Advances have been made in understanding the biology of panic disorder
and the role of the underlying serotonergic dysfunction. This review
summarizes the biological evidence for the involvement of serotonin in
the pathogenesis of panic disorder and considers the 2 opposing theor
ies that are currently prevalent (5-HT excess and 5-HT deficit). The s
erotonin selective reuptake inhibitors are increasingly considered as
first-line treatment for panic disorder, and the interaction of these
agents with the serotonergic system is considered.