Serotonin
An association between serotonergic transmission
and anxiety disorders was established more than 30 years ago with reports
(Graeff and Schoenfeld, 1970; Geller and Blum, 1970) that inhibitors of
serotonin synthesis (such as p-chlorophenylalanine)
reduced the ability of punishment (e.g., footshock) to suppress operant
responding. Many studies have confirmed and embellished the basic findings that
destruction of serotonergic pathways and or a reduction in the synthesis of
this biogenic amine results in an animal behaving as if it had been
administered an anxiolytic. There is a complementary body of evidence that
serotonin receptor activation exacerbates anxiety. For example, challenge doses
of meta-chlorphenylpiperazine (a serotonin agonist) were anxiogenic in PD
patients (Charney et al., 1987b),
individuals with OCD (Zohar et al.,
1987) and in patients with GAD (Nutt, 2001). The observation that anxiety can
initially be exacerbated in GAD patients receiving SSRIs (Nutt, 2001) provides
perhaps the most compelling evidence that acute elevation of synaptic serotonin
is anxiogenic.
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