We gave the indirect 5-HT agonist, D-fenfluramine (30 mg), the 5-HT antagonist methysergide (2 mg) and placebo to 11 patients with an anxiety disorder and 12 controls in a double-blind, balanced-order, cross-over design. Compared to controls, patients had significantly higher anxiety ratings, were slower in naming colours in computerized Stroop tests and showed greater interference for anxiety-related words. Patients tended to have a lower critical flicker fusion threshold (CFFT) than controls and in the subjects taken as a whole there was a significant inverse correlation between CFFT and Spielberger state (r = -0.54, p < 0.01) and trait anxiety (r = -0.55, p < 0.01). Neither drug had significant effects on anxiety ratings or on Stroop interference. D-Fenfluramine significantly increased CFFT (p < 0.02) and methysergide non-significantly reduced CFFT with no significant differences between patients and controls. 5-HT may be involved in lower-level visual information processing but we found no evidence for its direct involvement in the attentional bias for anxiety-related information in the emotional Stroop.
