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Alteration of the platelet serotonin transporter in romantic love
Abstract
BACKGROUND: The evolutionary consequences of love are so important that there must be some long-established biological process regulating it. Recent findings suggest that the serotonin (5-HT) transporter might be linked to both neuroticism and sexual behaviour as well as to obsessive-compulsive disorder (OCD). The similarities between an overvalued idea, such as that typical of subjects in the early phase of a love relationship, and obsession, prompted us to explore the possibility that the two conditions might share alterations at the level of the 5-HT transporter. METHODS: Twenty subjects who had recently (within the previous 6 months) fallen in love, 20 unmedicated OCD patients and 20 normal controls, were included in the study. The 5-HT transporter was evaluated with the specific binding of 3H-paroxetine (3H-Par) to platelet membranes. RESULTS: The results showed that the density of 3H-Par binding sites was significantly lower in subjects who had recently fallen in love and in OCD patients than in controls. DISCUSSION: The main finding of the present study is that subjects who were in the early romantic phase of a love relationship were not different from OCD patients in terms of the density of the platelet 5-HT transporter, which proved to be significantly lower than in the normal controls. This would suggest common neurochemical changes involving the 5-HT system, linked to psychological dimensions shared by the two conditions, perhaps at an ideational level.
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“In addition, research has shown that the early stages of romantic love may be linked to alterations in plasma levels of cortisol, sex steroids, nerve growth factor (NGF), and brain derived neurotrophic factor (BDNF) (Marazziti et al., 2009), as well as decreased density of the serotonin transporter in platelets (Emanuele et al., 2006; Marazziti et al., 1999; Marazziti and Canale, 2004), suggesting”
From Oxytocin during the initial stages of romantic attachment: Relations to couples’ interactive reciprocity (2012) · cites this paper as Marazziti et al., 1999
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“…neurotrophic factor (BDNF) (Marazziti et al., 2009), as well as decreased density of the serotonin transporter in platelets (Emanuele et al., 2006; Marazziti et al., 1999; Marazziti and Canale, 2004), suggesting that the initial period of romantic attachment is linked with neuroendocrine changes.”
Hormonal changes when falling in love
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“The strong suggestion is that different mechanisms may be involved (Panksepp, 1982; Jankoviak, 1986; Hazan and Shaver, 1987; Fisher, 1992; Porges, 1998; Insel and Young, 1997) and it has been recently demonstrated that the intrusive thoughts of the early, romantic phase of a falling in love are underlaid by a decrease…”
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“However, in most species courtship attraction is brief, lasting only minutes, hours, days, or weeks; while in humans, intense, early stage romantic love can last 12–18 months (Marazziti et al., 1999) or much longer (Acevedo et al., 2011).”
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“Indeed, retesting the lovers at 12–18 months revealed that serotonin levels had returned to baseline—at which point their “obsessive ideation regarding the partner” had disappeared as well (Marazziti et al. 1999, 744).”
BackgroundInfluentialLove is more than just a kiss: a neurobiological perspective on love and affection
de Boer, A., van Buel, E. M., & Ter Horst, G. J. (2012) · Neuroscience · doi:10.1016/j.neuroscience.2011.11.017 · Cited by 123
“Further similarities between obsessive behavior and early romantic love were elucidated by Marazziti et al. (1999), who evaluated platelet serotonin transporter levels in OCD patients and subjects who had recently fallen in love.”
InfluentialLove addiction: definition, etiology, treatment
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“Healthy romantic love has an evolutionary basis (for procreation), biological roots (eg, neurotransmission-related), cognitive and social learning aspects (eg, attachment development), and cultural features (eg, mass media depictions of romance and family creation) ( Fisher, 2006 ; Gordon, 2007 ; Marazziti, Akiskal, R…”
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Raised plasma nerve growth factor levels associated with early-stage romantic love
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“To date, the neurochemical bases of love in humans have only been studied in one investigation, which found that the intrusive thoughts of the early romantic phase of a falling in love could be due to a reduced functionality of the serotonin transporter (Marazziti et al., 1999).”
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Some Thoughts on the Neurobiology of Stalking
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“In this experiment 20 men and women who had fallen in love in the previous six months, 20 who suffered from unmedicated obsessive-compulsive disorder (OCD), and 20 normal (control) individuals who were not in love were tested for plasma levels of serotonin (78).”
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Blood Levels of Serotonin Are Differentially Affected by Romantic Love in Men and Women
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“Furthermore, the previous finding of a reduced platelet serotonin transporter density during romantic love (Marazziti et al., 1999) and the notion that this transporter transports serotonin back into the cell (e.”
BackgroundResultInfluentialGenetic loading on human loving styles.
