Hypothalamic-pituitary-adrenal axis activity in panic disorder: Effects of alprazolam on 24 h secretion of adrenocorticotropin and cortisol
Pre-clinical and some clinical evidence suggests that central overdrive within the hypothalamic-pituitary-adrenal (HPA) axis may play a role in panic disorder, and that the anti-panic efficacy of alprazolam may involve its ability to inhibit this drive. Detailed examination of 24 h secretion of adre...
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| Veröffentlicht in: | Journal of psychiatric research 1996-03, Vol.30 (2), p.79-93 |
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| creator | Abelson, James L. Curtis, George C. Cameron, Oliver G. |
| description | Pre-clinical and some clinical evidence suggests that central overdrive within the hypothalamic-pituitary-adrenal (HPA) axis may play a role in panic disorder, and that the anti-panic efficacy of alprazolam may involve its ability to inhibit this drive. Detailed examination of 24 h secretion of adrenocorticotropin (ACTH) and cortisol in 20 panic patients had revealed subtle HPA axis abnormalities prior to treatment. In order to determine whether these abnormalities resolve with alprazolam therapy, these patients were re-studied over a full circadian cycle after 12 weeks on alprazolam. Alprazolam produced substantial improvement in clinical status which was accompanied by nearly full resolution of pre-treatment hypercortisolemia. The impact of treatment on ACTH was more complex and influenced by symptom severity. The results are consistent with the hypotheses that HPA axis regulation is subtly disturbed in panic disorder and that impact on the HPA axis may play a role in alprazolam's mechanism of efficacy. |
| doi_str_mv | 10.1016/0022-3956(95)00035-6 |
| format | Article |
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Detailed examination of 24 h secretion of adrenocorticotropin (ACTH) and cortisol in 20 panic patients had revealed subtle HPA axis abnormalities prior to treatment. In order to determine whether these abnormalities resolve with alprazolam therapy, these patients were re-studied over a full circadian cycle after 12 weeks on alprazolam. Alprazolam produced substantial improvement in clinical status which was accompanied by nearly full resolution of pre-treatment hypercortisolemia. The impact of treatment on ACTH was more complex and influenced by symptom severity. The results are consistent with the hypotheses that HPA axis regulation is subtly disturbed in panic disorder and that impact on the HPA axis may play a role in alprazolam's mechanism of efficacy.</description><identifier>ISSN: 0022-3956</identifier><identifier>EISSN: 1879-1379</identifier><identifier>DOI: 10.1016/0022-3956(95)00035-6</identifier><identifier>PMID: 8816303</identifier><identifier>CODEN: JPYRA3</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Adrenocorticotropic Hormone - blood ; Adult ; Alprazolam - therapeutic use ; Anti-Anxiety Agents - therapeutic use ; Arousal - drug effects ; Arousal - physiology ; Biological and medical sciences ; Circadian Rhythm - drug effects ; Circadian Rhythm - physiology ; Corticotropin-Releasing Hormone - physiology ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Female ; Humans ; Hydrocortisone - blood ; Hypothalamo-Hypophyseal System - drug effects ; Hypothalamo-Hypophyseal System - physiopathology ; Male ; Medical sciences ; Neuropharmacology ; Panic Disorder - drug therapy ; Panic Disorder - physiopathology ; Pharmacology. Drug treatments ; Pituitary-Adrenal System - drug effects ; Pituitary-Adrenal System - physiopathology ; Psycholeptics: tranquillizer, neuroleptic ; Psychology. Psychoanalysis. Psychiatry ; Psychopharmacology ; Treatment Outcome</subject><ispartof>Journal of psychiatric research, 1996-03, Vol.30 (2), p.79-93</ispartof><rights>1996</rights><rights>1996 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c386t-fdcd1693e1259bd49c59e3f1a31fe5b8ea781e00a0822c3eb4bf7cfe0d70da603</citedby><cites>FETCH-LOGICAL-c386t-fdcd1693e1259bd49c59e3f1a31fe5b8ea781e00a0822c3eb4bf7cfe0d70da603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0022-3956(95)00035-6$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3137538$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8816303$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abelson, James L.