beta-endorphin and Panic-Disorder

The effects of pentagastrin, a synthetic analogue of the cholecystokinin tetrapeptide (CCK4), were studied in 15 patients with panic disorder and 15 healthy controls. Three different intravenous dosages of pentagastrin (0.1, 0.3 and 0.6 microgram/kg) and saline were investigated. Subjects were randomly allocated to two of the four treatment groups and tested on two separate occasions, 1 week apart, using an unbalanced double-blind incomplete block design. The mean panic rate with pentagastrin was 55% (12/22) for patients and 5% (1/22) for controls. None of the subjects panicked with saline. The frequency of panic attacks between the three pentagastrin doses in patients was not different. One control subject had a panic-like attack at the highest dose of pentagastrin. These findings concur with previous studies on the panicogenic effect of CCK4 and pentagastrin and suggest a greater sensitivity for CCK receptor agonists in patients suffering from panic disorder than in healthy controls.

Topics: Adult; beta-Endorphin; Cholecystokinin; Dose-Response Relationship, Drug; Double-Blind Method; Female; Humans; Hydrocortisone; Melatonin; Methoxyhydroxyphenylglycol; Middle Aged; Norepinephrine; Panic Disorder; Pentagastrin; Prolactin; Psychiatric Status Rating Scales; Psychometrics; Serotonin

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; Arousal; beta-Endorphin; Dynorphins; Female; Humans; Male; Panic Disorder; Peptide Fragments; Personality Inventory