Some Biochemical Correlates of Panic Attacks with Agoraphobia and Their Response to a New Treatment

Sheehan, David V.; Coleman, James H.; Greenblatt, David J.; Jones, Ken; Levine, Peter H.; Orsulak, Paul J.; Peterson, M. Alex; Schildkraut, Joseph J.; Uzogara, Eugene; Watkins, David I.

doi:10.1097/00004714-198404020-00002

Cited by 154 publications

(24 citation statements)

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“…MHPG was assayed in both studies (by D C. Jimerson), thereby controlling for variance which might be attributed to differences in laboratory tech niques. Sheehan et al [69] also found a trend for urinary MHPG excretion to be higher in pa tients with panic attacks compared to controls.…”

Section: Indices Of Noradrenergic Functionmentioning

confidence: 89%

Fear and Anxiety: Relationship to Noradrenergic Function

et al. 1984

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The experiences of human fear and anxiety are discussed within the context of locus ceruleus function in animals. The rationale for studying correlates of noradrenergic function, such as 3-methoxy-4-hydroxyphenethylene glycol (MHPG), is reviewed, and data demonstrating a positive correlation between plasma free MHPG and state anxiety in normal volunteers is presented. The behavioral effects of oral caffeine (240–720 mg), intravenous clonidine (2 µg/kg), and oral yohimbine (20 mg) were studied in various psychiatric patients and normal volunteers. Caffeine and yohimbine had anxiogenic properties; conversely, clonidine reduced self-rated measures of anxiety across a wide spectrum of psychiatric conditions. These findings expand previous research indicating that noradrenergic hyperactivity may be associated with many types of human fear and anxiety.

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Section: Indices Of Noradrenergic Functionmentioning

confidence: 89%

Fear and Anxiety: Relationship to Noradrenergic Function

et al. 1984

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“…Its major distinction is that its struc ture differs from that of the other benzodi azepines; it contains a triazolo ring, and seems to work not only in anxiety but has been reported by at least one group of inves tigators to have antipanic effects. In doses in the 2-to 10-mg range, with a mean dose of 6-6*/2 mg, it may be useful for the treatment of panic attacks and agoraphobia with panic attacks [30].…”

Section: T Riazolobenzodiazepinesmentioning

confidence: 99%

Benzodiazepine and Nonbenzodiazepine Anxiolytics

Goldberg¹

1984

Psychopathology

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A review of anxiolytic drugs is presented, including ethyl alcohol, barbiturates, diphenylmethane derivatives, glycerol and propanediol derivatives, antipsychotics, and anti-depressants. Focus on the benzodiazepines and their metabolism and method of action follows. The newest two groups are then reviewed: triazolobenzodiazepines and azaspirodecanediones. The first member of this latter group, buspirone, is then reviewed in detail including the author’s personal studies of the drug. The fact that it appears nonaddicting, nonsynergistic with alcohol, lacks impairment of driving-related skills, and is very effective in treating anxiety, may represent a breakthrough.

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“…Buspirone is scientifically interesting because of its rela tively selective effect on a subpopulation of serotonin receptors, and clinically interest ing because it has a different side effect pro file than drugs currently available for panic disorder. Alprazolam and other benzodiaze pines are effective for panic disorder, ac cording to numerous studies [23][24][25][26][27][28] …”

mentioning

confidence: 95%

Serotonergic Anxiolytics in the Treatment of Panic Disorder: A Controlled Study With Buspirone

et al. 1989

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The efficacy of buspirone for panic disorder was tested in 60 patients who met Diagnostic and Statistical Manual of Mental Disorders (3rd ed.) criteria for panic disorder or agoraphobia with panic attacks. Patients were randomly assigned to treatment with buspirone (mean dose 29.5 mg/day), imipramine (mean dose 140 mg/day), or placebo, and treated for 8 weeks after a 4- to 7-day placebo lead-in period. Patients with 4 or fewer attacks per month and those without attacks at the baseline visit were excluded from panic frequency comparisons. Both buspirone and imipramine tended to be better than placebo on total number of panic attacks, global psychopathology, and the Hamilton Anxiety rating scale, but end point differences among treatments were not statistically significant. At the end of the study, 25% of the buspirone patients were panic-free, as were 7% of the imipramine patients and 14% of the placebo patients; again, these differences were not statistically significant. The results of this study were inconclusive, partly because of the relatively small number of patients (10–11) completing the study in each treatment group, and partly because of a robust placebo response in this population. Possible reasons for this high placebo response are discussed, as well as suggestions for changes in study design for future studies.

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Some Biochemical Correlates of Panic Attacks with Agoraphobia and Their Response to a New Treatment

Cited by 154 publications

References 0 publications

Fear and Anxiety: Relationship to Noradrenergic Function

Fear and Anxiety: Relationship to Noradrenergic Function

Benzodiazepine and Nonbenzodiazepine Anxiolytics

Serotonergic Anxiolytics in the Treatment of Panic Disorder: A Controlled Study With Buspirone

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