Effects of the cortisol synthesis inhibitor metyrapone on the response to carbon dioxide challenge in panic disorder
| Autor: | Uri Loewenthal, Jonathan Arbelle, Jonathan Benjamin, Hagit Cohen, Leonid Knyazhansky, Andrey Belgorodsky |
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| Rok vydání: | 2005 |
| Předmět: |
Hypothalamo-Hypophyseal System
endocrine system medicine.medical_specialty Cortisol awakening response Hydrocortisone Antimetabolites Corticotropin-Releasing Hormone Pituitary-Adrenal System Placebo Corticotropin-releasing hormone Adrenocorticotropic Hormone Surveys and Questionnaires Internal medicine Administration Inhalation medicine Humans Metyrapone Panic disorder Panic Carbon Dioxide medicine.disease Diagnostic and Statistical Manual of Mental Disorders Psychiatry and Mental health Clinical Psychology Endocrinology Anxiogenic Panic Disorder Anxiety medicine.symptom Psychology hormones hormone substitutes and hormone antagonists medicine.drug |
| Zdroj: | Depression and Anxiety. 21:143-148 |
| ISSN: | 1520-6394 1091-4269 |
| DOI: | 10.1002/da.20062 |
| Popis: | Despite the well-known association between the hypothalamic-pituitary-adrenal (HPA) axis and normal fear, it is still unclear (a) to what extent corticotropin releasing hormone (CRH) or cortisol itself mediates fear responses, and (b) to what extent the HPA axis also affects panic disorder. The carbon-dioxide (CO2) challenge has been proposed as a model for panic. Participants received the cortisol synthesis inhibitor metyrapone 30 mg/kg of body weight once and placebo once, with 1 week between challenges, at 2300 h. The following morning, blood was taken for cortisol and ACTH levels, and then participants inhaled a single vital capacity inhalation of 35% CO2 and 65% oxygen. Before and after the inhalation, participants completed an inventory of the 13 DSM-IV symptoms of panic and the NIMH questionnaire of psychological and physical symptoms. Eight healthy controls and 14 patients with panic disorder completed the protocol. As expected, CO2 increased measures of anxiety, and metyrapone lowered cortisol and increased ACTH levels. Prechallenge anxiety was modestly lowered by metyrapone, but response to CO2 was not affected. Cortisol and ACTH levels before challenge partly predicted the response to CO2. The results support an anxiogenic role for cortisol in stress, and suggest that the pathophysiological mechanism that mediates CO2-induced panic differs from those underlying other kinds of anxiety. |
| Databáze: | OpenAIRE |
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