The impact of selective serotonin reuptake inhibitors on amygdala activation in patients with panic disorder

Abstract: Panic disorder (PD) is a debilitating anxiety disorder that often reduces the quality of life and some of its symptoms are physical distress and fear. PD is often comorbid with other anxiety disorders and depressive disorders and also cardiovascular and respiratory illnesses. Pharmacotherapy and psychotherapy are the two most common treatment options for people with PD. A standard type of pharmacotherapy is selective serotonin reuptake inhibitors (SSRI) which in short work by increasing the level of serotonin in the brain and has been shown to be efficacious and safe. A vital brain structure that is closely linked to PD is the amygdala, and some of its functions are learning, emotional processing, and memory. There seems to be a functional and structural abnormality in the amygdala for people with PD compared to healthy individuals, for example, a smaller volume of gray matter and increased activity. The aim of the thesis is to conduct a systematic review on the effect of SSRIs on the functional alterations of the amygdala in patients suffering from PD. The present systematic review will try to answer the question: If SSRIs affect amygdala activation for PD patients compared to healthy individuals who are currently not undergoing any kind of pharmacotherapy. The results showed opposite findings; one study did not detect activation changes in the amygdala for PD patients using SSRIs, one detected higher activity in the right amygdala, whereas the other two showed a decrease in the left amygdala (one study did not specify left, bilateral, or right). More research regarding amygdala activation in PD patients using SSRIs is needed due to the small scale of studies currently available.