Serotonin States and Social Anxiety


This Neuroscience and Psychiatry article discusses the role in social anxiety of a novel disrupted regulatory sequence in serotonin neurochemistry resulting from overactive serotonin signaling.

Social anxiety disorder is characterized by fear and avoidance of situations in which an individual believes he or she may be subject to scrutiny and at risk for embarrassment or humiliation. It is the most common of the anxiety disorders, affecting more than 5% of the general population, with an early age at onset that is frequently associated with high rates of depressive comorbidity.1 Social anxiety disorder is frequently treated pharmacologically with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors, several of which are approved by the US Food and Drug Administration for this indication. Nonetheless, only 30% to 40% of patients have full and satisfactory responses to these agents.2Attempts have been made to enable genetic prediction of response to SSRIs in patients with social anxiety disorder,3 but such efforts are still in the early stages and have, to our knowledge, yet to be replicated.