beta-endorphin and Agoraphobia

Cerebrospinal fluid (CSF) homovanillic acid, 5-hydroxyindoleacetic acid, 3-methoxy-4-hydroxyphenylglycol, and somatostatin and beta-endorphin levels were measured in 12 patients with panic disorder before and after 7 months of treatment with alprazolam or imipramine. The concentrations of CSF monoamine metabolites and neuropeptides were at baseline of the same order of magnitude in panic patients and controls. Neither alprazolam nor imipramine changed metabolite or neuropeptide levels in CSF despite clinical improvement in both treatment groups. According to present CSF data, the antipanic actions of alprazolam and imipramine do not involve the monoaminergic or peptidergic systems studied.

Topics: Adult; Agoraphobia; Alprazolam; Anxiety Disorders; beta-Endorphin; Clinical Trials as Topic; Double-Blind Method; Fear; Female; Glycols; Homovanillic Acid; Humans; Hydroxyindoleacetic Acid; Imipramine; Long-Term Care; Male; Methoxyhydroxyphenylglycol; Middle Aged; Panic; Somatostatin

Lactate infusions are anxiogenic in patients with panic disorder or agoraphobia with panic attacks, but few neuroendocrine profiles of this effect have appeared. The authors measured the number and intensity of panic symptoms and blood hormone levels during double-blind lactate infusions in 25 patients and 10 normal subjects and during placebo infusions in another five patients. Each patient was rechallenged with an identical infusate after chronic double-blind outpatient treatment with alprazolam or placebo. The results confirm the effectiveness of lactate infusions in evoking anxiety, extend previous hormone profiles of this maneuver, and indicate that chronic alprazolam treatment minimizes the neuroendocrine response to lactate challenges in patients with panic disorder or agoraphobia with panic attacks.

Topics: Adolescent; Adult; Agoraphobia; Alprazolam; Anti-Anxiety Agents; Anxiety Disorders; Benzodiazepines; beta-Endorphin; Endorphins; Epinephrine; Fear; Female; Growth Hormone; Hospitalization; Humans; Infusions, Parenteral; Lactates; Lactic Acid; Male; Methoxyhydroxyphenylglycol; Middle Aged; Norepinephrine; Panic; Placebos; Platelet Factor 4; Prolactin; Prostaglandins; Psychiatric Status Rating Scales; Sex Factors

Immunological, neuroendocrine and psychological parameters were examined in 14 psychophysically healthy subjects and in 17 panic disorder patients before and after a 30-day course of alprazolam therapy. T lymphocyte proliferation in response to the mitogen phytohemagglutinin, lymphocyte beta-endorphin (beta-EP) concentrations, plasma ACTH, cortisol and beta-EP levels were examined in basal conditions and after corticotropin-releasing hormone (CRH) stimulation. Cortisol inhibition by dexamethasone (DST) and basal growth hormone (GH) and prolactin levels were also examined. Depression, state or trait anxiety, anticipatory anxiety, agoraphobia, simple and social phobias, severity and frequency of panic attacks were monitored by rating scales. The immune study did not reveal any significant difference between patients and controls, or any effect of alprazolam therapy. The hormonal data for the two groups were similar, except for higher than normal basal ACTH and GH plasma levels, lower than normal ratios between the ACTH and cortisol responses to CRH, and blunted DST in some patients. All the impairments improved after alprazolam therapy, in parallel with decreases in anxiety and in severity and frequency of panic attacks.

Topics: Adolescent; Adrenocorticotropic Hormone; Adult; Agoraphobia; Alprazolam; beta-Endorphin; Corticotropin-Releasing Hormone; Dexamethasone; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Growth Hormone; Hormones; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Lymphocyte Activation; Male; Middle Aged; Panic Disorder; Personality Inventory; Pituitary-Adrenal System; Prolactin; Psychoneuroimmunology; T-Lymphocytes

Topics: Adult; Agoraphobia; beta-Endorphin; Depressive Disorder; Fear; Female; Humans; Infusions, Intravenous; Lactates; Lactic Acid; Male; Panic; Phobic Disorders