beta-adrenoceptor affinity as a biological predictor of treatment response to paroxetine in patients with acute panic disorder.
BACKGROUND
Few studies have reported on the functional differences of the beta-adrenoceptor between treatment responders and non-responders in panic disorder (PD). The aim of this study was to compare the nature of the beta-adrenoceptor function and clinical variables between treatment responders and non-responders to paroxetine treatment in acute PD patients.


METHODS
Paroxetine was administered to all of the panic patients for 12 weeks. The lymphocyte beta-adrenoceptor density (Bmax), affinity (1/Kd), and sensitivity (cAMP ratio) were measured in 22 untreated outpatients with acute PD and 22 age, sex and BMI matched control subjects. Psychological assessments were conducted using the HAM-A, and HAM-D, STAI-S and STAI-T, Anxiety sensitivity index (ASI), and Acute panic inventory (API).


RESULTS
A significantly higher Kd was observed in the panic patients before treatment as compared with the control subjects, but there was no significant difference in Kd between the panic patients and control subjects after the treatment. Among the 22 patients, the 11 treatment responders (50%) showed a significantly higher Kd and lower mean scores of HAM-D, STAI-S, STAI-T, and ASI at baseline, compared with the non-responders. Logistic regression revealed that the pretreatment Kd and HAM-D were significantly reliable predictors for treatment response (p<0.05).


CONCLUSIONS
The beta-adrenoceptor affinity (1/Kd) was decreased and adaptively normalized after treatment with paroxetine in the acute panic patients. In addition, a low pretreatment beta-adrenoceptor affinity (1/Kd) was found to predict the treatment response and can be suggested as a biological predictor of treatment response in acute PD.
Lee
In-Soo
IS
Department of Psychiatry, Semin Mental Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Kim
Kyung-Jeong
KJ
Kang
Eun-Ho
EH
Yu
Bum-Hee
BH
D000208:Acute Disease; D000328:Adult; D000553:Ambulatory Care; D015415:Biomarkers / Q000378:metabolism*; D035061:Control Groups; D000242:Cyclic AMP / Q000378:metabolism; D005260:Female; D006801:Humans; D007545:Isoproterenol / Q000494:pharmacology; D008214:Lymphocytes / Q000378:metabolism; D008297:Male; D016584:Panic Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D017374:Paroxetine / Q000627:therapeutic use*; D010555:Personality Inventory; D011336:Probability; D011943:Receptors, Adrenergic, beta / Q000378:metabolism*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D015415:Biomarkers; D000242:Cyclic AMP; D007545:Isoproterenol; D017374:Paroxetine; D011943:Receptors, Adrenergic, beta; D017367:Selective Serotonin Reuptake Inhibitors