A brain circuit is identified through which serotonin induces an anxiety-like state; this circuit also mediates the anxiety-like behaviour induced by acute administration of the selective serotonin reuptake inhibitor fluoxetine and may underlie the early adverse events that some patients with anxiety disorders have to these types of drugs. The circuits through which serotonin regulates mood are not well understood. Here Thomas Kash and colleagues describe a mechanism by which serotonin induces an anxiety-like state in mice. They show that serotonergic projections from the dorsal raphe nuclei to the bed nucleus of the stria terminalis (BNST), a forebrain structure involved in controlling autonomic, neuroendocrine and behavioural responses, activate corticotropin-releasing factor (CRF) neurons that inhibit anxiolytic outputs from the BNST to the ventral tegmental area and lateral hypothalamus. They further show that this circuit mediates anxiety-like behaviour induced by acute administration of the serotonin reuptake inhibitor (SSRI) fluoxetine. The authors suggest that a similar mechanism may underlie the early adverse reactions to SSRI treatment that have been shown to occur in some patients with anxiety disorders. Serotonin (also known as 5-hydroxytryptamine (5-HT)) is a neurotransmitter that has an essential role in the regulation of emotion. However, the precise circuits have not yet been defined through which aversive states are orchestrated by 5-HT. Here we show that 5-HT from the dorsal raphe nucleus (5-HTDRN) enhances fear and anxiety and activates a subpopulation of corticotropin-releasing factor (CRF) neurons in the bed nucleus of the stria terminalis (CRFBNST) in mice. Specifically, 5-HTDRN projections to the BNST, via actions at 5-HT2C receptors (5-HT2CRs), engage a CRFBNST inhibitory microcircuit that silences anxiolytic BNST outputs to the ventral tegmental area and lateral hypothalamus. Furthermore, we demonstrate that this CRFBNST inhibitory circuit underlies aversive behaviour following acute exposure to selective serotonin reuptake inhibitors (SSRIs). This early aversive effect is mediated via the corticotrophin-releasing factor type 1 receptor (CRF1R, also known as CRHR1), given that CRF1R antagonism is sufficient to prevent acute SSRI-induced enhancements in aversive learning. These results reveal an essential 5-HTDRN→CRFBNST circuit governing fear and anxiety, and provide a potential mechanistic explanation for the clinical observation of early adverse events to SSRI treatment in some patients with anxiety disorders1,2.

Serotonin engages an anxiety and fear-promoting circuit in the extended amygdala