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Measuring Romantic Love: Psychometric Properties of the Infatuation and Attachment Scales
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“…levels are thought to vary over time, with infatuation diminishing with time and attachment increasing with time (Ahmetoglu et al., 2010; Fisher, 1998, 2000; Fisher et al., 2002; Marazziti et al., 1999; Sprecher & Regan, 1998), the two factors could be expected to be negatively correlated.”
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Falling in love is associated with immune system gene regulation
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“Other work has found that new romantic love is associated with lower densities of specific serotonin transporter binding sites—densities that were equivalent to those found in individuals suffering from obsessive-compulsive disorder (Marazziti et al., 1999).”
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“…or biological markers of romantic love have also noted the similarities between romantic love and other behaviors including addiction (Reis and Aron 2008) and obsessive-compulsive disorders (Marazziti et al. 1999), suggesting the emotion shares many features with other behaviors or experiences.”
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“Moreover, there exist also indications of changes of SERT in healthy subjects [”
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“…whole blood or platelet 5-HT levels, whereas the binding capacity (Bmax) of the platelet 5-HTT is consistently reduced, both for [3H]-paroxetine (Marazziti et al. 1999; Sallee et al. 1996) and [3H]-imipramine (Bastani et al. 1991; Marazziti et al. 1992; Marazziti et al. 1997; Weizman et al.…”
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“Neurochemistry of Love Human attraction and romantic love is based on a complex neurobiological network involving altered levels of dopamine, noradrenalin and serotonin (5-HT; 2F), three neurotransmitters also associated with sexual arousal, motivation and obsessive thinking (Marazziti et al., 1999; Meston and Frohlic…”
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“Infatuation manifests itself as constantly thinking about (Marazziti et al. 1999) and longing to be with the person (Aron et al.”
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Decreased lymphocyte dopamine transporter in romantic lovers
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“Lymphocytes separation and membrane preparation for binding assay with [(3)H]-WIN 35,428 were carried out according to our method.(2) The [(3)H]-DA reuptake was performed according to the method of Amenta et al,(28) with slight modifications.”
BackgroundMethodThermal balneotherapy induces changes of the platelet serotonin transporter in healthy subjects
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“The density of serotonin transporters has an influence on the mental processes of infatuated couples such as obsessions with partners (Marazziti et al., 1999; Langeslag et al., 2012).”
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Romantic Love Is Associated with Enhanced Inhibitory Control in an Emotional Stop-Signal Task
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“This early phase is also characterized by low serotonin levels (Marazziti et al., 1999) and high nerve growth factor (Emanuele et al., 2006).”
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“Several studies have indicated an involvement of the serotonergic system in jealousy and treatment with serotonin selective re-uptake inhibitors has been reported to have beneficial effects (Marazziti et al., 1999, 2003).”
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“There has long been interest in passionate love—an intense state of romantic attraction [1] associated with reward-related activation in the brain [2–4], physiological arousal [5], and mental preoccupation with the partner [6].”
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“Finally, preliminary data suggest that being in love is accompanied by low 5-HT levels (Marazziti et al. 1999) and a greater crying proneness (Vingerhoets and van Assen 2009).”
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“It has been reported that a decreased function of 5-HT might be related to romantic love and, particularly, to what is considered its main feature, that is to say a sort of transient obsessional thoughts related to the partner.(5) Such a physiological form of OCD is considered essential to maintain the focus on the pa…”
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“Two studies [24,27] have identified changes in serotonin levels in people experiencing romantic love.”
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Selective Serotonin Reuptake Inhibitors and Their Effects on Relationship Satisfaction
Meyer, D. (2007) · The Family Journal · doi:10.1177/1066480707305470 · Cited by 10
CortiLove: A pilot study on hair steroids in the context of being in love and separation
Renner, J., Stanulla, M., Walther, A., & Schindler‐Gmelch, L. (2021) · Comprehensive Psychoneuroendocrinology · doi:10.1016/j.cpnec.2021.100061 · Cited by 6
“Further, the chosen control groups greatly vary with individuals in long-term relationships [25], singles [1,16,25], mixed groups [15], or unspecified "healthy controls" [26].”
BackgroundThe meaning of love in the debate for legal recognition of same-sex marriage in Australia
Grossi, R. (2012) · International Journal of Law in Context · doi:10.1017/s1744552312000341 · Cited by 8
Cross-Cultural Methods in Sexual Psychology: Love Research
Kowal, M. (2023) · Springer eBooks · doi:10.1007/978-3-031-08956-5_734-1 · Cited by 8
Babková, J., & Repiská, G. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26041533 · Cited by 8
“One study investigated the effects of naloxone, an opioid antagonist, on female sexual response.”
An Overview of Love Between Humans and Artificial Partners
Cheok, A. D., & Zhang, E. Y. (2019) · Human–Robot Intimate Relationships · doi:10.1007/978-3-319-94730-3_1 · Cited by 6
The Brain in Love: Has Neuroscience Stolen the Secret of Love?
