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- Andersch, Sven, 1939
(författare)
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Clinical studies of panic disorder
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aims: To study efficacy and safety of alprazolam, imipramine, and placebo in treatment of panic disorder, to investigate comorbidity with social phobia, to determine platelet monoamine oxidase (MAO), and to follow the long-term course in a cohort of patients with panic disorder.Subjects and Methods: A double-blind comparison of alprazolam, imipramine, and placebo was performed in 123 Scandinavian outpatients with panic disorder according to DSM-III. Patients were randomly allocated; 41 to each treatment group. Well validated psychiatric instruments were used for weekly ratings of key symptoms. Blood samples for determination of platelet MAO activity were collected and analysed in plasma from 58 patients. In a follow-up after 5 and 15 years, 52 and 55 patients, respectively, were re-assessed with the same instruments as in the initial examination.Results: Alprazolam and imipramine are effective and safe in treating panic disorder. Freedom from panic attacks was obtained for 68% with alprazolam, 61% with imipramine and 34% with placebo. Globally rated by physician and patients, about 60% had complete remission with alprazolam and imipramine and 30% on placebo. Side effects were generally mild with a preponderance of drowsiness for alprazolam and anticholinergic effects for imipramine.Occurrence of social phobia in the 123 panic disorder patients was 26%, and agoraphobia was more frequent in the patients with social phobia (91%) than in those without (69%). Social phobia patients had more psychiatric problems before the age of 18. Panic disorder patients had lower platelet MAO activity than healthy controls. Women with concomitant agoraphobia and social phobia had lower MAO activity than women without. After 5 and 15 years, more than 80% of the patients no longer fulfilled criterias for panic disorder diagnosis. However, after 15 years, the majority (69%) still had anxiety symptoms. After 5 and 15 years, more than 80% reported satisfactory daily functioning, although more than 70% used psychotropic drugs. Conclusion: Alprazolam and imipramine are effective and safe in treatment of panic disorder, and despite recurrent anxiety attacks, panic disorder has a favourable outcome in a substantial proportion of patients in the long-term course. In our patient sample MAO in platelets was lower than in controls. Social phobia is a complicating factor in patients with panic disorder.
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| 2. |
- Annerbrink, Kristina, 1974, et al.
(författare)
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Association between the catechol-O-methyltransferase Val158Met polymorphism and panic disorder: A replication
- 2010
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Ingår i: Psychiatry Research. - : Elsevier Science B.V., Amsterdam.. - 0165-1781 .- 1872-7123. ; 178:1, s. 196-198
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Tidskriftsartikel (refereegranskat)abstract
- The association between the catechol-O-methyltransferase Val158Met polymorphism and panic disorder was studied in a Swedish sample of 211 patients and 452 controls. We found a significant excess of the Val allele in both male and female patients, the latter but not the former finding being in line with previous studies.
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| 3. |
- Annerbrink, Kristina, 1974, et al.
(författare)
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Panic disorder is associated with the Val308Iso polymorphism in the hypocretin receptor gene
- 2011
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Ingår i: PSYCHIATRIC GENETICS. - : Rapid Communications of Oxford Ltd. - 0955-8829 .- 1473-5873. ; 21:2, s. 85-89
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Tidskriftsartikel (refereegranskat)abstract
- Background Orexin A and B are neuropeptides influencing, for example, arousal and respiration. Although panic disorder is characterized by both enhanced proneness for arousal and by respiratory abnormalities, the possible influence of orexin-related genes on the risk of developing this disorder has not been studied until now. Methods We have analyzed the Ile408Val polymorphism in the hypocretin receptor 1 (HCRTR1) gene and the Val308Iso (G1246A) polymorphism in the hypocretin receptor 2 (HCRTR2) gene in a sample of 215 panic disorder patients and 454 controls. Results Although the polymorphism in the HCRTR1 did not differ between groups, the Iso allele of the HCRTR2 polymorphism was significantly more frequent in patients than in controls. After the population was divided according to sex, the association between the Iso allele of the Val308Iso polymorphism and panic disorder was observed only in female patients. Conclusion Our results suggest that the HCRTR2 polymorphism may be of importance for the pathophysiology of panic disorder. The results should be regarded as preliminary until replicated in an independent sample. This indicates that further research on the possible role of orexin in panic disorder may prove rewarding.
