Role of serotonin in psychiatric and somatic comorbidities of attention-deficit/hyperactivity disorder: a systematic literature review
Open accessAbstract
INTRODUCTION: Serotonin is a well-established modulator of various neuropsychological processes, as well as organ and endocrine functioning, and metabolism and homeostasis. Serotonin has been implicated in the neurobiology of attention-deficit/hyperactivity disorder (ADHD). Herein, the evidence for a serotonergic link between psychiatric and somatic comorbidities associated with ADHD was evaluated. METHODS: A systematic literature review was conducted of the published literature to identify comorbidities proven to co-occur with ADHD and determine whether there was any serotonergic pathophysiology associated with these comorbidities. The average grade of serotonergic evidence was calculated and plotted alongside the volume of publications for each identified comorbidity. The date of the last search was 7 March 2024. RESULTS: One hundred eighty-two individual comorbidities commonly occurring in ADHD populations were identified; 135 (74.2 %) had evidence for serotonergic pathophysiology, including 91 psychiatric and 44 somatic conditions. The grade of evidence for a serotonergic role in the pathophysiology of a given comorbidity was generally medium to high or high. CONCLUSIONS: Findings indicate that serotonin plays a key role, alongside dopamine and norepinephrine, in ADHD neurobiology. Serotonin involvement in physiological functioning suggests that dysregulation is likely to generate a broad spectrum of clinical manifestations, which may account for the unique presentation of neuropsychiatric behaviors and comorbidities found in patients with ADHD.
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The serotonergic system has been implicated in ADHD, particularly in relation to impulsivity and high rates of comorbid mood and anxiety disorders.
“The serotonergic (5-HT) system has also been implicated, particularly in relation to impulsivity and the high rates of comorbid mood and anxiety disorders”
From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [71]
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- Authors
- Faraone, S. V., Ward, C. L., Boucher, M., Elbekai, R., & Brunner, E.
- Affiliations
- SUNY Upstate Medical University (US)
- Otsuka Pharmaceutical Development & Commercialization, Inc. (United States) (US)
- Otsuka Canada Pharmaceutical Inc. (Canada) (CA)
- Otsuka (United States) (US)
- Corresponding author
- Faraone, Stephen V.
- Venue
- Neuroscience & Biobehavioral Reviews
- Publisher
- Elsevier BV
- Published
- 2025-09
- Volume
- 176
- Pages
- 106275
- ISSN
- 0149-7634 (ISSN-L)
- OpenAlex
- W4412055753
- Cited by
- 10
- References
- 79
- Citations by year
- 2026: 7 · 2025: 3
- FWCI
- 1.81
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Neuroscience & Biobehavioral Reviews (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Otsuka Pharmaceutical Development and Commercialization Inc
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- serotonin, attention deficit hyperactivity disorder, psychiatric comorbidity, somatic comorbidity, dopamine, norepinephrine
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Mental Disorders, Humans, Serotonin, Comorbidity
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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