title: Evidence for serotonin function as a neurochemical difference between fear and anxiety disorders in humans?
abstract: The relationships between serotonin and fear and anxiety disorders have been much studied yet many important questions remain, despite selective serotonin reuptake inhibitors having been the primary treatments for these disorders for some time. In order to explore this issue we performed a pooled analysis of six of our studies in remitted patients with a fear/anxiety disorder who were exposed to syndrome-specific aversive stimulation under acute tryptophan depletion. We based our analysis on the hypothesis that the inconsistencies observed in the studies could be predicted by Deakin and Graeff's theory about the dual role of serotonin in responses to threats, whereby serotonin is critical to prevent fear (panic) but not anxiety. In accordance with this view, our results give support to a dissociation of the disorders traditionally grouped under fear and anxiety-related disorders in terms of different roles of serotonin in modulation of responses to aversive stimulation. Implications for future studies and psychiatric nosology are discussed.
authors.affiliation: Institute and Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil felipe.corchs@hotmail.com.
authors.forename: Felipe
authors.initials: F
authors.lastname: Corchs
authors.affiliation: Neuropsychopharmacology Unit, Division of Experimental Medicine, Imperial College London, London, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Nutt
authors.affiliation: School of Psychiatry & Clinical Neurosciences (M521), The University of Western Australia, Perth, WA, Australia.
authors.forename: Dana A
authors.initials: DA
authors.lastname: Hince
authors.affiliation: Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Simon J C
authors.initials: SJ
authors.lastname: Davies
authors.affiliation: Institute and Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Marcio
authors.initials: M
authors.lastname: Bernik
authors.affiliation: School of Psychiatry & Clinical Neurosciences (M521), The University of Western Australia, Perth, WA, Australia.
authors.forename: Sean D
authors.initials: SD
authors.lastname: Hood
mesh_terms: D000328:Adult; D001007:Anxiety / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology*; D001008:Anxiety Disorders / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology*; D005239:Fear / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D010200:Panic / Q000187:drug effects / Q000502:physiology; D012701:Serotonin / Q000378:metabolism*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D014364:Tryptophan / Q000378:metabolism
chemical_list: D012701:Serotonin; D017367:Selective Serotonin Reuptake Inhibitors; D014364:Tryptophan
keywords: 5-Hydroxytryptamine; anxiety; fear; tryptophan depletion