Serotonina: Il presente e il futuro

Serotonergic transmission is affected in a variety of psychiatric disorders; its involvement in each of these, is variable. There is evidence that in both animal models of depression and depressed humans, serotonin transmission is affected in various aspects, i.e., transporter production, turnover and sensitivity, autoreceptor and postsynaptic receptor sensitivity, serotonin content in various brain areas and metabolite content in the cerebrospinal fluid. Obsessive-Compulsive Disorder partly shares disordered serotonin transmission, but the circuitry involved and receptors involved are different from those involved in depression. For Panic Disorder there is also evidence of serotonergic involvement, although the role of raphé- coeruleus communications and that of the amygdala are far from being clarified. Alterations in serotonin transmission were shown also in Social Anxiety, Post-Traumatic Stress Disorder, and Generalized Anxiety Disorder, but their primacy over other mechanisms not is demonstrated. The results of brain imaging and molecular genetic studies match many of the hypotheses of disturbed serotonergic function in the above disorders, as does the finding that some drugs interfering with serotonin transmission may cause symptom exacerbation in challenge studies and the fact that drug treatment with serotonin transporter blocking drugs results in partial correction of these neurotransmitter transmission alterations.