Metyrapone tests in patients with panic disorder.

Abstract

BACKGROUND:

Studies of hypothalamic secretion of corticotropin-releasing hormone (CRH) in patients with panic disorder in the nonpanic state (using CRH tests) are contradictory. No data about the hypothalamic-pituitary response to metyrapone are available.

METHODS:

Study participants included 14 patients with panic disorder (DSM-IV criteria) and 14 healthy control subjects who underwent a standard overnight metyrapone test and a combined metyrapone/low-dose dexamethasone test.

RESULTS:

Significant treatment effects of metyrapone and combined metyrapone/dexamethasone were found on plasma corticotropin, cortisol, and 11-deoxycortisol, but no differences between patients and control subjects emerged. Considering visual analogue scale ratings of anxiety, tension, restlessness, and Beck Depression Inventory scores as covariates, no group effects were detected.

CONCLUSIONS:

Standard overnight metyrapone tests do not support a hypersecretion of hypothalamic CRH in panic disorder. Furthermore, no evidence for increased glucocorticoid negative feedback in panic was found. Hypothalamic CRH secretion in the nonpanic state needs further research.

• Authors: Michael Kellner, Mildred Schick, Alexander Yassouridis, Tobias Struttmann, Klaus Wiedemann, Barbara Alm
• Journal: Biological psychiatry (Biol Psychiatry) Vol. 56 Issue 11 Pg. 898-900 (Dec 01 2004) ISSN: 0006-3223 [Print] United States
• PMID: 15576069 (Publication Type: Clinical Trial, Comparative Study, Controlled Clinical Trial, Journal Article)

Chemical References

• Antimetabolites
• Drug Combinations
• Dexamethasone
• Adrenocorticotropic Hormone
• Cortodoxone
• Metyrapone

Topics

• Adrenocorticotropic Hormone (blood)
• Adult
• Antimetabolites (therapeutic use)
• Case-Control Studies
• Cortodoxone (blood)
• Dexamethasone (therapeutic use)
• Drug Combinations
• Female
• Humans
• Male
• Metyrapone (therapeutic use)
• Middle Aged
• Pain Measurement
• Panic Disorder (blood, drug therapy)
• Single-Blind Method