David S Baldwin

2 papers in the library · 105 citations · publishing 2023-2025

Papers

Pharmacological Treatment of Generalised Anxiety Disorder: Current Practice and Future Directions.

Expert review of neurotherapeutics June 1, 2023 Harry A Fagan, David S Baldwin 55 citations

Generalized Anxiety Disorder (GAD) is common and characterized by excessive worry. Current treatments include pharmacological and psychological options, but many patients do not respond to first-line drugs. This review covers diagnostic criteria, epidemiology, and effective medications such as duloxetine, escitalopram, pregabalin, quetiapine, and venlafaxine. It also discusses treatment guidelines, management of treatment resistance, and special considerations for older adults and children. Evidence for further pharmacological management after initial treatment failure is limited. Many novel anxiolytics have entered clinical trials, but translation from animal models has mostly been unsuccessful. Compounds including certain psychedelics, ketamine, oxytocin, and agents modulating the orexin, endocannabinoid, and immune systems show potential for further study.

DOI: 10.1080/14737175.2023.2211767 Full text Gad Generalized anxiety disorder Novel anxiolytics Pharmacological treatment +1

Expectancy Effects, Failure of Blinding Integrity, and Placebo Response in Trials of Treatments for Psychiatric Disorders: A Narrative Review.

JAMA psychiatry May 1, 2025 Nathan T M Huneke, Guilherme Fusetto Veronesi, Matthew Garner et al. 50 citations

Expectancy effects—participants' beliefs about treatment—can bias the results of psychiatric randomized clinical trials by compromising blinding integrity and inflating effect sizes. This narrative review is the first to examine the interplay between expectancy, unblinding, and treatment outcomes in such trials. Evidence from experimental and clinical studies shows that expectation shapes placebo and active treatment responses. Meta-analytic data from psychedelic and anxiety disorder research indicate that unblinding due to perceived efficacy or side effects can alter effect sizes. The authors recommend collecting expectancy data and monitoring blinding integrity, and they propose developing objective outcome measures less susceptible to expectancy effects to improve trial reliability.

DOI: 10.1001/jamapsychiatry.2025.0085 Full text