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| 4. |
- Hansson, Caroline, 1981, et al.
(författare)
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A possible association between panic disorder and a polymorphism in the preproghrelin gene
- 2013
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Ingår i: Psychiatry Research. - : Elsevier. - 0165-1781 .- 1872-7123. ; 206:1, s. 22-25
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to investigate whether polymorphisms in the preproghrelin gene are associated with anxiety disorders, such as panic disorder, in humans. Panic disorder is a severe anxiety disorder, characterized by sudden attacks of intense fear or anxiety in combination with somatic symptoms. The preproghrelin gene codes for two gut-derived circulating peptides that have been linked to anxiety-like behaviour in rodents: ghrelin (an orexigenic, pro-obesity hormone) and obestatin. In the present study, we genotyped three missense mutations in the preproghrelin gene in 215 patients suffering from panic disorder and in 451 controls. The A allele of the rs4684677 polymorphism was significantly associated with panic disorder, while there were no significant associations with the two other polymorphisms studied. We conclude that the rs4684677 (Gln90Leu) polymorphism in the preproghrelin gene may be associated with increased risk of panic disorder. It will be important to confirm these findings in additional panic disorder patient groups.
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| 5. |
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| 6. |
- Ho, Hoi-Por, 1962, et al.
(författare)
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Association between a functional polymorphism in the progesterone receptor gene and panic disorder in women.
- 2004
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 0306-4530. ; 58:2, s. 109-110
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Tidskriftsartikel (refereegranskat)abstract
- Although genetic factors are known to be important risk factors for panic disorder there is as yet no conclusive data regarding specific gene variants. Prompted by evidence supporting progesterone to influence the pathophysiology of panic disorder, polymorphisms in the progesterone receptor gene, a single nucleotide polymorphism (G331A) and an insertion/deletion polymorphism (PROGINS) were investigated in 72 patients with panic disorder and 452 controls. The frequency of the A-allele of the G331A polymorphism was higher in panic disorder patients than in controls (p = 0.01). When male and female patients were analyzed separately, the association was observed in female patients only (p = 0.0009), with an odds ratio of 3.5. No differences between groups were observed for the PROGINS polymorphism. In conclusion, these data suggest that the G331A polymorphism in the progesterone receptor gene may influence the risk for panic disorder in women.
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| 7. |
- Olsson, Marie, 1971, et al.
(författare)
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Angiotensin-related genes in patients with panic disorder.
- 2004
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Ingår i: American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics. - : Wiley. - 1552-4841. ; 127:1, s. 81-4
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Tidskriftsartikel (refereegranskat)abstract
- Enhanced respiratory variability and decreased heart rate variability have repeatedly been observed in patients with panic disorder. Prompted by the notion that angiotensin may be involved in the control of respiration, heart rate variability, and anxiety-like behavior, we investigated the putative association between polymorphisms in three angiotensin-related genes and panic disorder-angiotensinogen (AGT), angiotensin converting enzyme (ACE), and angiotensin II (ANG II) receptor type 1 (ATr1) in 72 patients with panic disorder and 504 controls. Allele and genotype distribution of the ATr1 A1166C allele and the AGT M235T did not differ between patients and controls. With respect to the ACE I/D polymorphism, the I allele was found to be more frequent in male (chi(2) = 8.042, df = 1, P = 0.005), but not female, panic disorder patients than in controls. The results of this investigation provide preliminary evidence for the suggestion that angiotensin-related genes may be associated with panic disorder in men.
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