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Cortisol concentrations following a 35% CO2 inhalation in panic disorder patients and healthy volunteers
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P.3. Anxiety disorders and anxiolytics
procedures. Mice were placed at the center of the apparatus and the time spent by each animal in open and closed arms was registered during 5 min. Anxiolytic compounds reduce the natural animal's aversion to the open arms and promote the exploration therefore it was considered as anxiolytic effect the increasing of the time spent in open arms, when compared with control group treated with vehicle. EOCc and EOCa were able to significantly enhance (p<0,05, ANOVA followed by Duncan's test) the time spent on open arms. EOCc increased twice (lg/kg) and EOCa was able to increase three (0,5 g/kg) and five (1,0 g/kg) times the permanence in open arms. Animals submitted to the same treatment were evaluated on open field (ambulation, rearing, grooming and freezing) and rota-rod tests (12 r.p.m.), to discard the possibility of these results to be due to motor impairment, represented by the incapacity of treated animals to move on EPM. There were no observed differences among control and treated groups in any of the parameters evaluated in these tests, suggesting that essential oils did not cause damages on motor coordination or equilibrium. These results indicate that the effect detected in EPM is due to presence of anxiolytic activity on essential oils obtained from both species. Besides the confirmation of ethnopharmacological use, which could be useful in primary medical care, compounds responsible for activity could be a source of prototypes to pharmacological and chemical studies, in order to design new safe drugs to treat anxiety. Financial support: FAPESR CAPES.
disorder and all had been free of psychotropic medication for at least three weeks before entering the study. The comparison group consisted of 12 healthy volunteers (7 women and 5 men). Baseline saliva samples were taken at 15.30. Directly thereafter, the CO2 challenge was applied, which consists of inhaling one vital breath capacity of a gas mixture consisting of 35% CO2 and 65% 02 through a self-administration mask. A second saliva sample was taken at 16.30. Results: At baseline, the patients had significantly lower saliva cortisol values (p=0.011) compared to the control group. At 16.30 the difference between the groups was not significant (p=0.076). The slight increase in corfisol concentrations in both groups between 15.30 and 16.30 was not significant. Conclusion: The difference in cortisol concentrations between the groups at baseline needs to be interpreted very carefully. The groups are small and the causal significance of this data remains unclear. It is possible that stronger reactions evolve when baseline cortisol values are lower. Further, the second saliva sample was taken almost an hour after the CO2 challenge. It is conceivable that the inhalation did induce a direct increase in cortisol secretion, which was no longer detectable after an hour. In conclusion, this study provides some indications for an aberrant cortisol secretion in PD. Whether this can be ascribed to stress reactivity or to a different circadian rhythm of cortisol secretion in PD needs further investigation.
References
•
[1] Almeida-Filho, N., Marl, J.J., Coutinho, E., Fran~a, J.F., Fernandes, J., Andreoli, S.B., Busnello, E.A., 1997. Brazilian multicentric study of psychiatric morbidity. Br. J. Psychiatry: 171,524 529. [2] Heinrich, M., Gibbons, S., 2001. Ethnopharmacology in drug discovery: an analysis of its role and potential contribution. J. Pharm. Pharmacol. 53:425432.
