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Anxiety and Alcoholism: A Serotonin Link

Published online by Cambridge University Press:  06 August 2018

Gary D. Tollefson
Gary D. Tollefson*
Affiliation:
Department of Psychiatry, St Paul-Ramsey Medical Center, 640 Jackson Street, St Paul, Minnesota, 55101, USA
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Abstract

The augmentation of serotonin (5-HT) neurotransmission attenuates alcohol consumption, whereas depletion enhances use. A number of serotonin-specific pharmacological probes appear to be effective in reducing the voluntary consumption of alcohol. The 5-HT1A receptor agonist buspirone is an anxiolytic which has been shown to diminish the desire to consume alcohol in anxious alcoholic patients. Thus, serotonin may represent a common denominator for a spectrum of behavioural disorders including anxiety and alcoholism. Novel serotonin drugs, such as the azapirones, may usefully supplement conventional treatment strategies for substance abuse.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 159 , Issue S12: Anxiety and Serotonin , September 1991 , pp. 34 - 39
Copyright
Copyright © The Royal College of Psychiatrists 

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References

Amies, P. L., Gelder, M. G. & Shaw, P. M. (1983) Social phobia: a comparative clinical study. British Journal of Psychiatry, 142, 174–179.Google Scholar
Ballenger, J., Goodwin, F., Major, L., et al (1979) Alcohol and central serotonin metabolism in man. Archives of General Psychiatry, 36, 224–227.Google Scholar
Banki, C. M. (1978) 5-Hydroxytryptamine content of the whole blood in psychiatric illness and alcoholism. Acta Psychiatrica Scandinavica, 57, 232.CrossRefGoogle ScholarPubMed
Banki, C. M. (1981) Factors influencing monoamine metabolites and tryptophan in patients with alcohol dependence. Journal of Neural Transmission, 50, 98–101.Google Scholar
Barnes, G. (1979) The alcoholic personality: a reanalysis of the literature. Journal of the Studies on Alcohol, 40, 571–634.Google Scholar
Bibb, J. & Chambless, D. L. (1986) Alcohol use and abuse among diagnosed agoraphobics. Behaviour Research and Therapy, 24, 49–58.Google Scholar
Blier, P. & deMontigny, C. (1987) Modification of 5-HT neuron properties by sustained administration of the 5-HT1A agonist gepirone: electrophysiologic studies in the rat brain. Synapse, 1, 470–480.Google Scholar
Boismare, F., Lhuintre, J. P., Daoust, M., et al (1987) Platelet affinity for serotonin is increased in alcoholics and former alcoholics: a biological marker for dependence? Alcohol and Alcoholism, 22, 155–159.Google ScholarPubMed
Bruno, F. (1989) Buspirone in the treatment of alcoholic patients. Psychopharmacology, 22 (suppl. ), 49–59.Google Scholar
Collins, A. C. (1979) Genetics of ethanol preferences: role of neurotransmitters. In Biochemistry and Pharmacology of Ethanol, vol. 2 (eds Majchrowicz, E. & Noble, E. P.), p. 207. New York: Plenum Press.Google Scholar
Conger, J.J. (1956) Alcoholism: theory, problem and challenge, II: reinforcement theory and the dynamics of alcoholism. Quarterly Journal of Studies on Alcohol, 13, 296–305.Google Scholar
Curlee, J. & Stern, H. (1973) The fear of heights among alcoholics. Bulletin of the Menninger Clinic, 37, 615–623.Google Scholar
Daoust, M., Chretien, P., Moore, N., et al (1985) Isolation and striatal (3H) serotonin uptake: role in the voluntary intake of ethanol by rats. Pharmacology, Biochemistry and Behavior, 2, 205–208.Google Scholar
Department of Health and Human Services (1987) Sixth Special Report to the U.S. Congress on Alcohol and Health, p. 21. Rockville, MA: US Government Printing Office.Google Scholar
Friedman, M. J., Krstulovic, A. M., Severinghaus, J. M., et al (1988) Altered conversion of tryptophan in kynurenine in newly abstinent alcoholics. Biological Psychiatry, 23, 89–93.Google Scholar
