Comparison of Aerobic Exercise, Clomipramine, and Placebo in the Treatment of Panic Disorder

Broocks, Andreas; Bandelow, Borwin; Pekrun, G.; George, Annette; Meyer, Tim; Bartmann, Uwe; Hillmer-Vogel, Ursula; Rüther, Eckart

doi:10.1176/ajp.155.5.603

Cited by 297 publications

(224 citation statements)

References 38 publications

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“…Reduced locomotor activity may confound interpretation of behavior in anxiety tests. Data from animals without locomotor depression in the open field (related to testing time) demonstrate decreased anxiety in exercise groups and are consistent with clinical studies that indicate beneficial effects of exercise for anxiety (Steptoe et al, 1989;Broocks et al, 1998).…”

Section: Discussionsupporting

confidence: 81%

Voluntary exercise produces antidepressant and anxiolytic behavioral effects in mice

et al. 2008

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Reports of beneficial effects of exercise on psychological health in humans are increasingly supported by basic research studies. Exercise is hypothesized to regulate antidepressant-related mechanisms and we therefore characterized the effects of chronic exercise in mouse behavioral paradigms relevant to antidepressant actions. Mice given free access to running wheels showed antidepressant-like behavior in learned helplessness, forced-swim (FST) and tail suspension paradigms. These responses were similar to responses of antidepressant drug-treated animals. When tested under conditions where locomotor activity was not altered, exercising mice also showed reduced anxiety compared to sedentary control mice. In situ hybridization analysis showed that BDNF mRNA was increased in specific subfields of hippocampus after wheel running. We chose one paradigm, the FST, in which to investigate a functional role for brain-derived neurotrophic factor (BDNF) in the behavioral response to exercise. We tested mice heterozygous for a deletion of the BDNF gene in the FST after wheel-running. Exercising wild-type mice showed the expected antidepressant-like behavioral response in the FST but exercise was ineffective in improving FST performance in heterozygous BDNF knockout mice. A possible functional contribution of a BDNF signaling pathway to FST performance in exercising mice was investigated using the specific MEK inhibitor PD184161 to block the MAPK signaling pathway. Subchronic administration of PD184161 to exercising mice blocked the antidepressant-like behavioral response seen in vehicle-treated exercising mice in the FST. In summary, chronic wheel-running exercise in mice results in antidepressant-like behavioral changes that may involve a BDNF related mechanism similar to that hypothesized for antidepressant drug treatment.

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Section: Discussionsupporting

confidence: 81%

Voluntary exercise produces antidepressant and anxiolytic behavioral effects in mice

et al. 2008

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“…In a prospective study without a control group, patients with panic disorder and agoraphobia improved following an 8-week inpatient programme, mainly consisting of daily aerobic exercise, but the majority relapsed at 1-year follow-up (31). To date, the only randomized test of exercise for anxiety disorders was conducted by Broocks and colleagues (32), who assigned patients with panic disorder to aerobic exercise, antidepressant medication and placebo tablets for 8 weeks. Both exercise and medication were significantly more effective than placebo, and medication was more effective than exercise.…”

Section: Treatment Of Anxiety Disordersmentioning

confidence: 99%

Physical activity in the prevention and treatment of anxiety and depression

Martinsen¹

2008

Nordic Journal of Psychiatry

312

180

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“…Essa envolve ainda dois outros fatores: comportamentos de evitação de atividades ou exercícios físicos e situações desencadeantes de sintomas cardiovasculares percebidos como perigosos e a hipervigilância para a ocorrência de tais sintomas 4 . Em uma revisão recente 5 , pudemos evidenciar que os exercícios físicos podem desempenhar um papel importante no tratamento do TP; isso se manifesta primariamente por meio de seu efeito antipânico agudo 6 e na melhora dos sintomas com a prática regular 7 . Algumas hipóteses mecanísticas foram aventadas para explicar tal efeito, incluindo o aumento dos níveis de fator neurotrófico cerebral (BDNF) 8 e o sistema serotoninérgico 9 .…”

Section: The Present Article Reports the Use Of An Interval Aerobic Eunclassified

Treinamento físico intervalado como ferramenta na terapia cognitivo-comportamental do transtorno de pânico

Sardinha

Araújo

Nardi

2011

J. bras. psiquiatr.

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rESUMoEste trabalho consiste no relato da utilização de um programa de exercícios físicos aeró-bicos intervalados no contexto da terapia cognitivo-comportamental em um caso de transtorno de pânico e agorafobia. São descritos os procedimentos utilizados, bem como os resultados positivos obtidos na redução da ansiedade cardíaca e na ansiedade cotidiana em relação a situações que exigem esforço físico. A ansiedade cardíaca é um tipo de ansiedade relacionada à saúde em que as preocupações do paciente estão especificamente voltadas para o sistema cardiovascular e para a possibilidade de ter um evento cardiovascular agudo ou de desenvolver uma doença coronariana 3 . Essa envolve ainda dois outros fatores: comportamentos de evitação de atividades ou exercícios físicos e situações desencadeantes de sintomas cardiovasculares percebidos como perigosos e a hipervigilância para a ocorrência de tais sintomas 4 . Em uma revisão recente 5 , pudemos evidenciar que os exercícios físicos podem desempenhar um papel importante no tratamento do TP; isso se manifesta primariamente por meio de seu efeito antipânico agudo 6 e na melhora dos sintomas com a prática regular 7 . Algumas hipóteses mecanísticas foram aventadas para explicar tal efeito, incluindo o aumento dos níveis de fator neurotrófico cerebral (BDNF) 8 e o sistema serotoninérgico 9 . É possível ainda que, dentro da hipótese do condicionamento interoceptivo 10 , a exposição gradual ao exercício físico possa promover habituação do sistema

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Comparison of Aerobic Exercise, Clomipramine, and Placebo in the Treatment of Panic Disorder

Abstract: These results suggest that regular aerobic exercise alone, in comparison with placebo, is associated with significant clinical improvement in patients suffering from panic disorder, but that it is less effective than treatment with clomipramine.

Cited by 297 publications

References 38 publications

Voluntary exercise produces antidepressant and anxiolytic behavioral effects in mice

Voluntary exercise produces antidepressant and anxiolytic behavioral effects in mice

Physical activity in the prevention and treatment of anxiety and depression

Treinamento físico intervalado como ferramenta na terapia cognitivo-comportamental do transtorno de pânico

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