vofopitant and Phobia--Social

Social anxiety disorder (SAD) is associated with increased fear-related neural activity in the amygdala and we recently found enhanced serotonin synthesis rate in the same region. Anxiolytic agents like selective serotonin re-uptake inhibitors (SSRIs) and neurokinin-1 receptor (NK1R) antagonists reduce amygdala activity and may attenuate serotonin formation according to animal studies. Here, we examined the effects of SSRI pharmacotherapy, NK1R antagonism, and placebo on serotonin synthesis rate in relation to neural activity, measured as regional cerebral blood flow (rCBF), and symptom improvement in SAD. Eighteen SAD patients were randomized to receive daily double-blind treatment for six weeks either with the SSRI citalopram (n=6; 40mg), the NK1R antagonist GR205171 (n=6; 5mg; 4 weeks following 2 weeks of placebo), or placebo (n=6). Serotonin synthesis rate at rest and rCBF during stressful public speaking were assessed, before and after treatment, using positron emission tomography with the tracers [

Topics: Adult; Amygdala; Anti-Anxiety Agents; Cerebrovascular Circulation; Citalopram; Double-Blind Method; Female; Humans; Kinetics; Male; Neurokinin-1 Receptor Antagonists; Phobia, Social; Piperidines; Positron-Emission Tomography; Psychiatric Status Rating Scales; Selective Serotonin Reuptake Inhibitors; Serotonin; Social Environment; Stress, Psychological; Tetrazoles