and according to WHO, AD ranks sixth among the causes of disability worldwide. People with AD have a high percentage of comorbidity with somatic diseases, compared with those who do not suffer from anxiety, among which cardiovascular diseases, diabetes mellitus, thyroid diseases, and gastrointestinal disorders are the most common. The relationship between AD and somatic diseases is two-way, since the presence of AD worsens the prognosis of bodily ailments. The article discusses neurotransmitters that somehow participate in the formation of AD, including GABA (γ-aminobutyric acid), norepinephrine, 5-hydroxytryptamine, dopamine, acetylcholine, Neuropeptide Y. The results of studies related to the use of Aviandra in AD, adaptation disorder, are described. The high efficacy and safety of the use of Aviander, which at a dose of 40 mg / day, prescribed for a period of at least 12 weeks, can be a successful treatment strategy for AD, especially in combination with educational programs and cognitive behavioral therapy.
anxiety disorders, pathogenesis of anxiety disorders, neurotransmitters, maritupirdin (Aviander)
1. Gong M., Dong H., Tang Y., Huang W., Lu F. Effects of aromatherapy on anxiety: a meta‐analysis of randomized controlled trials. J Affect Disord. 2020;274:1028‐1040.
2. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID‐19 pandemic. Lancet. 2021;398(10312):1700‐1712.
3. 21 vek: ot pandemii COVID-19 k novym psihosocial'nym stressam. Klinicheskoe rukovodstvo. [Elektronnyy resurs]. – M.: Izdatel'stvo «Pero», 2022.
4. Nakada S., Ho F.K., Celis‐Morales C., Jackson C.A., Pell J.P. Individual and joint associations of anxiety disorder and depression with cardiovascular disease: a UK biobank prospective cohort study. Eur Psychiatry. 2023;66(1):e54.
5. Zhao H., Zhou M., Liu Y., Jiang J., Wang Y. Recent advances in anxiety disorders: Focus on animal models and pathological mechanisms. Animal Model Exp Med. 2023 Dec;6(6):559-572. doi:https://doi.org/10.1002/ame2.12360.
6. Szuhany K.L., Simon N.M. Anxiety Disorders: A Review. Jama. 2022;328(24):2431‐2445.
7. Akarachkova E.S., Kotova O.V., Kadyrova L.R. Pandemiya COVID-19. Stress-svyazannye posledstviya. Uchebnoe posobie dlya vrachey. Izdanie vtoroe, ispravlennoe i dopolnennoe.– M.: OOO «Medicina-Inform», 2020. – 32 s.
8. Akarachkova E.S., Kotova O.V. i dr. Sindrom vegetativnoy distonii. Klinicheskoe rukovodstvo. [Elektronnyy resurs]. - M.: Izdatel'stvo «Mezhdunarodnoe obschestvo po izucheniyu i effektivnomu kontrolyu stressa i svyazannyh s nim rasstroystv. 2025.
9. Hodes G.E., Epperson C.N. Sex differences in vulnerability and resilience to stress across the life span. Biol Psychiatry. 2019;86(6):421‐432.
10. Samuel B., Wang H., Shi C. et al. The effects of coloring therapy on patients with generalized anxiety disorder. Animal Model Exp Med. 2022;5(6):502‐512.
11. Pavlidi P., Kokras N., Dalla C. Sex differences in depression and anxiety. Curr Top Behav Neurosci. 2023;62:103‐132.
12. Field D.T., Cracknell R.O., Eastwood J.R., et al. High‐dose vitamin B6 supplementation reduces anxiety and strengthens visual surround suppression. Hum Psychopharmacol. 2022;37(6):e2852.
13. Patt L., Tascio D., Domingos C. et al. Impact of developmental changes of GABA(a) receptors on interneuron‐NG2 glia transmission in the hippocampus. Int J Mol Sci. 2023;24(17):13490.