•
Cortisol concentrations following a 35% CO2 inhalation in panic disorder patients and healthy volunteers
M. Van Duinen 1, K. Schruers 2, E. Griez 2. 1Maastricht
University, PMS Vtjverdal, Academisch Angst Centrum, Maastricht, The Netherlands, :Maastricht University, Psychiatry & Neuropsychology, Maastricht, The Netherlands' Objective: The panic attack (PA), the core feature of the panic disorder (PD), is hard to investigate in its real-life appearance, as unpredictability is one of its most important features. The 35% CO2 challenge offers a good opportunity to study the PA in standardized laboratory surroundings. The symptoms elicited by the inhalation procedure resemble closely the symptoms of a PA, including the fast crescendo course. For healthy volunteers, this test causes some physical stress. In panic disorder patients, on the other hand, the 35% CO2 challenge elicits a reaction closely resembling a natural panic attack. Strong evidence exists for the involvement of the neurotransmitter serotonin (5-hydroxytryptamine; 5-HT) in PD. The functionality of the serotonergic system can be derived from a number of parameters which are considered to be under serotonergic control. The adrenal cortex hormone cortisol, determined in saliva, is used in this study to provide an index of central 5-HT activity. Method: Twelve PD patients (5 women, 7 men), with or without agoraphobia according to the DSM-IV criteria, participated in this study. None of the patients had a concurrent axis I or axis II
Predicting treatment response to SSRIs in panic disorder
A. Herran, D. Sierra-Biddle, M. Carrera, E. Cort~izar, A. Ayestarfin, J.L. Vazquez-Barquero. Hospital Marques de
Valdecilla. Univ. of Cantabria, Dept. Psyehiat~. Hospital Marques de Valdecilla, Santander, Spain Objective: Selective serotonin reuptake inhibitors (SSRIs) are the treatment of choice for patients with panic disorder. Despite a limited number of studies analysing clinical factors associated with short-term response to pharmacotherapy, there are not published reports studying this particular issue in patients treated with SSRIs in panic disorder. Methods: Patients with DSM-IV criteria of panic disorder, with or without agoraphobia were included in the study if they have never had previous treatment (neither pharmacotherapy nor psychotherapy). Diagnostic criteria were assessed by the Mini International Neuropsychiatric Interview (MINI). Clinical severity was measured by means of the Panic Disorder Severity Scale (PDSS) and the Clinical Global Impression (CGI) scale. In addition, patients were evaluated for their state and trait anxiety (STAI), depressive symptoms (Beck), anxiety sensitivity (Anxiety Sensitivity Index) and personality traits (Millon Clinical Multiaxial Inventory-lI - MCMI-II - and Costa y McCrae's NEO-FFI inventory). Patients entered in a flexible-dose design of SSRIs and were assessed at 8 weeks follow-up. Patients were considered responders if they were much or very much improved on the CGI and had a PDSS score at least 30% below their baseline. Data were analysed with the statistical package SPSS 8.0. Nonparamentric tests (Chi-square, Fisher's Exact Test, U-Mann-Whitney, Spearman) were used as appropriate, and linear regression was used in order to analyse the relative influence of independent variables. Results: Thirty-eight patients (12 male, 26 female; mean age 31 years-old) were included in the study and completed the followup. Mean age at onset of panic disorder was 28, and patients
P.3. Anxiety disorders and anxiolytics
procedures. Mice were placed at the center of the apparatus and the time spent by each animal in open and closed arms was registered during 5 min. Anxiolytic compounds reduce the natural animal's aversion to the open arms and promote the exploration therefore it was considered as anxiolytic effect the increasing of the time spent in open arms, when compared with control group treated with vehicle. EOCc and EOCa were able to significantly enhance (p<0,05, ANOVA followed by Duncan's test) the time spent on open arms. EOCc increased twice (lg/kg) and EOCa was able to increase three (0,5 g/kg) and five (1,0 g/kg) times the permanence in open arms. Animals submitted to the same treatment were evaluated on open field (ambulation, rearing, grooming and freezing) and rota-rod tests (12 r.p.m.), to discard the possibility of these results to be due to motor impairment, represented by the incapacity of treated animals to move on EPM. There were no observed differences among control and treated groups in any of the parameters evaluated in these tests, suggesting that essential oils did not cause damages on motor coordination or equilibrium. These results indicate that the effect detected in EPM is due to presence of anxiolytic activity on essential oils obtained from both species. Besides the confirmation of ethnopharmacological use, which could be useful in primary medical care, compounds responsible for activity could be a source of prototypes to pharmacological and chemical studies, in order to design new safe drugs to treat anxiety. Financial support: FAPESR CAPES.
disorder and all had been free of psychotropic medication for at least three weeks before entering the study. The comparison group consisted of 12 healthy volunteers (7 women and 5 men). Baseline saliva samples were taken at 15.30. Directly thereafter, the CO2 challenge was applied, which consists of inhaling one vital breath capacity of a gas mixture consisting of 35% CO2 and 65% 02 through a self-administration mask. A second saliva sample was taken at 16.30. Results: At baseline, the patients had significantly lower saliva cortisol values (p=0.011) compared to the control group. At 16.30 the difference between the groups was not significant (p=0.076). The slight increase in corfisol concentrations in both groups between 15.30 and 16.30 was not significant. Conclusion: The difference in cortisol concentrations between the groups at baseline needs to be interpreted very carefully. The groups are small and the causal significance of this data remains unclear. It is possible that stronger reactions evolve when baseline cortisol values are lower. Further, the second saliva sample was taken almost an hour after the CO2 challenge. It is conceivable that the inhalation did induce a direct increase in cortisol secretion, which was no longer detectable after an hour. In conclusion, this study provides some indications for an aberrant cortisol secretion in PD. Whether this can be ascribed to stress reactivity or to a different circadian rhythm of cortisol secretion in PD needs further investigation.
