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Critical notes on the locus coeruleus hypothesis of panic disorder

Published online by Cambridge University Press:  18 September 2015

J.A. den Boer  and
H.G.M. Westenberg
J.A. den Boer*
Affiliation:
Afdeling Biologische Psychiatrie AZU, Heidelberglaan 100, 3584 CX Utrecht
H.G.M. Westenberg
Affiliation:
Afdeling Biologische Psychiatrie AZU, Heidelberglaan 100, 3584 CX Utrecht
*
Universitair Hoofddocent Klinische en Biologische Psychiatrie, Academisch Ziekenhuis Utrecht, Postbus 85500, 3508 GA Utrecht
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Summary

One of the theories on the biology of panic disorder which received much attention is the locus coeruleus hypothesis. This hypothesis states that there exists an episodic overactivity of noradrenergic systems in panic disorder. Experiments with yohimbine form the cornerstone of this theory, and additional supporting evidence is provided by challenge studies with isoproterenol and treatment studies with clonidine. These studies are critically reviewed and it is argued that based upon the studies with yohimbine one cannot conclude that there is a specific noradrenergic abnormality in panic disorder, since yohimbine also affects dopaminergic and serotoninergic neurons in the brain.

In an alternative theory on the relationship between noradrenaline and anxiety it is postulated that increases in anxiety, irrespective of the diagnostic category, are related to increases in locus coeruleus activity.

Keywords

panic disorderlocus coeruleusnoradrenalineyohimbineisoproterenolclonidinepaniekstoornislocus coeruleusnoradrenalineyohimbineisoproterenolClonidine
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 5 , Issue 3 , September 1993 , pp. 48 - 54
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 1993

