Anxiety disorders are complex, influenced by a number of chemical, behavioral, and situational factors. There are several neurotransmitters in the brain that seem to play a role in anxiety, including norepinephrine, serotonin and gamma-aminobutyric acid (GABA). Of these, serotonin is perhaps the most well-known, as it is the target of the very commonly prescribed class of antidepressants known as SSRIs, or selective serotonin reuptake inhibitors. SSRIs are used to treat both depression and anxiety disorders and are often the first type of drug that will be prescribed to treat anxiety.
Newer groups of drugs, SNRIs or serotonin-norepinephrine reuptake inhibitors, selectively inhibit both norepinephrine and serotonin reuptake and are also proving to be effective at treating anxiety disorders.
While it is clear that mood and anxiety are affected by serotonin levels, we don't have a lot of details about exactly why and how. The brain's serotoninergic systems have been implicated in the regulation of appetite, energy, sleep, mood, libido, and cognitive functioning--all areas affected in people with an anxiety disorder. Neuroimaging studies have shown that abnormalities in the serotonergic system are associated with structural and functional alterations in specific areas of the brain.
More recent research into the connection between serotonin and anxiety is suggesting that abnormalities in the serotonin system are just one part of the complex brain chemistry involved in anxiety disorders, and are likely toward the middle or end of the chain of events that occurs in anxious brains. While current medications for anxiety tend to focus on increasing serotonin levels, medications in the future may focus on other molecular targets and enzymes that are closer to the root cause of mental illness.
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