Evidence that decreased function of lymphocyte beta adrenoreceptors reflects regulatory and adaptive processes in panic disorder with agoraphobia.
OBJECTIVE
This study was designed to clarify the nature of the reduced function of the peripheral beta adrenoceptor system observed in panic disorder with agoraphobia. The authors hypothesized that this phenomenon reflected a regulatory and adaptive process.


METHODS
Lymphocyte beta adrenoreceptor density and affinity, basal lymphocyte cAMP level, and isoproterenol-stimulated cAMP generation were measured in 27 untreated outpatients with panic disorder with agoraphobia and 24 healthy comparison subjects. Lymphocyte beta receptor attributes were again assessed in patients after 4 weeks of double-blind treatment with adinazolam (slow-release form) or placebo. Panic frequency, agoraphobic symptoms, overall anxiety, and improvement with treatment were assessed with standard rating instruments.


RESULTS
Multivariate statistics revealed significantly lower beta receptor density and isoproterenol-stimulated cAMP generation in patients than in comparison subjects. beta receptor density tended to normalize after adinazolam but not after placebo. Pretreatment beta receptor density was lower in treatment responders than nonresponders. Patients with mild agoraphobia had lower cAMP responsivity than patients with moderate or severe agoraphobia.


CONCLUSIONS
Decreased function of lymphocyte beta receptors in panic disorder with agoraphobia is expressed as both decreased density and decreased cAMP responsivity. This pattern of changes, and the tendency for receptor density to normalize with treatment, is consistent with an active, regulatory process rather than a structural deficit in the beta receptor system. Preliminary clinical findings suggest that these changes may reflect adaptive processes associated with a favorable clinical course in panic disorder with agoraphobia.
Maddock
R J
RJ
Department of Psychiatry, University of California, School of Medicine, Davis.
Carter
C S
CS
Magliozzi
J R
JR
Gietzen
D W
DW
D000328:Adult; D000379:Agoraphobia / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents / Q000494:pharmacology / Q000627:therapeutic use; D001569:Benzodiazepines / Q000494:pharmacology / Q000627:therapeutic use; D000242:Cyclic AMP / Q000097:blood; D004311:Double-Blind Method; D015536:Down-Regulation / Q000187:drug effects; D005260:Female; D006801:Humans; D007545:Isoproterenol / Q000494:pharmacology; D008214:Lymphocytes / Q000737:chemistry*; D008297:Male; D016584:Panic Disorder / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D010919:Placebos; D011943:Receptors, Adrenergic, beta / Q000032:analysis / Q000187:drug effects / Q000502:physiology*
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D010919:Placebos; D011943:Receptors, Adrenergic, beta; D001569:Benzodiazepines; D000242:Cyclic AMP; C039668:adinazolam; D007545:Isoproterenol