The Serotonin System — Part II: Pharmacological Interventions

ABSTRACTThere is increasing evidence that alterations in the serotonin system may mediate various psychiatric dysfunctions. By directly influencing and modifying either the specific receptor implicated in the dysfunction, or the serotonin system generally, success with treatment has been demonstrated.Price et al. have proposed a method for classifying pharmacological interventions which affect the serotonin system. The five groups of agents (precursors, releasers, reuptake inhibitors, receptor agonists, and receptor antagonists) act in different ways, which in part, accounts for their efficacy in treatment or prevention of psychiatric illness. This paper will review the medications which modulate serotonin production, resorption or interaction at the receptor level. The clinical implications of such modulation, and the success of such psychopharmacologic treatment will be assessed with respect to a variety of common psychoadaptive conditions.The underlying assumption of this psychopharmacologic approach is that the dysregulation of certain neurotransmitters, in particular serotonin, results in the expression of certain psychopathologies. Success with agents which directly or indirectly effect the serotonin system provides some support for this hypothesis