Summary: Yes, there are several new treatments for anxiety that work. There are also several new treatments for anxiety that show mixed results and need further research, and new treatments that were not effective in clinical trials.
Key Points:
- Rates of anxiety have increased in the U.S. and around the world in recent years.
- In response, research into new treatments for anxiety that work has increased.
- New treatments under research include both standalone approaches and approaches designed to augment/support existing evidence-based therapies.
What’s New in Anxiety Treatment?
In a new State of the Art clinical review published by the British Medical Journal (BMJ) called “New and Emerging Treatments for Anxiety Disorders,” a group of mental health researchers identified this goal:
“This review summarizes new and emerging stand-alone treatments and treatment augmentation strategies for anxiety disorders.”
They reviewed three types of treatment approaches:
- New standalone treatments
- New augmentation treatments designed to improve existing treatments
- Emerging treatments
In this article, we’ll summarize their findings and offer a brief description of each therapeutic approach. To place this research in context, we’ll offer this brief summary of the prevalence of anxiety among adults in the U.S. and the world:
Anxiety among adults in the U.S. in 2024:
- Mild symptoms: 37.5 million
- Moderate symptoms: 12.2 million
- Severe symptoms: 7.1 million
Anxiety among adults worldwide in 2024:
- Any anxiety disorder: 359 million
That’s over 400 million people in the world with anxiety that meets a clinical threshold. That’s why new research is important, and why mental health professionals are involved in a constant process of reviewing and improving their therapeutic techniques.
Let’s see that the researchers found.
New Research on Anxiety Treatment: What Works?
In the review, researchers evaluated two types of treatment: standalone treatments and treatments designed to enhance or improve existing treatments. Within these two types of treatment, researchers examined existing evidences for new approaches to anxiety treatment in the following categories:
- Psychotherapeutic techniques (3)
- Interoceptive techniques (1)
- Brain stimulation techniques (3)
- New pharmacological methods, i.e. medication (4)
In addition, researchers examined three emerging treatments, including one neuromodulation approach, one pharmacological approach, and one technological approach. We’ll summarize the findings on all of the above now, beginning with standalone treatments.
New/Novel Standalone Treatments
Psychotherapies
- Positive affect treatment (PAT):
- Confirmed effective
- Increases ability to anticipate and appreciate reward and positive emotion
- Replicated in follow-up clinical research
- Amplification of positivity treatment (AMP)
- Confirmed effective
- Increases awareness of, seeking for, and appreciation of positive events
- Replicated in follow-up clinical research
- Safety behavior reduction
- Positive outcomes in one clinical trial
- Involves restructuring thought and emotion processes associated with fear
- Not yet replicated
Interoception
- Floatation-REST (reduced environmental stimulation therapy)
- Confirmed effective
- Involves floating in an Epsom salt bath in an environment that attenuates sensory input such as sight, sound, smell, and touch. Floatation also imparts a sense of weightlessness considered therapeutic.
- Replicated in follow-up clinical research
Neuromodulation, i.e. brain stimulation
- Continuous transcranial brain stimulation (cTBS)
- Confirmed effective
- Involves continuous stimulation of brain areas associated with cognition, emotion, and cognitive-emotional processing
- Not yet replicated
- Repetitive transcranial brain stimulation (rTMS)
- Confirmed effective
- Involves intermittent, repetitive stimulation of brain areas associated with cognition, emotion, and cognitive-emotional processing
- Replicated in follow-up clinical research
- Transcranial direct current stimulation (tDCS)
- Mixed results efficacy
- Involves brain stimulation through electrodes placed on scalp, targets specific brain areas to increase or decrease activity
- Replicated, but with mixed results
Pharmacological Medication and Natural Supplements
- Aviandr
- Confirmed effective in initial studies
- Selective 5-HT receptor antagonist, non-benzodiazepine anxiolytic
- Not yet replicated in clinical research
- Cannabidiol
- Confirmed effective in initial studies
- Derived from the cannabis sativa plant, acts on human cannabinoid system
- Effectiveness not yet replicated in clinical research
- Ashwagandha
- Confirmed effective in clinical studies
- Herb called withania somnifera native to South Asia
- Traditional anti-inflammatory and anxiolytic
- Replicated in follow-up clinical research
- L-theanine
- Confirmed ineffective
- Amino acid found in camellia sinensis tea leaves found in many types of tea
- No attempt to replicate initial research
We’ll admit that the diversity and breadth of this current research is inspiring and aligns with our overall commitment to integrated treatment for the whole person. Among these new treatments, we see approaches that may meet the needs of a wide variety of patients: those who want new versions of traditional, time-tested methods, those interested in truly novel approaches such as floating in a sensory deprivation chamber, and those interested in both natural and pharmacological medication.
Next, we’ll report their findings on treatments designed to support or improve existing treatments, called augmentation or supportive treatments.
New/Novel Treatment Augmentation Methods
Behavioral Approaches
- Inhibitory retrieval model of exposure therapy
- Confirmed effective
- Focuses on helping patients learn, through exposure therapy, that “feared outcomes do not occur as expected, across a variety of situations.”
