[Neurotransmitters in anxiety and panic disorders].

The currently available empirical findings lead us to assume that various forms of anxiety disorders--such as generalised anxiety syndrome or panic disorder--are based on different pathophysiological mechanisms with varying involvement of different neurotransmitter systems. We must bear in mind that whereas the disturbance of a transmitter may predominate--such as the disturbance of the noradrenalin system in panic disorder and that of the GABA-ergen system in generalised anxiety--on the other hand the transmitter systems are mutually interlinked, so that an isolated disturbance of a system is very unlikely. However, to the present date it has not been possible to give a definite biochemical characterisation of a certain disease pattern, such as that of panic disorder. Likewise, no unequivocal conclusions can be drawn in respect of cerebral localisation. Nevertheless, results obtained in animal experiments suggest that in panic disorder certain brain areas like e.g. the locus ceruleus may be affected. Future hopes rest in developing more specific drugs that selectively change a transmitter system and on new techniques such as positron emission tomography enabling a better insight into the mode of functioning of the brain. New possibilities seem to be offered also by defining a predisposition via molecular-genetic methods.