Role of serotonergic and noradrenergic systems in the pathophysiology of depression and anxiety disorders

By K. Ressler, C. Nemeroff. Depression and Anxiety, 2000

1,020 citations recorded by the source corpus.

There is abundant evidence for abnormalities of the norepinephrine (NE) and serotonin (5HT) neurotransmitter systems in depression and anxiety disorders. The majority of evidence supports underactivation of serotonergic function and complex dysregulation of noradrenergic function, most consistent with overactivation of this system. Treatment for these disorders requires perturbation of these systems. Reproducible increases in serotonergic function and decreases in noradrenergic function accompany treatment with antidepressants, and these alterations may be necessary for antidepressant efficacy. Dysregulation of these systems clearly mediates many symptoms of depression and anxiety. The underlying causes of these disorders, however, are less likely to be found within the NE and 5HT systems, per se. Rather their dysfunction is likely due to their role in modulating, and being modulated by, other neurobiologic systems that together mediate the symptoms of affective illness. Clarification of noradrenergic and serotonergic modulation of various brain regions may yield a greater understanding of specific symptomatology, as well as the underlying circuitry involved in euthymic and abnormal mood and anxiety states. Disrupted cortical regulation may mediate impaired concentration and memory, together with uncontrollable worry. Hypothalamic abnormalities likely contribute to altered appetite, libido, and autonomic symptoms. Thalamic and brainstem dysregulation contributes to altered sleep and arousal states. Finally, abnormal modulation of cortical‐hippocampal‐amygdala pathways may contribute to chronically hypersensitive stress and fear responses, possibly mediating features of anxiety, anhedonia, aggression, and affective dyscontrol. The continued appreciation of the neural circuitry mediating affective states and their modulation by neurotransmitter systems should further the understanding of the pathophysiology of affective and anxiety disorders. Depression and Anxiety, Volume 12, Supplement 1:2–19, 2000. © 2000 Wiley‐Liss, Inc.

Subfields: Behavioral Neuroscience, Biological Psychiatry, Experimental and Cognitive Psychology

View Paper: https://www.semanticscholar.org/paper/837fba4f34118acebf56c7000769f1f4f36853b2

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Behavioral Neuroscience

1. Helen S. Mayberg
2. K. Ressler
3. Abigail Zisk A.B.
4. M. D. De Bellis

In Biological Psychiatry

1. Helen S. Mayberg
2. Abigail Zisk A.B.
3. M. D. De Bellis

In Experimental and Cognitive Psychology

1. Abigail Zisk A.B.
2. M. D. De Bellis
3. Christine Marcelle Heim
4. Elisabeth B. Binder

Citations in the corpus

• Targeting abnormal neural circuits in mood and anxiety disorders: from the laboratory to the clinic (2007, background): “Many brain areas may underlie some of the different symptom clusters of depressio”
• “The Biological Effects of Childhood Trauma” (2014, positive): “For example, decreased levels of serotonin activity have been associated with mental health problems such as depression and anxiety [149] as well as with aggressive behaviors in individuals with personality disorders such as borderline personality disorder[150].”