- Not yet replicated in clinical research
- Behavioral experiments for tolerance of uncertainty
- Based on the inhibitory retrieval model of exposure therapy
- Focuses on helping patients develop, through exposure therapy a new “tolerance of uncertainty in anxiety-provoking situations without need of reassurance.”
- Not yet replicated in clinical research
Pharmacological Approaches
- D-cycloserine
- Mixed results for effectiveness
- Intended to augment exposure therapy
- Partial NMDA receptor agonist, affects brain structures associated with memory and learning
- Not yet replicated in clinical research
- Cannabidiol
- Confirmed ineffective in support of exposure therapy
- Currently being studied further as a support for exposure therapy
- Scopolamine
- Mixed results for effectiveness
- Targets structures in brain that modulate the parasympathetic nervous system
- Associated with WWII and Cold War-era truth serum myths
- Hypothesized to “reduce renewal of fear after extinction, [decreasing likelihood] of return of fear when…anxiety-provoking stimulus is encountered in a different context.”
- Not yet replicated in clinical research
Here we see less diversity but an equal amount of forward-thinking. While these approaches were designed to support existing therapies, only those that support exposure therapy show significant, replicable results, with the new pharmacological approaches yielding mixed results, indicating the medications require additional clinical trials to resolve specific issues.
Finally, we’ll summarize the results on three emerging treatments for anxiety. These approaches are in the early stages of clinical review and implementation.
New and Emerging Treatments
Neuromodulation
- Low intensity focused ultrasound (LIFU)
- Promising outcomes in several initial studies.
- New neuromodulation technique that uses high-frequency sound waves rather than electromagnetic waves to target brain areas associated with anxiety
- Follow up research ongoing
Pharmacological
- Psilocybin
- Promising outcomes in studies on anxiety related to serious illness
- Considered a component of the nascent field of psychedelic psychotherapy
- Initial clinical research shows positive results for anxiety and depression
- Safey, dosage, delivery method, and how to incorporate with psychotherapy under review in ongoing clinical studies
Technological
- Augmented reality
- Shows effectiveness after one session in reducing fear of spiders, i.e. for specific phobias
- Shows effectiveness after one session in reducing social anxiety, i.e. for social anxiety disorder
- Involves a combination of virtual reality, reality, and exposure therapy in single sessions to reduce anxiety in specific situations, and various specific phobias.
- Clinical research for tolerance, dosage, and effectiveness ongoing
Here again we see an encouraging diversity, with treatments designed to approach anxiety from a variety of angles. We’ll discuss these results – and the current best practices in anxiety treatment – in the section below.
The Future of Anxiety Treatment
Our primary takeaway from this State of the Art Review from BMJ is positive:
There’s something there for everyone, which bodes well for the future of anxiety treatment.
For patients who don’t want medication or therapy, and are interested in an outpatient procedure only, neuromodulation techniques may offer relief, if research resolves issues around dosage and optimal delivery techniques.
Patients who prefer a traditional, established approach – but with improvements – may prefer the new aspects of exposure therapy under development, such as the inhibitory retrieval model of exposure therapy or behavioral experiments for tolerance of uncertainty.
Patients who prefer a medication, whether a natural supplement or a new pharmacological anxiolytic can find hope in the new medications under review, while patients interested in exploring cutting edge treatments such as psychedelic therapy or augmented reality therapy can be confident that researchers are covering all the bases and exploring any method that shows potential for helping people effectively manage their anxiety disorder.
These new and emerging treatments, if confirmed safe and effective by additional research, and approved by the Food and Drug Administration (FDA), may soon join the following approaches to anxiety treatment in common use today, which include medication, lifestyle changes, and psychotherapy.
Current Effective, Evidence-Based Anxiety Treatments
Evidence-based, effective medication for anxiety includes:
- Antidepressants:
- Selective serotonin reuptake inhibitors (SSRIs)
- Selective noradrenaline reuptake inhibitors (SNRIs)
- Anxiolytics:
- Benzodiazepines, for short term symptom relief
Research confirms the following lifestyle changes can help reduce anxiety symptoms:
- Mindfulness, including;
- Mindful meditation
- Mindful relaxation
- mindfulness-based stress reduction (MBSR)
- Exercise and activity
- 20-30 minutes minimum of mild or moderate aerobic exercise per day helps reduce anxiety symptoms, effect is short-term
Studies show the following psychotherapeutic approaches are effective for anxiety:
- Cognitive behavioral therapy (CBT)
- Acceptance and commitment therapy (ACT)
- Mindfulness-based cognitive therapy (MBCBT)
Finding Support: Resources
If you or someone you know needs professional treatment and support for anxiety or a different mental health disorder, challenge, or concern, please contact us here at Crownview Psychiatric Institute:
We can help.
In addition, you can find support through the following online resources:
- The National Alliance on Mental Illness (NAMI): NAMI Home Page
- The National institute of Mental Health (NIMH): NIMH Treatment Help Page
- American Psychiatric Association (APA): Treatment Locator
- Substance Abuse and Mental Health Services Administration (SAMHSA): Early Serious Mental Illness Treatment Locator
Gianna Melendez
Jodie Dahl, CpHT