A pilot study of noradrenergic and HPA axis functioning in PTSD vs. panic disorder.
The biological literature in the anxiety disorders has focused on comparisons between patient groups and normal volunteers, with relatively little comparative study of the anxiety disorders. We therefore conducted this pilot study to compare a group of patients with post-traumatic stress disorder (PTSD) (n = 7) to a contiguously studied panic disorder group (n = 17) and healthy control subjects (n = 16) on baseline levels of cortisol and 3-methoxy-4-hydroxyphenylglycol (MHPG), and response to clonidine challenge. Despite the small sample size, highly significant differences were found on the following measures: PTSD patients had lower cortisol, lower MHPG, reduced MHPG volatility to clonidine challenge, and marginally reduced cortisol volatility compared to patients with panic disorder. These biological findings support existing clinical, epidemiologic, family study, and clinical trial findings that distinguish these two disorders as distinct syndromes.
New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA. randall@nyspi.cpmc.columbia.edu
Randall D
RD
Marshall
Carlos
C
Blanco
David
D
Printz
Michael R
MR
Liebowitz
Donald F
DF
Klein
Jeremy
J
Coplan
D000293:Adolescent; D000316:Adrenergic alpha-Agonists; D000328:Adult; D000368:Aged; D003000:Clonidine; D005133:Eye Movements / Q000502:physiology; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism* / Q000503:physiopathology*; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000097:blood; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood*; D016584:Panic Disorder / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology*; D010865:Pilot Projects; D010913:Pituitary-Adrenal System / Q000378:metabolism* / Q000503:physiopathology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology*; D013997:Time Factors
D000316:Adrenergic alpha-Agonists; D008734:Methoxyhydroxyphenylglycol; D003000:Clonidine; D006854:Hydrocortisone; D009638:Norepinephrine