GABA(A) receptor-modulating neuroactive steroid composition in patients with panic disorder before and during paroxetine treatment.
OBJECTIVE
Previous studies have shown that neuroactive steroids modulate anxiety and stress reactivity. However, no data on the possible role of these gamma-aminobutyric acid(A) (GABA(A)) receptor-modulating neuroactive steroids in patients with anxiety disorders are available.


METHODS
The concentrations of 3alpha,5alpha-tetrahydroprogesterone (3alpha,5alpha-THP), 3alpha,5beta-THP, 3beta,5alpha-THP, and their precursors were studied in the plasma of 10 patients with panic disorder and 10 matched healthy comparison subjects. In addition, the effects of paroxetine treatment on neuroactive steroid concentrations were studied in the panic disorder patients over a 24-week period.


RESULTS
Unexpectedly, patients with panic disorder had significantly greater concentrations of the positive allosteric modulators 3alpha,5alpha-THP and 3alpha,5beta-THP and significantly lower concentrations of 3beta,5alpha-THP (a functional antagonist for GABA(A) agonistic steroids), which might result in greater GABA(A) receptor-mediated neuronal activity. Paroxetine treatment did not affect neuroactive steroid concentrations, which were highly stable over 24 weeks.


CONCLUSIONS
Differences in neuroactive steroid composition in patients with panic disorder were the opposite of those seen in patients with major depression and may reflect counterregulative mechanisms against the occurrence of spontaneous panic attacks.
Ströhle
Andreas
A
Max Planck Institute of Psychiatry, Munich, Germany. stroehle@mpipsykl.mpg.de
Romeo
Elena
E
di Michele
Flavia
F
Pasini
Augusto
A
Yassouridis
Alexander
A
Holsboer
Florian
F
Rupprecht
Rainer
R
D000328:Adult; D000379:Agoraphobia / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D058787:GABA-A Receptor Antagonists; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D017374:Paroxetine / Q000009:adverse effects / Q000627:therapeutic use*; D011280:Pregnanolone / Q000097:blood*; D011963:Receptors, GABA-A / Q000187:drug effects* / Q000502:physiology; D013237:Stereoisomerism; D016896:Treatment Outcome
D058787:GABA-A Receptor Antagonists; D011963:Receptors, GABA-A; D017374:Paroxetine; D011280:Pregnanolone