Effect of ethinyl estradiol on the panic response to the panicogenic agentpentagastrin

Background: Panic disorder (PD) symptomatology has been reported to be alte red by hormonal events or treatments which affect estrogen levels. Coryell et al. [Arch. Gen. Psychiatry, 39 (1982) 701-703; Am. J. Psychiatry, 143 (1 986) 508-510] have suggested that the increased cardiovascular risk associa ted with PD is significantly greater in males, alluding to a potential card ioprotective effect of female hormones in the context of panic attacks. In the present study, we were, therefore, interested in elucidating the role o f estrogen in modulating the behavioural and cardiovascular responses induc ed by the panicogenic agent pentagastrin, a cholecystokinin-B (CCKB) recept or agonist. Methods: A double-blind cross-over placebo-controlled design wi th randomization of the order of a 3-day pretreatment of ethinyl estradiol (EE) (50 mug/day) or placebo was used to assess the effect of a 30-mug i.v. bolus injection of pentagastrin on panic symptom intensity and on increase s in heart rate (Delta HR). systolic (Delta SBP) and diastolic (Delta DBP) blood pressure following each pretreatment. Subjects were 9 male healthy co ntrols and I I male PD patients. Results: EE pretreatment did not significa ntly reduce the pentagastrin-induced panic symptom scale (PSS) scores and h ad no effect on Delta DBP or Delta SBP. EE did. however, attenuate the pent agastrin-induced increase in HR in both PD patients and healthy controls. L imitations: Only male subjects were included in the present study, however, we are currently investigating the influence of female gonadal hormones on the panic response to pentagastrin in female PD patients and healthy contr ols. Conclusion: Our results Suggest that estrogens may display cardioprote ctive effects in the context of panic attacks. (C) 2001 Elsevier Science B. V. All rights reserved.