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

Area of Science:

• Neuroscience
• Pharmacology
• Clinical Psychology

Background:

• Exposure therapy is the standard anxiety treatment, but many patients do not respond or relapse.
• Novel pharmacological agents show promise as adjuncts to exposure therapy in preclinical research.
• Translating preclinical findings to clinical practice remains a significant challenge.

Purpose of the Study:

• To review factors influencing the efficacy of pharmacological adjuncts for anxiety.
• To highlight the gap between preclinical findings and clinical application of anxiety treatments.
• To advocate for broader consideration of individual differences in drug development for anxiety.

Main Methods:

• Literature review of factors affecting anxiety vulnerability and drug response.
• Analysis of how individual differences impact neurotransmitter systems targeted by anxiety medications.
• Discussion of translational challenges in psychopharmacology.

Main Results:

• Preclinical drug effects often fail to translate to human clinical populations.
• Factors such as age, sex, genetics, stress, diet, and microbiome significantly influence anxiety and drug efficacy.
• Current drug development rarely accounts for these individual variations.

Conclusions:

• Individual differences are critical for understanding and improving anxiety treatment outcomes.
• Future research must incorporate these factors to enhance the translation of promising anxiety medications.
• A personalized approach to drug development is essential for effective anxiety pharmacotherapy.