</creatorcontrib><creatorcontrib>Curtis, George C.</creatorcontrib><creatorcontrib>Cameron, Oliver G.</creatorcontrib><title>Hypothalamic-pituitary-adrenal axis activity in panic disorder: Effects of alprazolam on 24 h secretion of adrenocorticotropin and cortisol</title><title>Journal of psychiatric research</title><addtitle>J Psychiatr Res</addtitle><description>Pre-clinical and some clinical evidence suggests that central overdrive within the hypothalamic-pituitary-adrenal (HPA) axis may play a role in panic disorder, and that the anti-panic efficacy of alprazolam may involve its ability to inhibit this drive. Detailed examination of 24 h secretion of adrenocorticotropin (ACTH) and cortisol in 20 panic patients had revealed subtle HPA axis abnormalities prior to treatment. In order to determine whether these abnormalities resolve with alprazolam therapy, these patients were re-studied over a full circadian cycle after 12 weeks on alprazolam. Alprazolam produced substantial improvement in clinical status which was accompanied by nearly full resolution of pre-treatment hypercortisolemia. The impact of treatment on ACTH was more complex and influenced by symptom severity. The results are consistent with the hypotheses that HPA axis regulation is subtly disturbed in panic disorder and that impact on the HPA axis may play a role in alprazolam's mechanism of efficacy.</description><subject>Adrenocorticotropic Hormone - blood</subject><subject>Adult</subject><subject>Alprazolam - therapeutic use</subject><subject>Anti-Anxiety Agents - therapeutic use</subject><subject>Arousal - drug effects</subject><subject>Arousal - physiology</subject><subject>Biological and medical sciences</subject><subject>Circadian Rhythm - drug effects</subject><subject>Circadian Rhythm - physiology</subject><subject>Corticotropin-Releasing Hormone - physiology</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug Administration Schedule</subject><subject>Female</subject><subject>Humans</subject><subject>Hydrocortisone - blood</subject><subject>Hypothalamo-Hypophyseal System - drug effects</subject><subject>Hypothalamo-Hypophyseal System - physiopathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neuropharmacology</subject><subject>Panic Disorder - drug therapy</subject><subject>Panic Disorder - physiopathology</subject><subject>Pharmacology. Drug treatments</subject><subject>Pituitary-Adrenal System - drug effects</subject><subject>Pituitary-Adrenal System - physiopathology</subject><subject>Psycholeptics: tranquillizer, neuroleptic</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopharmacology</subject><subject>Treatment Outcome</subject><issn>0022-3956</issn><issn>1879-1379</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFrFTEUhYMo9bX6DxSyEKmL0WQymUm6EKRUKxTc6DrcSW5oZN5kTPKKz7_gnzbT93hLVyE5554bvkPIK87ec8b7D4y1bSO07C-1fMcYE7Lpn5ANV4NuuBj0U7I5WZ6T85x_VtPQ8u6MnCnFe8HEhvy93S-x3MME22CbJZRdKJD2DbiEM0wUfodMwZbwEMqehpkuMAdLXcgxOUxX9MZ7tCXT6ClMS4I_sUbRONO2o_c0o01YQr2u-poZbUwl2FhSXGoczI4-vuQ4vSDPPEwZXx7PC_Lj883369vm7tuXr9ef7horVF8a76zjvRbIW6lH12krNQrPQXCPclQIg-LIGDDVtlbg2I1-sB6ZG5iDnokL8vaQu6T4a4e5mG3IFqcJZoy7bAYlhJRaVWN3MNoUc07ozZLCtuIxnJm1A7MCNitgo6V57MD0dez1MX83btGdho7Qq_7mqEO2MPkEsw35ZBO1PCnW7R8PNqwsHgImk23A2aILqSI3Lob__-MflQCmBA</recordid><startdate>19960301</startdate><enddate>19960301</enddate><creator>Abelson, James L.</creator><creator>Curtis, George C.</creator><creator>Cameron, Oliver G.