What methods can calm the amygdala?

From the Guidelines

To calm the amygdala, mindfulness-based interventions, such as mindfulness meditation, are recommended, as they have been shown to decrease symptoms of anxiety and depression, and improve emotional regulation, as evidenced by a recent study published in 2022 1. The most effective methods to calm the amygdala include:

• Mindfulness-based interventions, such as mindfulness meditation, which have been shown to decrease symptoms of anxiety and depression, and improve emotional regulation 1
• Yoga, which has been recommended for treating symptoms of anxiety during and after cancer treatment 1
• Relaxation techniques, such as deep breathing exercises and progressive muscle relaxation, which can help reduce stress hormones that activate the amygdala
• Regular physical exercise, particularly 30 minutes of moderate activity, which reduces stress hormones that activate the amygdala
• Adequate sleep, which is essential as sleep deprivation increases amygdala reactivity
• Cognitive reframing techniques, which help by challenging catastrophic thoughts that trigger amygdala activation These approaches work because they activate the prefrontal cortex, which can inhibit amygdala activity, and reduce stress hormone production. It is also important to note that some studies have shown that certain medications, such as selective serotonin reuptake inhibitors (SSRIs), can be effective in reducing agitation and neuropsychiatric symptoms in individuals with vascular cognitive impairment (VCI) 1. However, these medications should be used with caution and under the guidance of a healthcare professional. In terms of specific techniques, mindfulness meditation for 10-20 minutes daily can help focus on the present moment without judgment, and regular physical exercise, such as walking or swimming, can reduce stress hormones that activate the amygdala. Overall, a combination of these approaches can help regulate amygdala activity and reduce anxiety or stress reactions.

From the FDA Drug Label

Alprazolam tablets are indicated for the management of anxiety disorder Anxiety or tension associated with the stress of everyday life usually does not require treatment with an anxiolytic. Generalized anxiety disorder is characterized by unrealistic or excessive anxiety and worry (apprehensive expectation) about two or more life circumstances, for a period of 6 months or longer, during which the person has been bothered more days than not by these concerns

The methods that can calm the amygdala include the use of anxiolytic medications such as alprazolam, which is indicated for the management of anxiety disorder.

• Alprazolam can help alleviate symptoms of anxiety, including those associated with an overactive amygdala. The FDA drug label does not provide direct information on how alprazolam calms the amygdala, but it does indicate that alprazolam is effective in managing anxiety disorder 2.

From the Research

Methods to Calm the Amygdala

The amygdala plays a crucial role in processing emotions, such as fear and anxiety. Several methods can calm the amygdala, including:

• Pharmacological interventions:
  • Selective serotonin reuptake inhibitors (SSRIs) have been shown to inhibit glutamatergic neurons of the amygdala, leading to an anti-anxiety effect 3, 4
  • Benzodiazepines also inhibit the amygdala, reducing fear or anxiety 3
• Psychotherapy:
  • Cognitive behavioral therapy (CBT) is a highly effective psychotherapy for anxiety disorders 5, 6
• Combination therapy:
  • Combining pharmacotherapy with psychological treatments, such as CBT, can be an effective approach for treating anxiety disorders 5, 6

Neurotransmitters and Brain Regions Involved

The amygdala is a key brain region involved in the processing of emotions, such as fear and anxiety. Neurotransmitters, such as serotonin, play a crucial role in regulating the activity of the amygdala.

• Serotonin:
  • Facilitation of serotonin neurotransmission decreases anxiety 4
  • SSRIs increase extracellular serotonin levels, leading to an anti-anxiety effect 3
• Glutamate:
  • Glutamatergic neurons in the amygdala are inhibited by SSRIs, leading to an anti-anxiety effect 3
  • Glutamate modulators are being investigated as potential novel treatments for anxiety disorders 7

Novel Treatment Strategies

Several novel treatment strategies are being investigated for the treatment of anxiety disorders, including:

• Medications that act on GABA, glutamate, and other neurotransmitter systems 6, 7
• Neuropeptides, neurosteroids, alpha- and beta-adrenergic agents, cannabinoids, and natural remedies 7