Dehydroepiandrosterone-sulfate/cortisol ratio in panic disorder

Area of Science:

• Endocrinology
• Psychiatry
• Neuroscience

Background:

• The dehydroepiandrosterone-sulfate (DHEA-S)/cortisol ratio is a key indicator of adrenocortical function.
• Alterations in this ratio may be implicated in the pathophysiology of psychiatric disorders.
• Previous research has not fully elucidated the role of the DHEA-S/cortisol ratio in panic disorder.

Purpose of the Study:

• To investigate the DHEA-S/cortisol ratio in patients diagnosed with panic disorder.
• To examine whether this ratio changes following treatment for panic disorder.
• To explore potential sex differences in the DHEA-S/cortisol ratio and its response to treatment.

Main Methods:

• Evaluated 24 outpatients meeting DSM-III-R criteria for panic disorder.
• Assessed the DHEA-S/cortisol ratio in patients and compared it to normal controls and depressed patients.
• Administered clonazepam, alprazolam, or placebo in a double-blind study and re-evaluated the ratio post-treatment.

Main Results:

• Panic disorder patients exhibited significantly higher DHEA-S/cortisol ratios compared to normal controls and depressed patients.
• Female panic disorder patients showed a significant decrease in the DHEA-S/cortisol ratio after treatment.
• Male panic disorder patients did not show a significant change in the DHEA-S/cortisol ratio post-treatment.
• No significant pre- to post-treatment changes in the DHEA-S/cortisol ratio were observed across treatment groups (alprazolam, clonazepam, placebo).

Conclusions:

• The DHEA-S/cortisol ratio is altered in panic disorder, being significantly higher than in control groups.
• Treatment appears to normalize the DHEA-S/cortisol ratio in female panic disorder patients, indicating a sex-specific effect.
• These findings suggest a potential role for adrenocortical function, specifically the DHEA-S/cortisol ratio, in the neurobiology of panic disorder and its treatment, with notable sex differences.