Progress in developing new medications for anxiety and stress-related disorders has been limited over the past 30 years, but researchers are now investigating novel molecular pathways beyond the traditional monoamine systems. Enhancing psychotherapy with pharmacological compounds could transform the standard of care and introduce a paradigm shift in how medications are conceptualized in psychiatric treatment. More human trials and translational research are needed, but pursuing innovative mechanisms is expected to yield substantial results and move beyond the reliance on 20th-century chemical agents.
For adults with anxiety disorders, Mindfulness-Based Stress Reduction (MBSR) delivered via videoconference was comparably effective to in-person MBSR, but MBSR-VC did not meet the threshold for non-inferiority compared to the antidepressant escitalopram (ESC) delivered by videoconference. In a randomized controlled trial with 202 participants, MBSR-VC and ESC-VC showed similar average improvement on the Clinical Global Impression of Severity scale (1.39 vs 1.51 points), but non-inferiority was not supported. In-person treatments had a greater impact on social anxiety than their video versions. ESC-VC received higher satisfaction ratings and had a greater effect on panic symptoms than MBSR-VC. Remotely delivered MBSR is a viable option for anxiety disorders, though social anxiety may benefit more from in-person care.