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Platelet serotonin binding and plasma cortisol in panic disorder before and after alprazolam plus behavioral guidance treatment

Published online by Cambridge University Press:  16 April 2020

A Tobeña ,
X Sanchez ,
J Masana  and
MJ Martinez de Osaba
A Tobeña
Affiliation:
Department of Pharmacology and Psychiatry, Unit of Medical Psychology, School of Medicine, Autonomous University of Barcelona, 08193Bellaterra, Catalonia, Spain
X Sanchez
Affiliation:
Department of Pharmacology and Psychiatry, Unit of Medical Psychology, School of Medicine, Autonomous University of Barcelona, 08193Bellaterra, Catalonia, Spain
J Masana
Affiliation:
Department of Psychiatry, Hospital Clinic of Barcelona
MJ Martinez de Osaba
Affiliation:
Department of Endocrinology, Hospital Clinic of Barcelona, School of Medicine, University of Barcelona
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Summary

In 32 patients with panic disorder with or without agoraphobia, Bmax measures of 5-HT binding in platelets did not differ from normal controls at baseline. Plasmatic cortisol levels were significantly higher than controls in the morning and in the evening measures as well as in post-dexamethasone assays. Following an 8-week treatment period with alprazolam plus behavioral guidance encouraging exposure, Bmax values did not alter but cortisol measures diminished significantly. Measures of phobic avoidance were negatively correlated with 5-HT Bmax values. Plasmatic cortisol correlated positively with the number of situational panic attacks in the month before treatment. There were no correlations between cortisol and 5-HT Bmax measures. A possible link between serotonin function and phobic avoidance is discussed. Cortisol changes were interpreted as being related to the global severity of the anxious state.

Keywords

serotonin bindingplateletcortisoldexamethasone suppression testpanic disorderagoraphobia
Type
Original article
Information
European Psychiatry , Volume 6 , Issue 1 , 1991 , pp. 31 - 37
Copyright
Copyright © Elsevier, Paris 1991

