The British Journal of Psychiatry (2008) 193: 229-234. doi: 10.1192/bjp.bp.107.041186
© 2008 The Royal College of Psychiatrists
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Serotonin 5-HT1A receptor binding in people with panic disorder: positron emission tomography study

Jon R. Nash, MRCP(UK), MRCPsych*

Pharmacology Unit, University of Bristol

Peter A. Sargent, MD, MRCPsych*

Oxfordshire and Buckinghamshire Mental Health NHS Foundation Trust

Eugenii A. Rabiner, FCPsychSA

Medical Research Council Cyclotron Unit, Hammersmith Hospital, London

Sean D. Hood, MSc, FRANZCP, Spilios V. Argyropoulos, PhD, MRCPsych and John P. Potokar, MD, MRCPsych

Pharmacology Unit, University of Bristol

Paul M. Grasby, MD, FRCP, MRCPsych

Medical Research Council Cyclotron Unit, Hammersmith Hospital, London

David J. Nutt, DM, FRCP, FRCPsych, FMedSci

Pharmacology Unit, University of Bristol, UK

Correspondence: Professor David Nutt, Psychopharmacology Unit, University of Bristol, Dorothy Hodgkins Building, Whitson Street, Bristol BS1 3NY, UK. Email: David.J.Nutt{at}bristol.ac.uk

Declaration of interest

Pump priming for the study was provided by a small grant from SmithKline Beecham (now GlaxoSmithKline). Funding detailed in Acknowledgements.

* These authors contributed equally to the work.

Background

The importance of the neurotransmitter serotonin (5-HT) in the pathophysiology of anxiety is well known. A key role for postsynaptic 5-HT1A receptors has recently been suggested in studies of genetic knockout mice.

Aims

To measure 5-HT1A receptor binding in patients with panic disorder in the untreated state and after recovery on treatment with selective serotonin reuptake inhibitors (SSRIs).

Method

Nine symptomatic untreated patients with panic disorder, seven patients recovered on SSRI medication and nineteen healthy volunteers underwent a single positron emission tomography (PET) scan using the 5-HT1A tracer [11C]WAY-100635.

Results

In comparison with controls, both presynaptic and postsynaptic 5-HT1A receptor binding was reduced in untreated patients, with the most significant reductions being in the raphe, orbitofrontal cortex, temporal cortex and amygdala. In recovered patients presynaptic binding was reduced, but there was no significant reduction in postsynaptic binding.

Conclusions

Panic disorder is associated with reduced 5-HT1A receptor availability, which is also known to have a key role in depression.


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