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Social Anxiety Disorder and Generalized Anxiety Disorder: Serotonergic and Dopaminergic Neurocircuitry

Dan J. Stein, MD, PhD; Herman G. M. Westenberg, PhD; and Michael R. Liebowitz, MD

Published: June 1, 2002

Article Abstract

Awareness that an amygdala-based fear circuit plays a crucial role in mediating fear conditioningas well as anxiety symptoms is growing. The efficacy of selective serotonin reuptake inhibitors incertain anxiety disorders has been argued to reflect their ability to modulate this circuit. Whether additionalneurocircuits play a differentiating role in specific anxiety disorders, such as social anxietydisorder and generalized anxiety disorder (GAD), is an ongoing subject of investigation. A review ofthe literature suggests that in social anxiety disorder, dopaminergically mediated striatal circuits mayalso be important, while in GAD, there may be abnormalities of prefrontal areas. Future work willundoubtedly clarify how genetic and environmental factors interact to fashion the neurocircuitry thatmediates anxiety symptoms.

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