Word: serotonin
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...first glance, these stories seem completely unrelated--three profoundly different disorders treated with three different drugs. Yet all three medications have one crucial element in common: they target the brain chemical serotonin. Though serotonin has been known to researchers for nearly a half-century, only in recent years have neuroscientists begun to understand how important this one substance is to the functioning of the human psyche. Serotonin, or the lack of it, has been implicated not only in depression, uncontrollable appetite and obsessive-compulsive disorder but also in autism, bulimia, social phobias, premenstrual syndrome, anxiety and panic, migraines, schizophrenia...
...growing awareness of serotonin's central role in mood and emotion has been paralleled--and in some cases driven--by a boom in drugs that target serotonin more or less specifically. Among them are such popular antidepressants as Elavil, Prozac, Zoloft and the hot new herbal medication St. John's wort; powerful appetite suppressants including Redux and fenfluramine; and antipsychotics such as clozapine. Like every other drug, the ones that zero in on serotonin have side effects. Elavil makes people sleepy. Zoloft can trigger headache and nausea. Zoloft and Prozac may cause sexual dysfunction. All these symptoms are annoying...
...abrupt change also reflects a deeper truth about serotonin: despite years of study and impressive breakthroughs, researchers are only beginning to understand the chemical's complex role in the functioning of the body and brain--and how doctors can make adjustments when serotonin levels go out of balance. So far, the tools used to manipulate serotonin in the human brain are more like pharmacological machetes than they are like scalpels--crudely effective but capable of doing plenty of collateral damage. Says Barry Jacobs, a neuroscientist at Princeton University: "We just don't know enough about how the brain works...
Still, there is plenty that researchers do understand. At the most basic level, they have been aware for more than two decades that without serotonin, dopamine, norepinephrine and the hundreds of other known neurotransmitters, the brain could not process information or send out instructions to run the rest of the body. That is because neurons, or nerve cells, do not actually touch one another; they are separated by gaps known as synapses. When the electrical impulses that carry information through the nervous system reach the end of a neuron, they have nowhere to go. The circuit is broken...
Biochemically, hypericum has some interesting properties. For starters, says University of Frankfurt psychopharmacologist Walter Muller, it appears to affect the brain in the same way Prozac does--by prolonging the activity of the mood-enhancing brain chemical serotonin. This is the same neurotransmitter acted on by the controversial diet pills fen-phen and Redux (see following story). But hypericum has much broader activity. In rats and mice, at least, it extends the action of at least two other powerful brain chemicals that are thought to play a role in depression: dopamine and norepinephrine. In each case, hypericum appears to work...