New non-sedating drug treatment for anxiety disorders

Existing drugs for anxiety such as diazepam and lorazepam alter a chemical messenger in the brain known as gamma-aminobutryic acid (GABA). These drugs are therefore known as ‘GABAergic’ drugs and, while effective against anxiety, have problems of sedation (reducing awareness) and addiction - side effects that our patients say they would like us to reduce.

The National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre created a partnership with the pharmaceutical company Bionomics Ltd that has led to the development of BNC210 - a drug designed to reduce anxiety while avoiding the problems with existing treatments. It works on a different chemical system in the brain (cholinergic) that is important in signalling uncertainty and forming memories.

Assessing effects of anxiety on brain

With BRC support, we developed a system to measure the effects of anxiety on the brain involving sophisticated psychological tests and brain imaging that allowed us to assess the effects of existing drugs.

We used this method to test BNC210 in 24 unmedicated participants with Generalised Anxiety Disorder. The study design proved acceptable to our participants in our pilot work. There were three findings supporting the use of BNC210 in anxiety disorders.

First, BNC210 decreased brain reactivity to fearful faces in an area of the brain known to process emotions (amygdala). Second, the drug reduced activity in a set of brain regions working together in regulating anxious responses to unpleasant stimuli. Third, BNC210 reduced participants’ subjective anxiety and anxiety-related behaviour during a simulated threat task. The test involved playing a threat-avoidance computer game we developed which can be anxiety-provoking.

Lower doses more effective

We tested two different doses of this new drug. It was the lower dose which showed these promising responses. The responses to lower dose were similar to those produced by an effective dose of an existing anxiety treatment, lorazepam. Watch a Sky News report (2013) showing the threat-avoidance game being trialled

Our findings are promising and have fuelled interest and investment in Bionomics Ltd to develop this drug in a formal trial with more people and different doses of drug. BNC210 is now being taken into the later stages of development following our scientific demonstration of its effects in the brain and on behaviour and subjective anxiety.

 

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