title: Anxiolytic therapy with alprazolam increases muscle sympathetic activity in patients with panic disorders.
abstract: Anxiolytic therapy with the benzodiazepine alprazolam is an established therapy in patients with panic disorder. Normally, panic-like anxiety and its concomitant physical symptoms quickly disappear under such treatment. Therefore we investigated whether there is a difference in sympathetic nervous system in patients with panic disorder compared to healthy controls. Three groups of subjects were included: ten patients with panic disorder, who received alprazolam and 20 healthy control subjects who were given either alprazolam (n=10) or matching placebo (n=10). Muscle sympathetic nerve activity (MSNA) and heart rate did not differ at baseline but significantly increased both in patients and healthy controls after intake of alprazolam (1 mg). However, in both groups both MSNA and heart rate were significantly elevated when compared to both baseline and the placebo control group. This study demonstrates (1) that anxiolytic therapy with alprazolam increases muscle sympathetic nerve activity and heart rate not only in patients with panic disorder but also in healthy controls and (2) that a significant difference in sympathetic nervous system activity between patients and controls, at baseline and during the therapy with alprazolam could not be demonstrated.
authors.affiliation: Cardiovascular Center, Cardiology, University Hospital, Rämistrasse 100, 8091 Zürich, Switzerland. markus.bechir@usz.ch
authors.forename: Markus
authors.initials: M
authors.lastname: Béchir
authors.forename: Kyrill
authors.initials: K
authors.lastname: Schwegler
authors.forename: Rémy
authors.initials: R
authors.lastname: Chenevard
authors.forename: Christian
authors.initials: C
authors.lastname: Binggeli
authors.forename: Christian
authors.initials: C
authors.lastname: Caduff
authors.forename: Stefan
authors.initials: S
authors.lastname: Büchi
authors.forename: Claus
authors.initials: C
authors.lastname: Buddeberg
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.forename: Georg
authors.initials: G
authors.lastname: Noll
mesh_terms: D000328:Adult; D000525:Alprazolam / Q000008:administration & dosage*; D014151:Anti-Anxiety Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation; D016584:Panic Disorder / Q000188:drug therapy* / Q000503:physiopathology*; D010919:Placebos; D013564:Sympathetic Nervous System / Q000187:drug effects* / Q000503:physiopathology
chemical_list: D014151:Anti-Anxiety Agents; D010919:Placebos; D000525:Alprazolam