Gardner, C. R. (1986) Recent development in 5HT-related pharmacology of animal models of anxiety. Pharmacology, Biochemistry and Behavior, 24, 1479–1485.Google Scholar
Gatto, G. J., McBride, W. J., Murphy, J. M., et al (1989) Effects of serotonin (5-HT) agonists on alcohol drinking behavior of the NP (alcohol nonpreferring) line of rats (abstract). Alcoholism, 13, 305.Google Scholar
Gill, K., Filion, Y. & Amit, Z. (1988) A further examination of the effects of sertraline on voluntary ethanol consumption. Alcohol, 5, 355–358.Google Scholar
Gorelick, D. A. (1986) Effect of fluoxetine on alcohol consumption (abstract). Alcohol, 10, 113.Google Scholar
Gray, J. A. (1982) The Neuropsychology of Anxiety: An Inquiry into the Functions of the Septo-Hippocampal System. New York: Oxford University Press.Google Scholar
Haraguchi, M., Samson, H. H. & Tolliver, G. A. (1989) Reduction in oral ethanol self-administration in the rat by the 5-HT uptake blocker fluoxetine (abstract). Alcoholism, 13, 305.Google Scholar
Hill, S. Y. (1974) Intraventricular injection of 5-hydroxytryptamine and alcohol consumption in rats. Biological Psychiatry, 8, 151–158.Google ScholarPubMed
Hippocrates (1886) Aphorisms VII, 56. In Works of Hippocrates, Vol. 2, p. 269. New York: William Wood.Google Scholar
Holman, R. B. & Snape, B. M. (1985) Effects of ethanol on 5-hydroxytryptamine release from rat corpus striatum in vivo. Alcohol, 2, 249–253.Google Scholar
Jellinek, E. M. (1954) The problems of alcohol. In Alcohol, Science, and Society (ed. Yale University Center of Alcohol Studies Staff). Westport, CT: Greenwood Press.Google Scholar
Kahn, R. S., Westenberg, H. G. M., Verhoeven, W. M. A., et al (1987) Effect of a serotonin precursor uptake inhibitor in anxiety disorders; a double-blind comparison of 5-hydroxytryptophan, clomipramine and placebo. International Clinical Psychopharmacology, 2, 33–45.CrossRefGoogle ScholarPubMed
Kahn, R. S., van Praag, H. M., Wetzler, S., et al (1988) Serotonin and anxiety revisited. Biological Psychiatry, 23, 189–203.Google Scholar
Karno, M., Golding, J. M., Sorenson, S. B., et al (1988) The epidemiology of obsessive–compulsive disorders in five U.S. communities. Archives of General Psychiatry, 45, 1094–1099.Google Scholar
Kempf, E., Fuhrmann, G. & Ebel, A. (1985) Genotypic variations in ethanol effect of striatal and hippocampal transmitter interactions. Alcohol, 2, 231–237.Google Scholar
Kent, T. A., Campbell, J. L., Pazdernik, T. L., et al (1985) Blood platelet uptake of serotonin in men alcoholics. Journal of the Studies on Alcohol, 46, 357–359.Google Scholar
Kushner, M. G., Sher, K. J. & Beitman, B. D. (1990) The relation between alcohol problems and the anxiety disorders. American Journal of Psychiatry, 147, 685–695.Google Scholar
Lawrin, M. O., Naranjo, C. A. & Sellers, E. M. (1983) Studies on the mechanism of zimelidine-induced decrease in alcohol consumption in rats. Proceedings of the Canadian Federation of Biological Societies, 26, 116.Google Scholar
LeBourhis, B., Uzan, A., Aufrere, G., et al (1981) Effects of indalpine, a specific 5-HT reuptake inhibitor, on the ethanol behavioral dependence and on the voluntary ethanol consumption in rats. Annates Pharmaceutiques Francoises, 29, 11–20.Google Scholar
Levy, A. D., McBride, W. J. & Murphy, J. M. (1989) Effects of intra-accumbens infusions of DA & 5-HT on ethanol intake of alcohol-preferring (P) rats (abstract). Alcoholism, 13, 305.Google Scholar
Leysen, J. E., Gommeren, W. & van Gompel, P. (1985) Receptor binding properties in vitro and in vivo of ritanserin: a very potent and long acting 5HT2 antagonist. Molecular Psychopharmacology, 27, 600–611.Google Scholar
Linnoila, M., Eckardt, M., Durcan, M., et al (1987) Interactions of serotonin with ethanol: clinical and animal studies. Psychopharmacology Bulletin, 23, 452–457.Google Scholar
McBride, W. J., Lumeng, L. & Li, T. K. (1988) Effects of serotonin and dopamine agents on ethanol intake of alcohol-preferring (P) rats (abstract). Alcoholism, 12, 306.Google Scholar
