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Situational panic attacks. Behavioral, physiologic, and biochemical characterization.

S W Woods, D S Charney, C A McPherson

    Archives of General Psychiatry
    |April 1, 1987
    PubMed
    Summary

    Nonpharmacologically induced panic attacks in agoraphobic patients show increased heart rate but not stress hormones. Chronic panic may alter neuroendocrine responses to anxiety.

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    Area of Science:

    • Psychiatry
    • Neuroscience
    • Psychophysiology

    Background:

    • Panic attacks are often triggered by specific situations in individuals with agoraphobia.
    • The underlying physiological mechanisms of these nonpharmacologically induced panic attacks require further investigation.

    Purpose of the Study:

    • To explore the pathophysiology of situational panic attacks in agoraphobic patients.
    • To compare physiological and neuroendocrine responses during induced panic attacks between patients and healthy controls.

    Main Methods:

    • 18 drug-free agoraphobic patients and 13 healthy subjects underwent structured exposure to phobic situations.
    • Physiological measures (heart rate, blood pressure) and plasma levels of MHPG, cortisol, growth hormone, and prolactin were assessed before, during, and after exposure.

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    Main Results:

    • Fifteen patients experienced panic attacks during exposure.
    • Panicking patients showed significantly higher heart rate increases compared to controls.
    • No significant differences were observed in blood pressure or plasma MHPG and cortisol levels; growth hormone and prolactin responses were lower in patients.

    Conclusions:

    • Elevated heart rate during situational panic attacks is confirmed, but plasma MHPG and cortisol do not significantly increase.
    • Noradrenergic hyperactivity in the brain during panic may be too localized or transient to impact plasma MHPG.
    • Recurrent panic attacks might lead to adaptive changes in neuroendocrine stress response systems.