Increased ACTH concentrations associated with cholecystokinin tetrapeptide-induced panic attacks in patients with panic disorder

Citation
A. Strohle et al., Increased ACTH concentrations associated with cholecystokinin tetrapeptide-induced panic attacks in patients with panic disorder, NEUROPSYCH, 22(3), 2000, pp. 251-256
Citations number
46
Categorie Soggetti
Neurosciences & Behavoir
Journal title
NEUROPSYCHOPHARMACOLOGY
ISSN journal
0893133X → ACNP
Volume
22
Issue
3
Year of publication
2000
Pages
251 - 256
Database
ISI
SICI code
0893-133X(200003)22:3<251:IACAWC>2.0.ZU;2-#
Abstract
Preclinical findings on the role of corticotropin releasing hormone (CRH) i n stress and anxiety, on the interaction of CRH and cholecystokinin (CCK) i n modulating anxiety, as well as the blunted corticotropin (ACTH) response to CRH in panic disorder suggest that CRH may play a role in panic disorder . To further characterize the role of the hypothalamic-pituitary-adrenocort ical (HPA) system in panic disorder, we compared patients with and without CCK tetrapeptide (CCK-4) induced panic attacks. Twenty-four patients with p anic disorder were given injections of CCK-4 (25 mu g). Panic attacks, psyc hopathological changes, as well as ACTH and cortisol secretion were recorde d. Fifteen of the 24 patients experienced a panic attack after CCK-4. ACTH secretion wa significantly higher in the patients with CCK-4-induced panic attacks than in those without such attacks. The patients without CCK-4-indu ced attacks had a brief but less pronounced increase in ACTH concentrations . Cortisol concentrations were not significantly increased after CCK-4 admi nistration. The increased ACTH concentrations suggest that the activation o f the HPA system in CCK-4-inducd panic attacks plays a physiological role. CRH may be involved in experimentally-occurring and perhaps in naturally-oc curring panic attacks as well. [Neuropsychopharmacology 22:251-256, 2000] ( C) 2000 American College of Neuropsychopharmacology. Published by Elsevier Science Inc.