References
•
[1] Almeida-Filho, N., Marl, J.J., Coutinho, E., Fran~a, J.F., Fernandes, J., Andreoli, S.B., Busnello, E.A., 1997. Brazilian multicentric study of psychiatric morbidity. Br. J. Psychiatry: 171,524 529. [2] Heinrich, M., Gibbons, S., 2001. Ethnopharmacology in drug discovery: an analysis of its role and potential contribution. J. Pharm. Pharmacol. 53:425432.
•
Cortisol concentrations following a 35% CO2 inhalation in panic disorder patients and healthy volunteers
M. Van Duinen 1, K. Schruers 2, E. Griez 2. 1Maastricht
University, PMS Vtjverdal, Academisch Angst Centrum, Maastricht, The Netherlands, :Maastricht University, Psychiatry & Neuropsychology, Maastricht, The Netherlands' Objective: The panic attack (PA), the core feature of the panic disorder (PD), is hard to investigate in its real-life appearance, as unpredictability is one of its most important features. The 35% CO2 challenge offers a good opportunity to study the PA in standardized laboratory surroundings. The symptoms elicited by the inhalation procedure resemble closely the symptoms of a PA, including the fast crescendo course. For healthy volunteers, this test causes some physical stress. In panic disorder patients, on the other hand, the 35% CO2 challenge elicits a reaction closely resembling a natural panic attack. Strong evidence exists for the involvement of the neurotransmitter serotonin (5-hydroxytryptamine; 5-HT) in PD. The functionality of the serotonergic system can be derived from a number of parameters which are considered to be under serotonergic control. The adrenal cortex hormone cortisol, determined in saliva, is used in this study to provide an index of central 5-HT activity. Method: Twelve PD patients (5 women, 7 men), with or without agoraphobia according to the DSM-IV criteria, participated in this study. None of the patients had a concurrent axis I or axis II
Predicting treatment response to SSRIs in panic disorder
A. Herran, D. Sierra-Biddle, M. Carrera, E. Cort~izar, A. Ayestarfin, J.L. Vazquez-Barquero. Hospital Marques de
Valdecilla. Univ. of Cantabria, Dept. Psyehiat~. Hospital Marques de Valdecilla, Santander, Spain Objective: Selective serotonin reuptake inhibitors (SSRIs) are the treatment of choice for patients with panic disorder. Despite a limited number of studies analysing clinical factors associated with short-term response to pharmacotherapy, there are not published reports studying this particular issue in patients treated with SSRIs in panic disorder. Methods: Patients with DSM-IV criteria of panic disorder, with or without agoraphobia were included in the study if they have never had previous treatment (neither pharmacotherapy nor psychotherapy). Diagnostic criteria were assessed by the Mini International Neuropsychiatric Interview (MINI). Clinical severity was measured by means of the Panic Disorder Severity Scale (PDSS) and the Clinical Global Impression (CGI) scale. In addition, patients were evaluated for their state and trait anxiety (STAI), depressive symptoms (Beck), anxiety sensitivity (Anxiety Sensitivity Index) and personality traits (Millon Clinical Multiaxial Inventory-lI - MCMI-II - and Costa y McCrae's NEO-FFI inventory). Patients entered in a flexible-dose design of SSRIs and were assessed at 8 weeks follow-up. Patients were considered responders if they were much or very much improved on the CGI and had a PDSS score at least 30% below their baseline. Data were analysed with the statistical package SPSS 8.0. Nonparamentric tests (Chi-square, Fisher's Exact Test, U-Mann-Whitney, Spearman) were used as appropriate, and linear regression was used in order to analyse the relative influence of independent variables. Results: Thirty-eight patients (12 male, 26 female; mean age 31 years-old) were included in the study and completed the followup. Mean age at onset of panic disorder was 28, and patients