The biological factors that determine whether an individual develops mental illness, such as depression or posttraumatic stress disorder, or responds adequately to pharmacotherapy remain almost completely unknown. Using genetically modified mice, we demonstrate that low levels of brain serotonin lead to increased vulnerability to psychosocial stress and prevent the antidepressant-like effects of fluoxetine following stress exposure. Our data also show that inhibiting the lateral habenula can reverse stress-induced behavioral avoidance in serotonin-deficient animals, which fail to respond to fluoxetine. Our results provide additional insight into the serotonin deficiency hypothesis of depression and highlight the potential of targeting the lateral habenula to treat depression and anxiety disorders in patients who fail to respond to selective serotonin reuptake inhibitors.
Brain serotonin (5-HT) deficiency and exposure to psychosocial stress have both been implicated in the etiology of depression and anxiety disorders, but whether 5-HT deficiency influences susceptibility to depression- and anxiety-like phenotypes induced by psychosocial stress has not been formally established. Most clinically effective antidepressants increase the extracellular levels of 5-HT, and thus it has been hypothesized that antidepressant responses result from the reversal of endogenous 5-HT deficiency, but this hypothesis remains highly controversial. Here we evaluated the impact of brain 5-HT deficiency on stress susceptibility and antidepressant-like responses using tryptophan hydroxylase 2 knockin (Tph2KI) mice, which display 60–80% reductions in brain 5-HT. Our results demonstrate that 5-HT deficiency leads to increased susceptibility to social defeat stress (SDS), a model of psychosocial stress, and prevents the fluoxetine (FLX)-induced reversal of SDS-induced social avoidance, suggesting that 5-HT deficiency may impair antidepressant responses. In light of recent clinical and preclinical studies highlighting the potential of inhibiting the lateral habenula (LHb) to achieve antidepressant and antidepressant-like responses, we also examined whether LHb inhibition could achieve antidepressant-like responses in FLX-insensitive Tph2KI mice subjected to SDS. Our data reveal that using designer receptors exclusively activated by designer drugs (DREADDs) to inhibit LHb activity leads to reduced SDS-induced social avoidance behavior in both WT and Tph2KI mice. This observation provides additional preclinical evidence that inhibiting the LHb might represent a promising alternative therapeutic approach under conditions in which selective 5-HT reuptake inhibitors are ineffective.