Marks, I. M. (1987) Fears, Phobias, and Rituals. New York: Oxford University Press.Google Scholar
Modell, J. G., Mountz, J. M. & Beresford, T. P. (1990) Basal ganglia/limbic striatal and thalamocorticol involvement in craving and loss of control in alcoholism. Journal of Neuropsychiatry and Clinical Neurosciences, 2, 123–144.Google Scholar
Morey, L. C. & Blashfield, R. K. (1981) Empirical classifications of alcoholism: a review. Journal of the Studies on Alcohol, 42, 925–937.Google Scholar
Morinan, A. (1987) Reduction in striatal 5-hydroxytryptamine turnover following chronic administration of ethanol to rats. Alcohol, 22, 53–60.Google ScholarPubMed
Murphy, J. M., McBride, W. J., Lumeng, L., et al (1982) Regional brain levels of monoamines in alcohol-preferring and nonpreferring lines of rats. Pharmacology, Biochemistry and Behavior, 16, 145–149.Google Scholar
Murphy, J. M., Waller, M. B., Gatto, G. J., et al (1985) Monoamine uptake inhibitors attenuate ethanol intake in alcohol-preferring (P) rats. Alcohol, 2, 349–352.Google Scholar
Murphy, J. M., McBride, W. J., Lumeng, L., et al (1989) Effects of spiroxatrine on the fluoxetine-induced reduction of ethanol intake of alcohol preferring rats. Alcoholism: Clinical and Experimental Research, 13, 305.Google Scholar
Murphy, J. M. & Pigott, T. A. (1990) A comparative examination of a role for serotonin in obsessive–compulsive disorder, panic, and anxiety. Journal of Clinical Psychiatry, 51 (suppl. ), 53–58.Google Scholar
Naranjo, C. A., Sellers, E. M. & Larwin, M. O. (1986) Modulation of ETOH intake by 5-HT uptake inhibitor. Journal of Neuropsychiatry and Clinical Neurosciences, 47 (suppl. ), 16–22.Google Scholar
Neiman, J., Beving, H. & Malmgren, R. (1987) Platelet uptake of serotonin (5-HT) during ethanol withdrawal in male alcoholics. Thrombosis Research, 46, 803–809.Google Scholar
Noyes, R. Jr, Crowe, R. R., Harris, E. L., et al (1986) Relationship between panic disorder and agoraphobia: a family study. Archives of General Psychiatry, 43, 227–232.Google Scholar
Olivera, A. A., Sarvis, S. & Heard, C. (1990) Anxiety disorders coexisting with substance dependence: treatment with buspirone. Current Therapeutic Research, 47, 52–60.Google Scholar
Pazos, A. & Palacios, J. M. (1985) Quantitative autoradiographic mapping of serotonin receptors in the rat brain. I. Serotonin-1 receptors. Brain Research, 346, 205–230.CrossRefGoogle Scholar
Peroutka, S., Sleight, A. J., McCarthy, B. G., et al (1989) The clinical utility of pharmacological agents that act as serotonin receptors. Journal of Neuropsychiatry and Clinical Neurosciences, 1, 253–262.Google Scholar
Powell, B. J., Penick, E. C., Othmer, E., et al (1982) Prevalence of additional psychiatric syndromes among male alcoholics. Journal of Clinical Psychiatry, 43, 404–407.Google Scholar
Privette, T. H., Hornsby, R. L. & Myers, R. D. (1987) Buspirone alters alcohol drinking induced in rats by tetrahydropapaveroline injected into brain monoaminergic pathways. Alcohol, 5, 147–152.Google Scholar
Quitkin, F. M., Rifkin, A., Kaplan, J., et al (1972) Phobic anxiety syndrome complicated by drug dependence and addiction: a treatable form of drug abuse. Archives of General Psychiatry, 27, 154–162.CrossRefGoogle ScholarPubMed
Richardson, J. S. & Novakowski, D. M. (1978) Brain monoamines and free choice ethanol consumption in rats. Drug and Alcohol Dependence, 3, 253–264.Google Scholar
Robins, L. N., Helzer, J. E., Weissman, M. M., et al (1984) Lifetime prevalence of specific psychiatric disorders in three sites. Archives of General Psychiatry, 41, 949–958.Google Scholar
Rockman, G. E., Amit, Z., Carr, G., et al (1979) Attenuation of ethanol intake by 5-hydroxytryptamine uptake blockade in laboratory rats. I. Involvements of brain 5-hydroxytryptamine in the mediation of the positive reinforcing properties of ethanol. Archives Internationales de Pharmacodynamic et de Therapy, 241, 245–259.Google Scholar
