Serotonin related functions in panic-anxiety: a critical overview.
The antipanic utility of imipramine and monoamine oxidase inhibitors has led to hypotheses of noradrenergic and/or serotonin (5-HT)-related abnormalities underlying panic disorder (PD) and its agoraphobic complications. Further data support significant antipanic effects for agents with acute 5-HT reuptake blockade effects. It is unlikely that ameliorative effects observed following chronic administration of 5-HT drugs remain 5-HT specific. Despite a range of recently discovered 5-HT receptor subtypes, evidence for a specific receptor abnormality in PD is lacking. Preclinical studies suggest an important role for 5-HT effects in several animal models of anxiety, including separation-induced infant protest responses and respiratory modulation. Induction of anxiety with putative 5-HT agents such as meth-chloro-phenylpiperazine and fenfluramine lend further support to 5-HT involvement in anxiety states. Critical behavioral, physiologic, and neuroendocrine differences between putative 5-HT anxiogens and "classic" panicogens, such as lactate and carbon dioxide are discussed. We propose that 5-HT agents mediate antipanic effects through amelioration of a deranged internal evaluative mechanism along cybernetic lines, rather than simple augmentation or reduction of 5-HT function.
Coplan
J D
JD
College of Physicians and Surgeons, Columbia University, New York State Psychiatric Institute, New York 10032.
Gorman
J M
JM
Klein
D F
DF
D000818:Animals; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy / Q000378:metabolism*; D001522:Behavior, Animal / Q000187:drug effects; D001792:Blood Platelets / Q000187:drug effects; D006801:Humans; D014179:Neurotransmitter Uptake Inhibitors / Q000627:therapeutic use; D016584:Panic Disorder / Q000188:drug therapy / Q000378:metabolism*; D011985:Receptors, Serotonin / Q000378:metabolism; D012701:Serotonin / Q000378:metabolism*; D012702:Serotonin Antagonists / Q000627:therapeutic use
D000929:Antidepressive Agents, Tricyclic; D014179:Neurotransmitter Uptake Inhibitors; D011985:Receptors, Serotonin; D012702:Serotonin Antagonists; D012701:Serotonin