Effect of medication and psychotherapy on heart rate variability in panic disorder

Garakani, Amir; Martı́nez, José M.; Aaronson, Cindy J.; Voustianiouk, Andrei; Kaufmann, Horacio; Gorman, Jack M.

doi:10.1002/da.20533

Cited by 90 publications

(54 citation statements)

References 58 publications

(48 reference statements)

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“…Seven studies with Panic Disorder patients were found, four randomized (Meuret et al, 2012;Craske et al, 2005;Riley et al, 1995;Roth et al, 1987), two controlled trials (Garakani et al, 2009;Mussgay and Rüddel, 2004) and one open study (Ehlers et al, 1995).…”

Section: Panic Disorder With or Without Agoraphobiamentioning

confidence: 99%

Listening to the heart: A meta-analysis of cognitive behavior therapy impact on the heart rate of patients with anxiety disorders

Gonçalves

Rodrigues

Novaes

et al. 2015

Journal of Affective Disorders

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Section: Panic Disorder With or Without Agoraphobiamentioning

confidence: 99%

Listening to the heart: A meta-analysis of cognitive behavior therapy impact on the heart rate of patients with anxiety disorders

Gonçalves

Rodrigues

Novaes

et al. 2015

Journal of Affective Disorders

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“…Previous studies (Garakani et al, 2009;Martinez, Garakani, Kaufmann, Aaronson, & Gorman, 2010) found a significantly lowered pNN50% in panic disorders relative to controls, suggesting that more anxiety caused a decrease in pNN50%. This study also found a significant increase of the pNN50 from the post-compared to the pretreatment mpTSST, showing that participants had lower levels of anxiety during the posttreatment mpTSST.…”

Section: Sdnnmentioning

confidence: 75%

1120 Effects of Post-Exposure Naps on Change in Autonomic Arousal to A social Challenge Across Exposure Therapy for Social Anxiety

Kim

Bottary

et al. 2017

Sleep

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“…Interestingly, patients with depression and several forms of anxiety disorder have evidence of reduced heart rate variability. Others and we have shown that effective cognitive behavioral therapy for patients with panic disorder also results in an increase in high frequency heart period variability, representing an improvement in parasympathetic control over cardiovascular physiology [2]. Thus the well-known links between psychiatric illness and risk for heart disease may be similarly mediated at least in part by ANS imbalance and be susceptible to behavioral interventions.…”

mentioning

confidence: 74%

A plausible mechanism for a non-pharmacological therapy for hypertension

Gorman¹

2015

Clin Auton Res

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One of the triumphs of modern medicine and public health has been the recognition that high blood pressure is a risk factor for cardiovascular disease and the subsequent development of multiple effective pharmacological interventions to lower blood pressure in hypertensive patients.None of these medications is, of course, without adverse side effects. Because autonomic nervous system (ANS) dysfunction is suspected as an important cause of hypertension there is long-standing interest in the possibility that behavioral interventions that affect the ANS might also be effective for treating hypertension, with fewer risks. Modesti et al. provide us with impressive evidence that this may indeed be possible. It was previously shown that daily sessions of slow breathing significantly lowered 24-h ambulatory blood pressure in patients with mild hypertension, an effect that was sustained for 6 months after breathing sessions had been discontinued. Here they sought to understand whether the ameliorative effect of slow breathing on blood pressure is accompanied by measureable changes in ANS function. In a controlled study, they indeed found that 1 week of music-guided slow breathing sessions lasting at least 30 min each increased the high frequency component of heart period variability and reduced renal resistance. These changes preceded improvement in both baroreflex sensitivity and blood pressure.The findings are important because they not only add to mounting evidence that behavioral interventions like meditation, yoga, and slow breathing can improve cardiovascular and immune function but also provide a plausible mechanism by which slow breathing improves blood pressure in patients with hypertension. Autonomic imbalance, characterized by excessive sympathetic and deficient parasympathetic innervation to the heart, has long been linked to risk for cardiovascular disease [1]. Interestingly, patients with depression and several forms of anxiety disorder have evidence of reduced heart rate variability. Others and we have shown that effective cognitive behavioral therapy for patients with panic disorder also results in an increase in high frequency heart period variability, representing an improvement in parasympathetic control over cardiovascular physiology [2]. Thus the well-known links between psychiatric illness and risk for heart disease may be similarly mediated at least in part by ANS imbalance and be susceptible to behavioral interventions.As Modesti et al. recognize, this is a small sample study that requires replication. It will also be interesting to find out how long these positive ANS changes persist once slow breathing sessions are discontinued. It may at first be difficult to understand how they could be sustained in the absence of an ANS manipulation like slow breathing, but it must also be remembered that the effect on blood pressure seems to last at least 6 months after treatment discontinuation. The ultimate test of slow breathing efficacy will be comparison of antihypertensive medication to behavioral inte...

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Effect of medication and psychotherapy on heart rate variability in panic disorder

Cited by 90 publications

References 58 publications

Listening to the heart: A meta-analysis of cognitive behavior therapy impact on the heart rate of patients with anxiety disorders

Listening to the heart: A meta-analysis of cognitive behavior therapy impact on the heart rate of patients with anxiety disorders

1120 Effects of Post-Exposure Naps on Change in Autonomic Arousal to A social Challenge Across Exposure Therapy for Social Anxiety

A plausible mechanism for a non-pharmacological therapy for hypertension

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