title: Beta-adrenergic receptor mechanisms and pain sensitivity in women with menstrually related mood disorders.
abstract: Somatic symptoms experienced by women with a menstrually related mood disorder (MRMD) during their premenstrual luteal phase contribute to functional impairment. Yet, investigations on pathophysiological mechanisms contributing to heightened pain sensitivity in MRMD are sparse. During the luteal phase, 61 women with an MRMD and 61 non-MRMD controls were evaluated for β-adrenergic receptor (β-AR) responsivity using the isoproterenol sensitivity test. A subset (43 MRMD and 50 non-MRMD) then entered a double-blind, placebo-controlled, crossover protocol to examine the effect of β-AR blockade with intravenous propranolol on sensitivity to experimental (cold pressor and ischemic) and clinical (McGill Pain Questionnaire score) pain. Women with an MRMD exhibited greater β1- and β2-AR responsivity, ischemic pain intensity, and affective clinical pain ratings than controls. Propranolol increased cold pressor pain tolerance in both groups, but it decreased cold pain intensity and ischemic pain unpleasantness ratings only in non-MRMD women. In contrast, propranolol decreased affective ratings of clinical pain in women with MRMD. Exploratory analyses indicated that only in MRMD women did greater β-AR responsivity predict greater sensitivity to cold pressor and ischemic pain. This study provides the first evidence for a role of β-AR mechanisms in the hyperalgesia and clinical pain experienced by women with MRMDs.
  
  
  CONCLUSIONS
  This article describes the effects of β-adrenergic receptor stimulation and blockade on experimental and clinical pain sensitivity in women with an MRMD. The results of this study may have implications for the management of the substantial somatic premenstrual symptomatology experienced by women with an MRMD.
authors: Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors: Adomas
authors: A
authors: Bunevicius
authors: Alan
authors: A
authors: Hinderliter
authors: Rebecca
authors: R
authors: Klatzkin
authors: Ankit
authors: A
authors: Patel
authors: Cara
authors: C
authors: Arizmendi
authors: Susan S
authors: SS
authors: Girdler
mesh_terms: D000318:Adrenergic beta-Agonists / Q000494:pharmacology; D000328:Adult; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000150:complications / Q000503:physiopathology*; D007545:Isoproterenol / Q000494:pharmacology; D008183:Luteal Phase / Q000187:drug effects / Q000502:physiology; D019964:Mood Disorders / Q000150:complications / Q000503:physiopathology*; D010147:Pain Measurement; D058748:Pain Perception / Q000187:drug effects / Q000502:physiology*; D011293:Premenstrual Syndrome / Q000150:complications / Q000503:physiopathology*
chemical_list: D000318:Adrenergic beta-Agonists; D007545:Isoproterenol
keywords: menstrually related mood disorders; pain sensitivity; propranolol; β-adrenergic receptors