Rockman, G. E., Amit, Z., Brown, Z. W., et al (1982) An investigation of the mechanisms of action of 5-hydroxytryptamine in the suppression of ethanol intake. Neuropharmacology, 21, 341–347.Google Scholar
Rosenthal, N. E., Davenport, Y., Cowdry, R. W., et al (1980) Monoamine metabolites in cerebrospinal fluid of depressive subgroups. Psychiatry Research, 2, 113–119.CrossRefGoogle ScholarPubMed
Ross, H. E., Glasser, F. B. & Germanson, T. (1988) The prevalence of psychiatric disorders in patients with alcohol and other drug problems. Archives of General Psychiatry, 45, 1023–1031.Google Scholar
Roy, A., Virkkunen, M. & Linnoila, M. (1987) Reduced central serotonin turnover in a subgroup of alcoholics. Progress in Neuro-psychopharmacology and Biologic Psychiatry, 11, 173–177.Google Scholar
Sellers, E. M. & Naranjo, C. A. (1986) Therapeutic use of serotonergic drugs in alcohol abuse. Clinical Neuropharmacology, 9, 60–62.Google Scholar
Sher, K. J. (1986) Stress response dampening. Excerpt from Alcohol and tension reduction: an update on research and theory (H. Cappell & J. Greeley). In Psychological Theories of Drinking and Alcoholism in Psychological Theories of Drinking and Alcoholism (eds Blane, H. T. & Leonard, K. E.). New York: Guilford Press.Google Scholar
Sjoquist, B., Liljequist, S. & Engel, J. V. (1982) Increased salsolinol levels in rat striatum and limbic forebrain following chronic ethanol treatment. Journal of Neurochemistry, 39, 259–262.Google Scholar
Smail, P., Stockwell, T., Canter, S., et al (1984) Alcohol dependence and phobic anxiety states, I. A prevalence study. British Journal of Psychiatry, 144, 53–57.Google Scholar
Solomon, J. (1982) Alcoholism and clinical psychiatry. In Alcoholism and Clinical Psychiatry (ed. Solomon, J.). New York: Plenum Press.Google Scholar
Sun, G. Y. & Sun, A. Y. (1985) Ethanol and membrane lipids. Alcohol, 9, 164–180.Google Scholar
Takahashi, S., Yamane, H., Kondo, H., et al (1974) CSF monoamine metabolites in alcoholism, a comparative study with depression. Folia Psychiatrica et Neurologica Japanica, 28, 347–354.Google Scholar
Thoren, P., Asberg, M., Cronholm, B., et al (1980) Clomipramine treatment of obsessive compulsive disorder: I. A controlled clinical trial. Archives of General Psychiatry, 37, 1281–1289.CrossRefGoogle Scholar
Thyer, B. A., Parrish, R. T., Himle, J., et al (1986) Alcohol abuse among clinically anxious patients. Behaviour Research and Therapy, 24, 357–359.CrossRefGoogle ScholarPubMed
Tollefson, G. D., Montague-Clouse, J. & Lancaster, S. P. (1990) Buspirone in comorbid alcohol dependency and generalized anxiety disorders. Drug Therapy, 20(suppl. ), 35–50.Google Scholar
Tytell, M. & Myers, R. D. (1973) Metabolism of (14C)-serotonin in the coudate nucleus, hypothalamus and reticular formation of the rat after ethanol administration. Biochemical Pharmacology, 2, 361–372.Google Scholar
van Praag, H. M., Lemus, C. Z. & Kahn, R. S. (1987) Hormonal probes of central serotonergic activity: do they really work? Biological Psychiatry, 22, 86–98.CrossRefGoogle Scholar
Weiss, K. J. & Rosenberg, D. J. (1985) Prevalence of anxiety disorder among alcoholics. Journal of Clinical Psychiatry, 46, 3–4.Google Scholar
Weissman, M. M., Myers, J. K. & Harding, P. S. (1980) Prevalence and psychiatric heterogeneity of alcoholism in United States urban community. Journal of the Studies on Alcohol, 41, 672–681.Google Scholar
Zabik, J. K., Binkerd, K. & Roache, J. D. (1985) Serotonin and ethanol aversion in the rat. In Research Advances in New Psychopharmacologic Treatment for Alcoholism (eds Naranjo, C. A. & Sellers, E. M.), pp. 75–93. Amsterdam: Elsevier.Google Scholar
Zohar, J., Zohar-Kadouch, R. C., Insel, T. R., et al (1988) Serotonergic responsivity in obsessive–compulsive disorder: effects of chronic clomipramine treatment. Archives of General Psychiatry, 45, 167–172.Google Scholar
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