The experience of managing patients with anxiety disorders in real clinical practice

Anxiety disorders (AD) are one of the main health care challenges. Epidemiological studies indicate that ADs occur in 21–30% of the population over a lifetime. The annual prevalence of AD in the USA is 18.1%, with a lifetime prevalence of 28.2%. In Europe, the annual prevalence ranges from 12 to 27%, with a lifetime prevalence of about 21–30%. In Russia, the frequency of AD varies from 16 to 31%, more commonly found in women and starting at a young age. Treating AD is complex due to the potential negative impact of medications on psychophysiological functions. It is important to select therapy considering its effectiveness, safety, and availability, especially after the COVID-19 pandemic. Treatment of AD includes psychotherapy and psychopharmacotherapy. Normally, neurons that limit and implement anxiety are in equilibrium. During anxiety, the activity of neurons limiting anxiety decreases, while the activity of neurons implementing anxiety increases. The goal of therapy is to activate GABAergic and serotonergic neurons to reduce anxiety. In recent years, a comprehensive therapy consisting of two types of drugs has been used in the treatment of AD: SSRIs and a serotonin tranquilizer called buspirone. Buspirone is a non-benzodiazepine anxiolytic effective in treating AD. It has fewer side effects compared to benzodiazepines. Buspirone acts on serotonin receptors of the 1A-type, providing a gradual reduction of anxiety. It can also be used for monotherapy of GAD, augmentation of antidepressant therapy, and is actively applied in routine neurological practice. It has significant therapeutic potential, a sufficiently small profile of side effects, and good tolerability. The article is illustrated by a clinical case of the successful use of buspirone.