14. Qin X., Pan H.Q., Huang S.H. et al. GABA(a)(δ) receptor hypofunction in the amygdala‐hippocampal circuit underlies stress‐induced anxiety. Sci Bull (Beijing). 2022;67(1):97‐110.
15. Schopman S.M.E., Bosman R.C., Muntingh A.D.T, van Balkom A., Batelaan N.M. Effects of tryptophan depletion on anxiety, a systematic review. Transl Psychiatry. 2021;11(1):118.
16. Garcia‐Garcia A.L., Canetta S., Stujenske J.M. et al. Serotonin inputs to the dorsal BNST modulate anxiety in a 5‐HT(1A) receptor‐dependent manner. Mol Psychiatry. 2018;23(10):1990‐1997.
17. Wu M., Chen Y., Shen Z. et al. Electroacupuncture alleviates anxiety‐like behaviors induced by chronic neuropathic pain via regulating different dopamine receptors of the basolateral amygdala. Mol Neurobiol. 2022;59(9):5299‐5311.
18. Brandão M.L., Coimbra N.C. Understanding the role of dopamine in conditioned and unconditioned fear. Rev Neurosci. 2019;30(3):325‐337.
19. de Siqueira U.L., Freese L., Almeida F.B. et al. Effects of neonatal dopaminergic lesion on oral cocaine self‐administration in rats: higher female vulnerability to cocaine consumption. Pharmacol Biochem Behav. 2022;212:173315.
20. Kuo H.I., Paulus W., Batsikadze G., Jamil A., Kuo M.F., Nitsche M.A. Acute and chronic noradrenergic effects on cortical excitability in healthy humans. Int J Neuropsychopharmacol. 2017;20(8):634‐643.
21. McCall J.G., Al‐Hasani R., Siuda E.R. et al. CRH engagement of the locus coeruleus noradrenergic system mediates stress‐induced anxiety. Neuron. 2015;87(3):605‐620.
22. Tillage R.P., Foster S.L., Lustberg D., Liles L.C., McCann K.E., Weinshenker D. Co‐released norepinephrine and galanin act on different timescales to promote stress‐induced anxiety‐like behavior. Neuropsychopharmacology. 2021;46(8):1535‐1543.
23. Śmiałowska M., Zięba B., Domin H. A role of noradrenergic receptors in anxiolytic‐like effect of high CRF in the rat frontal cortex. Neuropeptides. 2021;88:102162.
24. Arcadi F.A., Corallo F., Torrisi M., et al. Role of citicoline and choline in the treatment of post‐stroke depression: an exploratory study. J Int Med Res. 2021;49(11):3000605211055036.
25. Anderson S.M., Brunzell D.H. Anxiolytic‐like and anxiogenic‐like effects of nicotine are regulated via diverse action at β2*nicotinic acetylcholine receptors. Br J Pharmacol. 2015;172(11):2864‐2877.
26. Carboni L., El Khoury A., Beiderbeck D.I., Neumann I.D., Mathé A.A. Neuropeptide Y, calcitonin gene‐related peptide, and neurokinin a in brain regions of HAB rats correlate with anxiety‐like behaviours. Eur Neuropsychopharmacol. 2022;57:1‐14.
27. Fonseca I.C.F., Castelo‐Branco M., Cavadas C., Abrunhosa A.J. PET imaging of the neuropeptide Y system: a systematic review. Molecules. 2022;27(12):3726.
28. Tasan R.O., Verma D., Wood J. et al. The role of neuropeptide Y in fear conditioning and extinction. Neuropeptides. 2016;55:111‐126.
29. Petelin D.S., Sorokina O.Yu., Galyautdinova A.N., Dolgopolova Yu.V., Volel' B.A. Trevozhnye rasstroystva v klinicheskoy praktike (obzor literatury s klinicheskoy illyustraciey). Medicinskiy sovet. 2024;18(12):52–60. https://doi.org/10.21518/ms2024-297.
