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Biological concepts of anxiety disorders

Published online by Cambridge University Press:  18 September 2015

H.G.M. Westenberg
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Extract

Since the seminal work of Geller and Blum there is a vast expanding literature relating anxiety symptoms to serotonin (5-hydroxytryptamine; 5-HT). The general picture emerging from animal research is that increasing 5-HT function is anxiogenic. However, animal research is confined by the fact that extrapolations from animal behavior to human emotions have limited validity. Human anxiety can range from normal emotions to clinical syndromes. It can be a component of different physical and mental disorders, but also the central feature of a syndromes.

During the last decade, a wealth of knowledge about the origin and anatomical distribution of 5-HT neuronal systems has been obtained. Our understanding of the neuroanatomy and neurochemistry of anxiety has also considerably advanced, but the picture is still puzzling. We are faced with a large number of 5-HT-receptor subtypes, each with its own specific distribution and presumably specific function. The complexity of the 5-HT system in terms of receptor heterogeneity offers a dazzling opportunity to the development of new drugs affecting selective 5-HT functions, but it also precludes that firm conclusions can be drawn when less selective agents are being used.

Keywords

Anxietypanic disorderserotoninantidepressants
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 9 , Issue 2 , June 1997 , pp. 77 - 80
Copyright
Copyright © Cambridge University Press 1997

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References

Literature

1.Katterndahl, DA, Realini, JP. Lifetime prevalence of panic states. Am J Psychiat 1993;150:246–9.Google Scholar
2.Westenberg, HGM. Developments in the drug treatment of panic disorder: What is the place of the selective serotonin reuptake inhibitors. J affect Disord 1996;40:85–93.CrossRefGoogle ScholarPubMed
3.Evans, L, Kenardy, P, Hoey, H. Effect of a slecetive serotonin uptake ihibitor in agoraphobia with panic attacks. Acta psychiat scand 1986;73:40–53.CrossRefGoogle Scholar
4.Kahn, RS, Westenberg, HGM, Verhoeven, WMA, et al.Effects of a serotonin precursor and uptake inhibitor in anxiety disorders: a double-blind comparison of 5-hydroxytryptophan, clomipramine and placebo. Int J clin Psychopharmacol 1987;2:33–45.CrossRefGoogle ScholarPubMed
5.Boer, JA den, Westenberg, HGM, Kamerbeek, WDJ, et al.Effect of serotonin uptake inhibitors in anxiety disorders; a double-blind comparison of clomipramine and fluvoxamine. Int clin Psychopharmacol 1987;2:21–32.CrossRefGoogle Scholar
6.Boer, JA den, Westenberg, HGM. Effect of a serotonin and noradrenalin uptake inhibitor in panic disorder, a double-blind comparative study with fluvoxamine and maprotiline. Int clin Psychopharmacol 1988;3:59–74.CrossRefGoogle Scholar
7.Cassano, GB, Petracca, A, Perugi, G, et al.Clomipramine for panic disorder, I. The first 10 weeks of a long-term comparison with Imipramine. J affect Disord 1988;14:123–7.CrossRefGoogle ScholarPubMed
8.Johnston, DG, Troyer, IE, Whitsett, SF. Clomipramine treatment of agoraphobic women. An eight-week controlled trial. Arch gen Psychiat 1988;45:453–9.CrossRefGoogle ScholarPubMed
9.Boer, JA den, Westenberg, HGM. Serotonin function in panic disorder: a double-blind placebo-controlled study with fluvoxamine and ritanserin. Psychopharmacol 1990;102:85–94.CrossRefGoogle Scholar
10.Black, DW, Wesner R, Bowers, et al.A comparison of fluvoxa-mine,cognitive therapy and placebo in the treatment of panic disorder. Arch gen Psychiat 1993;50:44–50.CrossRefGoogle ScholarPubMed
11.Hoehn-Saric, R, Fawcett, J, Munjack, DJ, et al.A multicentre, double-blind, placebo-controlled study of fluvoxamine in the treatment of panic disorder. Neuropsychopharmacol 1994; 10: 102S.Google Scholar
12.Woods, SW, Black, D, Brown, S, et al.Fluvoxamine in the treatment of panic disorder in outpatients; A double-blind, placebo-controlled study. Neuropsychopharmacol 1994;10:103S.Google Scholar
13.Gorman, J, Wolkow, R. Sertraline: a treatment for panic disorder. Neuropsychopharmacol 1994; 10:197S.Google Scholar
14.Oehrberg, S, Christiansen, PE, Behnke, K, et al.Paroxetine in the treatment of panic disorder; a randomised, double-blind, placebo-controlled study. Br J Psychiat 1995;167:374–9.CrossRefGoogle ScholarPubMed
15.Beurs, E de, Balkom, AJLM van, Lange, A, et al.Treatment of panic disorder with agoraphobia: Comparison of fluvoxamine, placebo, and psychololical panic management combinde with exposure and of exposure in vivo alone. Am J Psychiat 1995;152:683–91.Google ScholarPubMed
16.Lecrubier, Y, Bakker, A, Judge, R. A comparisonm of paroxetine, clomopramine and placebo in the treatment of panic disorder. Acta psychiat scand 1997;95:145–52.CrossRefGoogle ScholarPubMed
17.Vliet, IM van, Westenberg, HGM, Boer, JA den. Effects of the 5-HT1A receptor agonist flesinoxan in panic disorder. Psychopharmacol 1996;127:174–80.CrossRefGoogle ScholarPubMed
18.Bosker, FJ, Winter, TYCE de, Klompmakers, AA, et al.Flesinoxan dose-dependently reduces extracellular 5-hydroxytryptamine (5-HT) in rat median raphe and dorsal hippocampus through activation of 5-HT1A receptors. J Neurochem 1996;66:2546–55.CrossRefGoogle Scholar
19.Berman, RM, Darnell, AM, Anad, A, et al.Effect of pindolol in hastening response to fluoxetine in the treatment of major depression: a double-blind, placebo-controlled trial. Am J Psychiat 1997;154:37–43.Google ScholarPubMed
20.Benjamin, J, Greenberg, BD, Murphy, DL. Daily administration of m-chlorophenylpiperazine to healthy volunteers rapidly attenuates may of its behavioral, hormonal, cardiovascular and temperature effects. Psychopharmacol 1996;127:140–9.CrossRefGoogle ScholarPubMed