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The noradrenergic paradox: implications in the management of depression and anxiety

Overview of attention for article published in Neuropsychiatric Disease and Treatment, March 2016
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (82nd percentile)
  • Good Attention Score compared to outputs of the same age and source (76th percentile)

Mentioned by

twitter
8 tweeters
facebook
4 Facebook pages
wikipedia
1 Wikipedia page

Citations

dimensions_citation
29 Dimensions

Readers on

mendeley
144 Mendeley
Title
The noradrenergic paradox: implications in the management of depression and anxiety
Published in
Neuropsychiatric Disease and Treatment, March 2016
DOI 10.2147/ndt.s91311
Pubmed ID
Authors

Alonso Montoya, Robert Bruins, Martin Katzman, Pierre Blier

Abstract

Both major depressive disorder and the anxiety disorders are major causes of disability and markedly contribute to a significant global burden of the disease worldwide. In part because of the significant socioeconomic burden associated with these disorders, theories have been developed to specifically build clinical treatment approaches. One such theory, the monoaminergic hypothesis, has led to the development of several generations of selective and nonselective inhibitors of transporters of serotonin and norepinephrine, with the goal of augmenting monoaminergic transmission. These efforts have led to considerable success in the development of antidepressant therapeutics. However, there is a strong correlation between enhanced noradrenergic activity and fear and anxiety. Consequently, some physicians have expressed concerns that the same enhanced noradrenergic activity that alleviates depression could also promote anxiety. The fact that the serotonergic and noradrenergic reuptake inhibitors are successfully used in the treatment of anxiety and panic disorders seems paradoxical. This review was undertaken to determine if any clinical evidence exists to show that serotonergic and noradrenergic reuptake inhibitors can cause anxiety. The PubMed, EMBASE, and Cochrane Library databases were searched, and the results limited to randomized, double-blind, placebo-controlled studies performed in nongeriatric adults and with clear outcome measures were reported. Based on these criteria, a total of 52 studies were examined. Patients in these studies suffered from depression or anxiety disorders (generalized and social anxiety disorders, panic disorder, and posttraumatic stress disorder). The large majority of these studies employed venlafaxine or duloxetine, and the remainder used tri-cyclic antidepressants, atomoxetine, or reboxetine. All the studies reported clinically significant alleviation of depressive and/or anxious symptoms by these therapeutics. In none of these studies was anxiety a treatment-emergent adverse effect. This review argues against the impression that enhanced generalized noradrenergic activity promotes the emergence of anxiety.

Twitter Demographics

The data shown below were collected from the profiles of 8 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 144 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 <1%
Unknown 143 99%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 28 19%
Student > Master 21 15%
Student > Ph. D. Student 19 13%
Researcher 15 10%
Student > Doctoral Student 10 7%
Other 24 17%
Unknown 27 19%
Readers by discipline Count As %
Medicine and Dentistry 29 20%
Neuroscience 25 17%
Agricultural and Biological Sciences 18 13%
Psychology 13 9%
Pharmacology, Toxicology and Pharmaceutical Science 9 6%
Other 22 15%
Unknown 28 19%

Attention Score in Context

This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 February 2021.
All research outputs
#2,463,867
of 17,606,952 outputs
Outputs from Neuropsychiatric Disease and Treatment
#384
of 2,674 outputs
Outputs of similar age
#48,155
of 271,632 outputs
Outputs of similar age from Neuropsychiatric Disease and Treatment
#19
of 80 outputs
Altmetric has tracked 17,606,952 research outputs across all sources so far. Compared to these this one has done well and is in the 84th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,674 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.9. This one has done well, scoring higher than 85% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 271,632 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 82% of its contemporaries.
We're also able to compare this research output to 80 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 76% of its contemporaries.