30. Medvedev V.E., Kotova O.V., Akarachkova E.S., Belyaev A.A., Parshakova E.S. Generalizovannoe trevozhnoe rasstroystvo: anatomicheskie i funkcional'nye osobennosti golovnogo mozga. Aviandr — novye vozmozhnosti terapii // Sovremennaya terapiya v psihiatrii i nevrologii. 2024; №2: URL: https://cyberleninka.ru/article/n/generalizovannoe-trevozhnoe-rasstroystvo-anatomicheskie-i-funktsionalnye-osobennosti-golovnogo-mozga-aviandr-novye-vozmozhnosti (data obrascheniya: 25.12.2025).
31. Ivashchenko A.A., Morozova M.A., Vostokova N.V. 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 Nov;143:436-444. doi:https://doi.org/10.1016/j.jpsychires.2021.10.008. Epub 2021 Oct 11. PMID: 34656876.
32. Parfenov V.A. Aviandr – novyy original'nyy preparat dlya terapii trevozhnyh rasstroystv. Nevrologiya, neyropsihiatriya, psihosomatika. 2024;16(4):98–102. DOI:https://doi.org/10.14412/2074-2711-2024-4-98-102.
33. Morozova M., Safarova T., Gluskina L., Penchul N., Kasimova L., Zayarnaya I., Boychevskaya Yu., Shiryaev O., Reznikov M., Buhanovskaya O., Mavani D., Reutova M., Nekrasov V., Gorchakov D., Balakin K., Tarakanova A., Yakubova E., Ivaschenko A., Ivaschenko A. Dvoynoe slepoe placebo-kontroliruemoe issledovanie effektivnosti i perenosimosti preparata Aviandr® pri lechenii generalizovannogo trevozhnogo rasstroystva. Sovremennaya terapiya psihicheskih rasstroystv. 2024;(3):2—16. DOI:https://doi.org/10.21265/PSYPH.2024.82.78.001.
34. Popova V.B., Antonova E.A., Hlyabova P.M., Rodyukova I.S., Alpenidze D.N., Drozdova Yu.V., Shamaeva K.I., Kryzhanovskiy S.M., Tarakanova A.S., Yakubova E.V., Ivaschenko A.V., Ivaschenko A.A. Effektivnost' i bezopasnost' novogo preparata Aviandr v lechenii trevogi u pacientov s rasstroystvom adaptacii posle perenesennoy ostroy koronovirusnoy infekcii. Zhurnal nevrologii i psihiatrii im. S.S. Korsakova. 2024;124(7):131–138. https://doi.org/10.17116/jnevro2024124071131.
35. Kinkul'kina M.A., Danilov A.B., Volel' B. A., Morozov E. N., i dr. Effektivnost' i bezopasnost' preparata AVIANDR® u pacientov s trevozhnymi sostoyaniyami posle perenesennoy koronavirusnoy infekcii (COVID-19): promezhutochnye rezul'taty mnogocentrovogo nablyudatel'nogo postregistracionnogo issledovaniya. Vestnik nevrologii, psihiatrii i neyrohirurgii. 2025;1.
36. Esipov A.V., Samushiya M.A., Ivolgin A.F., Hommyatov M.R. i dr. Novye vozmozhnosti terapii rasstroystva adaptacii u uchastnikov boevyh deystviy: rezul'taty issledovaniya otechestvennogo preparata Aviandr. Zhurnal nevrologii i psihiatrii im. S.S. Korsakova. 2025;125(3):1–8. https://doi.org/10.17116/jnevro20251250311.
37. Morozov E.N., Smolyarchuk E.A., Appolonova S.A., i dr. Otkrytoe randomizirovannoe klinicheskoe issledovanie farmakokinetiki, mezhlekarstvennyh vzaimodeystviy i bezopasnosti sovmestnogo priema preparata Aviandr i drugih lekarstvennyh preparatov u zdorovyh dobrovol'cev. Psihiatriya i psihofarmakoterapiya. 2025; 5: 40–49. DOI:https://doi.org/10.62202/2075-1761-2025-27-5-40-49.