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References

Literatuur

3.Svensson, Th. Peripheral autonomic regulation of locus coeruleus noradrenergic neurons in brain: putative implications for psychiatry and psychopharmacology. Psychopharmacol 1987;92:1–7.CrossRefGoogle ScholarPubMed
5.Segal, M. Serotoninergic innervation of the locus coeruleus from the dorsal raphe and its action on responses to noxious stimuli. J Physiol 1979; 286:401–15.CrossRefGoogle Scholar
8.Andrade, R, Aghajanian, GK. Intrinsic regulation of locus coeruleus neurons: electrophysiological evidence indicating a predominant role for autoinhibition. Brain Res 1984; 310:401–6.CrossRefGoogle ScholarPubMed
10.Guyenet, PG, Aghajanian, GK. Ach, substance P and met-enkepha-lin in the locus coeruleus: Pharmacological evidence for independent sites of action. Eur J Pharmacol 1979; 53:319–28.CrossRefGoogle ScholarPubMed
29.Kenardy, J, Evans, L, Oei, TP. The importance of cognitions in panic attacks. Behavior Ther 1988; 19: 471–83.CrossRefGoogle Scholar
31.Rasmussen, SA, Goodman, WK, Woods, SW, Heninger, GR, Charney, DS. Effects of yohimbine in obsessive-compulsive disorder. Psychopharmacol 1987; 93: 303–13.CrossRefGoogle ScholarPubMed
32.Lee, MA, Cameron, OG, Gurguis, GNM, Glitz, D, Smith, CB, Hariharan, M, Abelson, JL, Curtis, GC. Alpha2-adrenoreceptor status in obsessive-compulsive disorder. Biol Psychiat 1990; 27: 1083–93.CrossRefGoogle Scholar
33.Hollander, E, Decaria, C, Nitescu, A, et al.Noradrenergic function in obsessive-compulsive disorder: behavioral and neuroendocrine responses to clonidine and comparison to healthy controls. Psychiat Res 1991; 37: 161–77.CrossRefGoogle ScholarPubMed
34.Charney, DS, Woods, SW, Heninger, GR. Noradrenergic function in generalized anxiety disorder: effects of yohimbine in healthy subjects and patients with generalized anxiety disorder. Psychiat Res 1989;27:173–82.CrossRefGoogle ScholarPubMed
36.Charney, DS, Krystal, JH, Southwick, SM, Delgado, PL. The role of noradrenergic function in human anxiety and depression. In: Den Boer, JA & Sitsen, JMA, red. Handbook of depression and anxiety; a biological approach. New York Marcel Dekker, 1993: in press.Google Scholar
37.Uhde, TW, Redmond, DE Jr., Kleber, HD. Clonidine supresses the opioid abstinence syndrome without clonidine-withdrawal symptoms: a blind inpatient study. Psychiat Res 1980; 2:37–47.CrossRefGoogle Scholar
46.Pohl, R, Yeragani, V, Balon, R, et al.Isoproterenol induced panic attacks. Biol Psychiat 1990;24:891–902.CrossRefGoogle Scholar
51.Balon, R, Yeragani, VK, Pohl, R, Muench, J, Berchou R.ced panic attacks. Biol Psychiat 1990a;24:891–902. Somatic and Psychological Symptoms During Isoproterenol-Induced Panic Attacks. Psychiat Res 1990;32:103-12.Google Scholar
52.Noyes, R, Anderson, DJ, Clancy, J, Crowe, RR, Slymen, DJ, Ghoneim, MM, Hinrichs, JV. Diazepam and propranolol in panic disorder and agoraphobia. Arch gen Psychiat 1984;41:287–92.CrossRefGoogle ScholarPubMed
53.Hafner, RJ, Milton, F. The influence of propranolol on the exposure in vivo of agoraphobics. Psychol Med 1977;7:419–25.CrossRefGoogle ScholarPubMed
54.Gorman, JM, Levy, JM, Liebowitz, MRet al.Effect of acute β-adrenergic blockade on lactate induced panic. Arch gen Psychiat 1983;40:1079–82.CrossRefGoogle ScholarPubMed
55.Den Boer, JA, Westenberg, HGM. Effects of a serotonin and noradrenaline uptake inhibitor in panic disorder, a double blind comparative study with fluvoxamine and maprotiline. Int Clin Psychopharm 1988;3:59–74.CrossRefGoogle ScholarPubMed
56.Woods, SW, Charney, DS, McPherson, CA, Gradman, AH, Heninger, GR. Situational Panic Attacks. Arch gen Psychiatry 1987; 44:365–75.CrossRefGoogle ScholarPubMed
57.Nakagawa, R, Tanaka, M, Kohno, Y, Noda, Y, Nagasaki, N. Regional responses of rat brain noradrenergic neurons to acute intense stress. Pharmacol Biochem Behav 1981;14:729–32.CrossRefGoogle ScholarPubMed
60.Den Boer, JA, Westenberg, HGM, Klompmakers, AA, van Lint, LEM. Behavioral biochemical and neuroendocrine concommi-tants of lactate-induced panic anxiety. Biol Psychiat 1989;26:612–22.CrossRefGoogle ScholarPubMed
62.Woods, SW, Charney, DS, Goodman, WK, Heninger, GR. Carbon induced anxiety; behavioral physiologic and biochemical effects of carbon dioxide in patients with panic disorders and healthy subjects. Arch gen Psychiat 1988; 45:43–52.CrossRefGoogle ScholarPubMed
63.Van Megen, HJGM, Den Boer, JA, Westenberg, HGM. Enhanced sensitivity for pentagastrin in Panic Disorder. 1993, submitted.Google Scholar
74.Pliszka, SR, Rogeness, GA, Medrano, MA. DBH, MHPG and MAO in children with depressive anxiety and conduct disorders: relationship to diagnosis and symptom ratings. Psychiat Res 1988; 24:35–44.CrossRefGoogle Scholar
75.Sevy, S, Papadimitriou, GN, Surmont, DW, Goldman, S, Mendlewicz, J. Noradrenergic function in generalized anxiety disorder, major depressive disorder and healthy subjects. Biol Psychiat 1989;25:141–52.CrossRefGoogle ScholarPubMed