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Sympathetic nervous system activity in panic disorder.

E C Villacres, M Hollifield, W J Katon

    Psychiatry Research
    |August 1, 1987
    PubMed
    Summary
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    Panic disorder is linked to higher epinephrine levels, indicating selective sympathetic nervous system activation in the adrenal medulla. This study measured norepinephrine and epinephrine in patients and controls.

    Area of Science:

    • Neuroscience
    • Psychiatry
    • Endocrinology

    Background:

    • Panic disorder is a debilitating psychiatric condition.
    • Sympathetic nervous system (SNS) activity is implicated in panic attacks.
    • The specific role of SNS components in resting panic disorder requires further elucidation.

    Purpose of the Study:

    • To investigate sympathetic nervous system (SNS) activity in patients with panic disorder.
    • To compare plasma levels and kinetics of norepinephrine (NE) and epinephrine (EPI) between panic disorder patients and healthy controls.
    • To explore the relationship between anxiety ratings and catecholamine levels in panic disorder.

    Main Methods:

    • Arterialized venous blood samples were collected from 10 panic disorder patients and 10 matched controls.

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  • Plasma concentrations of norepinephrine (NE) and epinephrine (EPI) were measured.
  • Norepinephrine kinetics were assessed using a tritiated NE isotope dilution technique.
  • Plasma cortisol levels were also determined.

    • Main Results:

    • No significant differences were found in resting plasma NE levels, NE appearance rate, NE clearance, or cortisol between groups.
    • Plasma EPI levels were significantly elevated in panic disorder patients compared to controls (103 +/- 23 vs. 33 +/- 16 pg/ml).
    • A significant positive correlation was observed between anxiety ratings and plasma EPI levels in panic disorder patients.

    Conclusions:

    • Resting panic disorder is associated with selective activation of the adrenomedullary component of the SNS.
    • Elevated epinephrine, but not norepinephrine, may be a biomarker for panic disorder.
    • These findings highlight the role of the adrenal medulla in the pathophysiology of panic disorder.