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Neurosteroid secretion in panic disorder.

Francesca Brambilla1, Giovanni Biggio, Maria Giuseppina Pisu

  • 1Dipartimento di Scienze Neuropsichiche, Istituto Scientifico Ospedale S. Raffaele, Universita' Vita e Salute, Milan, Italy. francesca.brambilla4@tin.it

Psychiatry Research
|June 12, 2003
PubMed
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Patients with panic disorder exhibit altered neurosteroid levels, with higher progesterone and allopregnanolone concentrations observed. These findings suggest neurosteroid imbalances may contribute to panic disorder pathogenesis.

Area of Science:

  • Neuroendocrinology
  • Psychiatry
  • Neuropharmacology

Background:

  • Neurosteroids possess anxiolytic properties, suggesting their involvement in anxiety disorders.
  • Alterations in neurosteroid secretion may play a role in the pathophysiology of human anxiety.
  • GABA(A) receptor sensitivity is modulated by neurosteroids.

Purpose of the Study:

  • To investigate plasma neurosteroid concentrations in female patients with panic disorder (PD) compared to healthy controls.
  • To examine neurosteroid levels during different phases of the menstrual cycle and during paroxetine therapy in PD patients.

Main Methods:

  • Plasma levels of progesterone (PROG), pregnenolone (PREG), allopregnanolone (3alpha,5alpha-THPROG), dehydroepiandrosterone (DHEA), and tetrahydrodeoxycorticosterone (3alpha,5alpha-THDOC) were measured.

Related Experiment Videos

  • Measurements were taken in 25 female PD patients and 11 healthy female controls during a drug-free month and a paroxetine therapy month.
  • Samples were collected during the early follicular, mid-luteal, and premenstrual phases of the menstrual cycle.

    • Main Results:

    • Patients with PD showed significantly higher levels of PROG (mid-luteal phase), PREG (premenstrual phase, drug-free month), 3alpha,5alpha-THPROG (follicular phase, drug-free month; premenstrual phase, therapy month), and 3alpha,5alpha-THDOC (premenstrual phases, both months) compared to controls.
    • No significant differences in DHEA levels were observed between patients and controls.
    • These elevated neurosteroid levels were noted during specific menstrual cycle phases and during paroxetine treatment.

    Conclusions:

    • Neurosteroid levels appear to be hypersecreted in patients with panic disorder.
    • This hypersecretion might represent a compensatory mechanism against anxiogenic hyperactivity of the hypothalamo-pituitary-adrenal axis.
    • Altered neurosteroid profiles could also indicate a reduced GABA(A) receptor sensitivity in PD.