</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19960301</creationdate><title>Hypothalamic-pituitary-adrenal axis activity in panic disorder: Effects of alprazolam on 24 h secretion of adrenocorticotropin and cortisol</title><author>Abelson, James L. ; Curtis, George C. ; Cameron, Oliver G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-fdcd1693e1259bd49c59e3f1a31fe5b8ea781e00a0822c3eb4bf7cfe0d70da603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Adrenocorticotropic Hormone - blood</topic><topic>Adult</topic><topic>Alprazolam - therapeutic use</topic><topic>Anti-Anxiety Agents - therapeutic use</topic><topic>Arousal - drug effects</topic><topic>Arousal - physiology</topic><topic>Biological and medical sciences</topic><topic>Circadian Rhythm - drug effects</topic><topic>Circadian Rhythm - physiology</topic><topic>Corticotropin-Releasing Hormone - physiology</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug Administration Schedule</topic><topic>Female</topic><topic>Humans</topic><topic>Hydrocortisone - blood</topic><topic>Hypothalamo-Hypophyseal System - drug effects</topic><topic>Hypothalamo-Hypophyseal System - physiopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neuropharmacology</topic><topic>Panic Disorder - drug therapy</topic><topic>Panic Disorder - physiopathology</topic><topic>Pharmacology. Drug treatments</topic><topic>Pituitary-Adrenal System - drug effects</topic><topic>Pituitary-Adrenal System - physiopathology</topic><topic>Psycholeptics: tranquillizer, neuroleptic</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopharmacology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abelson, James L.</creatorcontrib><creatorcontrib>Curtis, George C.</creatorcontrib><creatorcontrib>Cameron, Oliver G.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of psychiatric research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abelson, James L.</au><au>Curtis, George C.</au><au>Cameron, Oliver G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hypothalamic-pituitary-adrenal axis activity in panic disorder: Effects of alprazolam on 24 h secretion of adrenocorticotropin and cortisol</atitle><jtitle>Journal of psychiatric research</jtitle><addtitle>J Psychiatr Res</addtitle><date>1996-03-01</date><risdate>1996</risdate><volume>30</volume><issue>2</issue><spage>79</spage><epage>93</epage><pages>79-93</pages><issn>0022-3956</issn><eissn>1879-1379</eissn><coden>JPYRA3</coden><abstract>Pre-clinical and some clinical evidence suggests that central overdrive within the hypothalamic-pituitary-adrenal (HPA) axis may play a role in panic disorder, and that the anti-panic efficacy of alprazolam may involve its ability to inhibit this drive. Detailed examination of 24 h secretion of adrenocorticotropin (ACTH) and cortisol in 20 panic patients had revealed subtle HPA axis abnormalities prior to treatment. In order to determine whether these abnormalities resolve with alprazolam therapy, these patients were re-studied over a full circadian cycle after 12 weeks on alprazolam. Alprazolam produced substantial improvement in clinical status which was accompanied by nearly full resolution of pre-treatment hypercortisolemia. The impact of treatment on ACTH was more complex and influenced by symptom severity. The results are consistent with the hypotheses that HPA axis regulation is subtly disturbed in panic disorder and that impact on the HPA axis may play a role in alprazolam's mechanism of efficacy.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>8816303</pmid><doi>10.1016/0022-3956(95)00035-6</doi><tpages>15</tpages></addata></record> |
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| subjects | Adrenocorticotropic Hormone - blood Adult Alprazolam - therapeutic use Anti-Anxiety Agents - therapeutic use Arousal - drug effects Arousal - physiology Biological and medical sciences Circadian Rhythm - drug effects Circadian Rhythm - physiology Corticotropin-Releasing Hormone - physiology Dose-Response Relationship, Drug Drug Administration Schedule Female Humans Hydrocortisone - blood Hypothalamo-Hypophyseal System - drug effects Hypothalamo-Hypophyseal System - physiopathology Male Medical sciences Neuropharmacology Panic Disorder - drug therapy Panic Disorder - physiopathology Pharmacology. Drug treatments Pituitary-Adrenal System - drug effects Pituitary-Adrenal System - physiopathology Psycholeptics: tranquillizer, neuroleptic Psychology. Psychoanalysis. Psychiatry Psychopharmacology Treatment Outcome |
| title | Hypothalamic-pituitary-adrenal axis activity in panic disorder: Effects of alprazolam on 24 h secretion of adrenocorticotropin and cortisol |
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