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References

American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders (3rd ed revised), Work Group to revise DSM-III. Washington, DCGoogle Scholar
Avery, DHOsgood, TBIshiki, DMWilson, LGKenny, MDunner, DL (1985) The DST in psychiatric outpatients with generalized anxiety disorder, panic disorder, or primary affective disorder. Am J Psychiatry 142, 844–848Google ScholarPubMed
Ballenger, JCBurrows, GDDuPont, RLLesser, IMNoyes, RPecknold, JCRifkin, ASwinson, RP (1988) Alprazolam in panic disorder and agoraphobia: Results from a multicenter trial. I. Efficacy in short-term treatment. Arch Gen Psychiatry 45, 413–422CrossRefGoogle ScholarPubMed
Ballenger, JC (1990) Neurobiology of Panic Disorder. New York, Wiley-Liss, 91–120Google Scholar
Balon, RPohl, RYeragani, VRainey, JOxenkrug, GF (1987) Platelet serotonin levels in panic disorder. Acta Psychiatr Scand 75, 315–317CrossRefGoogle ScholarPubMed
Breier, AAlbus, MPickar, DZahn, TPWolkowiz, OMPaul, SM (1987) Controllable and uncontrollable stress in humans: alterations in mood and neuroendocrine and psychophysiological function. Am J Psychiatry 144, 1419–1424Google ScholarPubMed
Carr, DBSheehan, DVSurman, OSColeman, JHGreenblatt, DJHeninger, GRJones, KJLevine, PHWatkins, WD (1986) Neuroendocrine correlates of lactate-induced anxiety and their response to chronic alprazolam therapy. Am J Psychiatry 143, 483–494Google ScholarPubMed
Carrol, BJFeinberg, MGreden, JFTarika, JAlbala, AAHaskett, RFJames, NMKronfol, ZLohr, NSteiner, Mde Vigne, JPYoung, E (1981) A specific laboratory test for the diagnosis of melancholia. Standardization, validation and clinical utility. Arch Gen Psychiatry 38, 15–22CrossRefGoogle Scholar
Charney, DSHeninger, GRBreier, A (1984) Noradrenergic function in panic anxiety: effects of yohimbine in healthy subjects and patients with agoraphobia and panic disorder. Arch Gen Psychiatry 41, 751–763CrossRefGoogle ScholarPubMed
Charney, DSHeninger, GR (1985a) Noradrenergic function and the mechanism of action of antianxiety treatment: I The effect of longterm alprazolam treatment. Arch Gen Psychiatry 42, 458–467CrossRefGoogle Scholar
Charney, DSHeninger, GR (1985b) Noradrenergic function and the mechanism of action of antianxiety treatment: II The effect of long-term imipramine treatment. Arch Gen Psychiatry 42, 473–481CrossRefGoogle Scholar
Charney, DSHeninger, GRJatlow, PI (1985) Increased anxiogenic effects of caffeine in panic disorders. Arch Gen Psychiatry 42, 233–243CrossRefGoogle ScholarPubMed
Charney, DSHeninger, GR (1986a) Abnormal regulation of noradrenergic function in panic disorders: effects of clonidine in healthy subjects and patients with agoraphobia and panic disorder. Arch Gen Psychiatry 43, 1042–1054CrossRefGoogle Scholar
Charney, DSHeninger, GR (1986b) Serotonin function in panic disorders: The effect of intravenous tryptophan in healthy subjects and patients with panic disorder before and during alprazolam treatment. Arch Gen Psychiatry 43, 1059–1065CrossRefGoogle Scholar
Charney, DSWoods, SWGoodman, WKRifkin, BKinch, MAiken, BHeninger, GR (1986) Drug treatment of panic disorder: the comparison efficacy of imipramine, alprazolam, and trazodone. J Clin Psychopharmacol 47, 580–585Google Scholar
Chouinard, GAnnable, LFontaine, RSolyom, L (1982) Alprazolam in the treatment of generalized anxiety and panic disorders: A double-blind placebo-controlled study. Psychopharmacology 77, 229–233CrossRefGoogle ScholarPubMed
Derogatis, LR (1983) Symptom Checklist-90R Manual.Clinical Psychological Response Towson MDGoogle Scholar
Dorow, RHorowski, RPaschelke, GAmin, MBreastrup, C (1983) Severe anxiety induced by FG7142, a beta-carboline ligand for benzodiacepine receptors. Lancet ii, 98–99CrossRefGoogle Scholar
Gastó, CValbejo, JBallús, JOriola, JMartinez de Osaba, MJRivera, F (1985) In: Platelet 5-HT binding and response to antidepressant drugs (Shagass, CHJosiassen, RCBridger, WHWeias, KJStoff, DSimpson, GM eds) Elsevier, New YorkGoogle Scholar
Goldstein, SHalbreich, UAsnis, GEndicott, JAlvir, J (1987) The hypothalamic pituitary adrenal system in panic disorder. Am J Psychiatry 144, 1320–1323Google ScholarPubMed
Gorman, JMFyer, MRGoetz, RAskanazi, JLiebowitz, MRFyer, AJKinney, JKlein, DF (1988) Ventilatory physiology of patients with panic disorder. Arch Gen Psychiatry 45, 31–39CrossRefGoogle ScholarPubMed
Gram, LFChristensen, P (1986) Benzodiazepine suppression of cortisol secretion: A measure of anxiolytic activity? Pharmacopsychiatry 19, 19–22CrossRefGoogle ScholarPubMed
