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Different roles for serotonin in anti-obsessional drug action and the pathophysiology of obsessive-compulsive disorder

Published online by Cambridge University Press:  06 August 2018

Pedro L. Delgado  and
Fransisco A. Moreno
Pedro L. Delgado*
Affiliation:
Department of Psychiatry, University of Arizona College of Medicine, 7402 AHSC, 1501 N. Campbell, Tucson, Arizona 85274, USA
Fransisco A. Moreno
Affiliation:
Department of Psychiatry, University of Arizona College of Medicine, 7402 AHSC, 1501 N. Campbell, Tucson, Arizona 85274, USA
*
Correspondence: Dr P. L. Delgado, Department of Psychiatry, University of Arizona College of Medicine, 7402 AHSC, 1501 N. Campbell, Tucson, Arizona 85274, USA. Fax: +1 520 626 6050; e-mail: delgado@u.arizona.edu
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Abstract

Background There is a major role for serotonin in the mechanism of anti-obsessional drug action. Drugs that block uptake of noradrenaline are not effective in the treatment of obsessive-compulsive disorder (OCD), while drugs that potently bock serotonin reuptake are effective. While enhancement of serotonin neurotransmission is clearly involved in the treatment of OCD, the role of serotonin in the pathophysiology of OCD is less clear.

Method This paper provides a brief, focused review ofthe literature regarding treatment of OCD, the effects of drugs with selective action at various serotonin receptors and results of neurotransmitter depletion studies in patients with OCD.

Results Some patients with OCD may experience remission of OCD symptoms during intoxication with psychedelic drugs that have potent 5-HT2A/2c agonist activity. These findings, coupled with results from serotonin depletion studies in depressed and OCD patients, suggest that enhancement of serotonin neurotransmission may underlie both antidepressant and anti-obsessional drug action, although the targeted brain areas may differ.

Conclusions OCD may not involve a dysfunction ofthe serotonin system. Rather, it is more likely to involve a dysfunction of specific brain circuits, particularly in the frontal cortex. Modulation of these circuits by serotonin neurons may underlie the specific action of anti-obsessional drugs.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 173 , Issue S35: New perspectives in research and treatment of obsessive-compulsive disorder , August 1998 , pp. 21 - 25
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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