In­haled ver­sion of blood pres­sure drug shows promise in treat­ing anx­i­ety, pain

Tehran Times - - HEALTH -

An in­haled form of a high blood pres­sure med­i­ca­tion has po­ten­tial to treat cer­tain types of anx­i­ety as well as pain, ac­cord­ing to a new study by the Cen­tre for Ad­dic­tion and Men­tal Health (CAMH).

Anx­i­ety dis­or­ders are usu­ally treated with dif­fer­ent types of med­i­ca­tions, such as an­tide­pres­sants, and psy­chother­apy. Amiloride is a med­i­ca­tion of­fer­ing a new ap­proach, as a short-act­ing nasal spray that could be used to pre­vent an anx­i­ety attack.

“In­haled amiloride may prove to have ben­e­fits for panic dis­or­der, which is typ­i­cally char­ac­ter­ized by spells of short­ness of breath and fear, when peo­ple feel anx­i­ety lev­els ris­ing,” says lead au­thor Dr. Marco Battaglia, As­so­ciate Chief of Child and Youth Psy­chi­a­try and Clin­i­cian Sci­en­tist in the Campbell Fam­ily Men­tal Health Re­search In­sti­tute at CAMH.

The study was based on un­der­stand­ing the key phys­i­o­log­i­cal changes in brain func­tion­ing that are linked to anx­i­ety and pain sen­si­tiv­ity. The re­searchers then tested a mol­e­cule, amiloride, which tar­gets this func­tion­ing.

Amiloride was in­haled so that it could im­me­di­ately ac­cess the brain. The study showed that it re­duced the phys­i­cal re­s­pi­ra­tory signs of anx­i­ety and pain in a pre­clin­i­cal model of ill­ness. This ther­a­peu­tic ef­fect didn’t oc­cur when amiloride was ad­min­is­tered in the body, as it didn’t cross the blood-brain bar­rier and did not reach the brain.

Re­sults were pub­lished in the Jour­nal of Psy­chophar­ma­col­ogy.

The role of early life ad­ver­sity

The study is based on years of re­search into how a per­son’s early life ex­pe­ri­ences af­fect their genes, says Dr. Battaglia. Child­hood ad­ver­sity, such as loss or sep­a­ra­tion from par­ents, in­creases the risk of anx­i­ety dis­or­ders and pain, among other health is­sues.

At a molec­u­lar level, th­ese neg­a­tive life ex­pe­ri­ences are linked to changes in some genes of the ASIC (acid-sens­ing-ion-chan­nels) fam­ily. While the DNA it­self doesn’t change, the way it func­tions is af­fected.

DNA is con­verted into work­ing pro­teins through a process called gene ex­pres­sion. As a re­sult of child­hood ad­ver­sity, some ASIC genes showed in­creased ex­pres­sion and epige­nomic changes. (“Epige­nomic” refers to changes in gene reg­u­la­tion that can in­her­ited by chil­dren). Over­lap­ping ge­netic changes were also seen in blood taken from twins who re­sponded to spe­cific tests de­signed to pro­voke panic.

Th­ese ge­netic changes are linked to phys­i­cal symp­toms. Breath­ing can be af­fected, due to over-sen­si­tiv­ity to higher car­bon diox­ide lev­els in the air. In such sit­u­a­tions, a per­son might hy­per­ven­ti­late and ex­pe­ri­ence grow­ing anx­i­ety. Pre­clin­i­cal and hu­man data are strik­ingly sim­i­lar in this re­gard. “As a treat­ment, amiloride turned out to be very ef­fec­tive pre­clin­i­cally,” says Dr. Battaglia.

The next step in his re­search is to test whether it eases anx­i­ety symp­toms. Dr. Battaglia is now launch­ing a pi­lot clin­i­cal trial, sup­ported through a seed grant from CAMH’s new Dis­cov­ery Fund. Col­lab­o­ra­tors at the Univer­sity of Utah are test­ing the drug’s safety.

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