Tarlacı, S. (2012) · NeuroQuantology · doi:10.14704/nq.2012.10.4.581 · Cited by 7
Antidepressant Psychopharmacology and the Social Brain
Novick, A. M. (2011) · Psychiatry · doi:10.1521/psyc.2011.74.1.72 · Cited by 7
“, & Cassano, G. B. (1999). Alteration of the platelet serotonin transporter in romantic love.”
BackgroundInfluentialEight survival strategies in traumatic stress.
Valent, P. (2007) · Traumatology An International Journal · doi:10.1177/1534765607302281 · Cited by 9
Die Chemie – eine zentrale Säule der menschlichen Kultur
Shaik, S. S. (2003) · Angewandte Chemie · doi:10.1002/ange.200230038 · Cited by 7
Emotions, Facultative Adaptation, and the History of Homicide
Roth, R. A. (2014) · The American Historical Review · doi:10.1093/ahr/119.5.1529 · Cited by 9
“Beyond Emotion: Love as an Encounter of Myth and Drive” by Lubomir Lamy
Marazziti, D. (2015) · Emotion Review · doi:10.1177/1754073915594437 · Cited by 7
Bode, A., & Kavanagh, P. S. (2025) · Personality and Individual Differences · doi:10.1016/j.paid.2025.113108 · Cited by 8
Abordaje de la sexualidad en atención primaria: ¿qué valorar?
Figueroa-Martín, L., Clíments, G. D., Gómez, M. B. S., & Brito, P. R. B. (2015) · Ene · doi:10.4321/s1988-348x2015000200006 · Cited by 6
McLauchlan, J., Thompson, E. M., Ferrão, Y. A., Miguel, E. C., Albertella, L., Marazziti, D., & Fontenelle, L. F. (2021) · CNS Spectrums · doi:10.1017/s1092852921000444 · Cited by 7
“Possible total scores for the BAI ranges from 0 (low) to 63 (high); depending on the score, the anxiety level can be interpreted as “minimal” (0-7), “mild” (8-15), “moderate” (16-25), or “severe” (26-63).”
BackgroundDoherty, J. K., & Brumbaugh, C. C. (2024) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197544754.013.10 · Cited by 5
Marazziti, D., Massa, L., Carbone, M. G., Palermo, S., Arone, A., D'Angelo, G., Crivelli, N. S. B., Gurrieri, R., Perrone, P., Palagini, L., et al. (2024) · PubMed Central · doi:10.36131/cnfioritieditore20240101 · Cited by 6
“…levels of interleukins (IL) IL-2, IL-4, IL-6, IL-10 and tumor necrosis factor-α (TNF-α) in adult OCD patients, compared to controls (Brambilla et al, 1997; Marazziti et al., 1999; 2018, Fontenelle et al., 2012), as well as higher rates of anti-basal ganglia antibodies (Khanna et al., 1997a; 1997b).”
BackgroundPassionate love and sexual desire: Multidisciplinary perspectives.
Hatfield, E. C., & Rapson, R. L. (2008) · Cited by 5
Love, Veritably—A Mélange of Love, Intimacy, Attraction, and Sensuality
Das, K., & Rao, T. S. (2022) · Journal of Psychosexual Health · doi:10.1177/26318318221102126 · Cited by 5
Lovesickness: The Most Common Form of Heart Disease
Dzaja, N. (2008) · Cited by 5
Decreased Lymphocyte 3H-Paroxetine Binding in Obsessive-Compulsive Disorder
Marazziti, D., Baroni, S., Másala, I., Giannaccini, G., Mungai, F., Nasso, E. D., & Cassano, G. B. (2003) · Neuropsychobiology · doi:10.1159/000070580 · Cited by 5
Metadata
- Authors
- MARAZZITI, D., AKISKAL, H. S., ROSSI, A., & CASSANO, G. B.
- Affiliations
- University of Pisa (IT)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 1999-05
- Volume
- 29
- Issue
- 3
- Pages
- 741-745
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2006411360
- Cited by
- 175
- References
- 27
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 7 · 2023: 7 · 2022: 7 · 2021: 7 · 2020: 6 · 2019: 3 · 2018: 7 · 2017: 14 · 2016: 6 · 2015: 6 · 2014: 10 · 2013: 4 · 2012: 15
- FWCI
- 0.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroendocrine regulation and behavior
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Keywords
- platelet serotonin transporter, romantic love, obsessive-compulsive disorder, serotonergic system, overvalued ideas, obsession, neuroticism, sexual behavior, evolution of love
- MeSH terms
- Adult, Binding Sites, Biological Transport, Buffers, Female, Humans, Interpersonal Relations, Love, Male, Obsessive-Compulsive Disorder, Serotonin, Sexual Behavior, Selective Serotonin Reuptake Inhibitors, Paroxetine
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