Experimental induction of panic-like symptoms in patients with postural tachycardia syndrome

Khurana, Ramesh K.

doi:10.1007/s10286-006-0365-0

Cited by 36 publications

(17 citation statements)

References 29 publications

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“…Masuki et al showed that excessive increase in heart rate in patients with POTS in response to orthostatic stress is not caused by anxiety 29. Khurana collected data on anxiety and somatic symptoms in response to anxiety provoking stimuli and found that symptoms of POTS were distinguishable from symptoms of panic disorder 31. Taken together, the evidence suggests that clinically observed anxiety in patients with POTS is caused by biological rather than psychological factors.…”

Section: Discussionmentioning

confidence: 99%

Psychiatric profile and attention deficits in postural tachycardia syndrome

Raj

Haman

Raj

et al. 2009

Journal of Neurology, Neurosurgery & Psychiatry

105

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Objectives-Patients with postural tachycardia syndrome (POTS) often appear anxious and report inattention. We formally assessed patients with POTS for psychiatric disorders and inattention and compared them to patients with attention deficit hyperactivity disorder (ADHD) and control subjects. Methods-Patients with POTS (N=21), ADHD (N=18) and normal control subjects (N=20) were assessed for DSM-IV psychiatric disorders and completed a battery of questionnaires that assessed depression, anxiety and ADHD characteristics.Results-Patients with POTS did not have an increased prevalence of major depression or anxiety disorders, including panic disorder, compared to the general population. Patients with POTS had mild depression. They scored as moderately anxious on the Beck Anxiety Inventory, but did not exhibit a high level of anxiety sensitivity. Patients with POTS scored significantly higher on inattention and ADHD subscales than control subjects. These symptoms were not present during childhood.Conclusions-Patients with POTS do not have an increased lifetime prevalence of psychiatric disorders. Although they may seem anxious, they do not have excess cognitive anxiety. They do experience significant inattention, which may be an important source of disability. Search Terms

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Section: Discussionmentioning

confidence: 99%

Psychiatric profile and attention deficits in postural tachycardia syndrome

Raj

Haman

Raj

et al. 2009

Journal of Neurology, Neurosurgery & Psychiatry

105

View full text Add to dashboard Cite

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“…Later Stewart et al also carried out studies in the pediatric field, and reported three different types of POTS from the aspect of peripheral circulation 27,28 . POTS has also drawn attention from another field in relation to chronic fatigue syndrome 29 or psychiatric diseases such as panic disorder 30 . In 1991 Tanaka et al first reported a new type of OD involving standing dizziness in children 31 .…”

Section: Research On Orthostatic Dysregulationmentioning

confidence: 99%

Japanese clinical guidelines for juvenile orthostatic dysregulation version 1

Tanaka

Fujita

Takenaka

et al. 2009

Pediatrics International

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This clinical practice guideline provides recommendations for the assessment, diagnosis and treatment of school-aged children and juveniles with orthostatic dysregulation (OD), usually named orthostatic intolerance in USA and Europe. This guideline is intended for use by primary care clinicians working in primary care settings. The guideline contains the following recommendations for diagnosis of OD: (i) initial evaluation composed of including and excluding criteria, the assessment of no evidence of other disease including cardiac disease and so on; (ii) a new orthostatic test to determine four different subsets: instantaneous orthostatic hypotension, postural tachycardia syndrome, neurally mediated syncope and delayed orthostatic hypotension; (iii) evaluation of severity; and (iv) judgment of psychosocial background with the use of rating scales. The guideline also contains the following recommendations for treatment of OD on the basis of the result of an orthostatic test in addition to psychosocial assessment: (i) guidance and education for parents and children; (ii) non-pharmacological treatments; (iii) contact with school personnel; (iv) use of adrenoceptor stimulants and other medications; (v) strategies of psychosocial intervention; and (vi) psychotherapy. This clinical practice guideline is not intended as a sole source of guidance in the evaluation of children with OD. Rather, it is designed to assist primary care clinicians by providing a framework for decision making of diagnosis and treatments.

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“…POTS patients present with cardiovascular and panic-like symptoms [12]. Treatment is mostly symptom-oriented and includes methylphenidate, bupropion, octreotide, midodrine, and modafinil [5,7,25].…”

Section: Discussionmentioning

confidence: 99%