Grunhaus, LTiongco, DHaskett, RFGreden, JF (1987) The dexamethasone suppression test in inpatients with panic disorder or agoraphobia with panic attacks. Biol Psychiatry 22, 517–521CrossRefGoogle ScholarPubMed
Hamilton, M (1960) A rating scale depression. J Neurosurg Psychiatry 23, 56–62CrossRefGoogle Scholar
Innis, RBCharney, DSHeninger, GR (1987) Differential 3H-Imipramine platelet binding in patients with panic disorder and depression. Psychiatr Res 21, 33–41CrossRefGoogle ScholarPubMed
Insel, TRNinan, PTAloi, JJimerson, DCSkolnick, PPaul, SM (1984) A benzodiazepine receptor-mediated model of anxiety. Arch Gen Psychiatry 41, 741–750CrossRefGoogle ScholarPubMed
Iversen, SD (1984) 5-HT and anxiety. Neuropharmacology 23, 1553–1560CrossRefGoogle ScholarPubMed
Kahn, RSvan Praag, HMWetzler, SAsnis, GMBarr, G (1988) Serotonin and anxiety revisited. Biol Psychiatry 23, 189–208CrossRefGoogle Scholar
Klein, DF (1981) In: Anxiety: new research and changing concepts (Klein, DFKabbin, JG eds) New YorkRaven Press, 235–263Google Scholar
Ko, GNElsworth, JDRoth, RHRifkin, BGLeigh, HRedmond, DE Jr (1983) Panic-induced elevation of plasma MHPG levels in phobic-anxious patients: effects of clinidine and imipramine. Arch Gen Psychiatry 40, 425–430CrossRefGoogle Scholar
Lewis, DANoyes, R JrCoryell, WClancy, J (1985) Tritiated imipramine binding to platelets is decreased in patients with agoraphobia. Psychiatr Res 16, 1–9CrossRefGoogle ScholarPubMed
Lieberman, JABrenner, RLesser, MCoccaro, EBorenstein, MKane, JM (1983) Dexamethasone suppression tests in patients with panic disorder. Am J Psychiatry 140, 917–919Google ScholarPubMed
Marks, IMMathews, AM (1979) Brief standard self-rating for phobic patients. Behav Res Ther 17, 263–267CrossRefGoogle ScholarPubMed
Nesse, RMCameron, OGCurtis, GCMcCann, DSHuber-Smith, MJ (1984) Adrenergic function in patients with panic anxiety. Arch Gen Psychiatry 41, 771–776CrossRefGoogle ScholarPubMed
Nutt, DJ (1989) Altered central α-adrenoceptor sensitivity in panic disorder. Arch Gen Psychiatry 46, 165–169CrossRefGoogle Scholar
Pecknold, JCSuranyi-Cadotte, BChang, HNair, NPV (1988) Serotonin uptake in panic disorder and agoraphobia. Neuropsychopharmacology 1, 173–176CrossRefGoogle ScholarPubMed
Rose, RM (1980) Endocrine response to stressful psychological events.In: The Psychiatric Clinics North America: Advances in Psychoendocrinology (Sachar, EJ ed) Philadelphia. WB Saunders Co, 3, 251–277Google Scholar
Roy-Byrne, PPUhde, TWPost, RMGalluci, WChrousos, GPGold, PW (1986) The corticotropin-releasing hormone stimulation test in patients with panic disorder. Am J Psychiatry 143, 896–899Google ScholarPubMed
Schick, PKMcKlan, L (1979) Serotonine binding in human platelet. Biochem Pharmacol 28, 2667–2670CrossRefGoogle Scholar
Schneider, LSMunjack, DSeverson, JAPalmer, R (1987) Platelet 3H-Imipramine binding in generalized anxiety disorder, panic disorder and agoraphobia with panic attacks. Biol Psychiatry 22, 59–66CrossRefGoogle ScholarPubMed
Sheehan, DV (1982) Current views on the treatment of panic and phobic disorders. Drug Therapy 12, 49–63Google Scholar
Sheehan, DVClaycomb, JBSurman, OSBaer, LColeman, JGelles, L (1983) Panic attacks and the dexamethasone suppression test. Am J Psychiatry 140, 1063–1064Google ScholarPubMed
Soubrié, P (1986) Reconciling the role of central serotonin neurons in human and animal behavior. Behav Brain Sci 9, 319–364CrossRefGoogle Scholar
Stokes, E (1985) The neuroendocrinology of anxiety.In: Anxiety and Anxiety Disorders (Tuma, HMasser, J eds) Eribaum, Hillsdale, New York, 77–86Google Scholar
Tobeña, ASànchez, XMassana, JPose, RMartin DelCampo, A (1990) Brief treatment with alprazolam and behavioral guidance in panic disorder. Anxiety Res 3, 163–174CrossRefGoogle Scholar
Torrubia, RTobeña, A (1984) A scale for the assessment of susceptibility to punishment’ as a measure of anxiety: preliminary results. PAID 5, 371–375Google Scholar
Uhde, TWBerretini, WHRoy-Byrne, PPBoulenger, JPPost, RM (1987) Platelet 3H Imipramine binding in patients with panic disorder. Biol Psychiatry 22, 52–58CrossRefGoogle ScholarPubMed
Woods, SWCharney, DSMcPherson, CAGradman, AHHeninger, GR (1987) Situational panic attacks: Behavioral, physiologic and biochemical characterization. Arch Gen Psychiatry 44, 365–375CrossRefGoogle ScholarPubMed
Woods, SWCharney, DSGoodman, WKHeninger, GR (1988) Carbondioxide-induced anxiety: Behavioral, physiologic and biochemical effects of carbon dioxide in patients wich panic disorders and healthy subjects. Arch Gen Psychiatry 45, 43–52CrossRefGoogle Scholar
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