SEROTONIN FUNCTION IN PANIC DISORDER - A DOUBLE-BLIND PLACEBO CONTROLLED-STUDY WITH FLUVOXAMINE AND RITANSERIN
SEROTONIN FUNCTION IN PANIC DISORDER - A DOUBLE-BLIND PLACEBO CONTROLLED-STUDY WITH FLUVOXAMINE AND RITANSERIN
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DOI：
10.1007/bf02245749
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发表时间：
1990-01-01
影响因子：
3.4
通讯作者：
WESTENBERG, HGM
中科院分区：
文献类型：
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作者：
DENBOER, JA;WESTENBERG, HGM
为评价惊恐障碍患者5-HT功能，采用5-HT 2受体拮抗剂利坦色林和5-HT再摄取抑制剂氟伏沙明双盲对照研究方法，对60例惊恐障碍患者进行了5-HT功能研究。患者接受150 mg氟伏沙明、20 mg利坦色林或安慰剂治疗8周; 1周后达到这些剂量水平。此外，作为惊恐障碍的5-HT功能指标，测定了血浆β-内啡肽、皮质醇和5-羟吲哚乙酸（5-HIAA）的浓度。此外，5-HT摄取血小板进行了评估。通过测定血浆MHPG浓度评估去甲肾上腺素能功能。此外，测量血浆褪黑激素浓度。用氟伏沙明治疗导致恐慌发作次数的大幅减少，随后是回避行为的减少。用利坦色林治疗似乎无效。在治疗期间，未观察到血浆β-内啡肽、皮质醇、5-HIAA和MHPG浓度的显著变化。关于血小板中5-HT的动力学，用氟伏沙明治疗后观察到Km显著增加，而Vmax降低。用氟伏沙明治疗后，血浆中褪黑素的浓度显著增加，这表明褪黑素的合成部分地受肾上腺素能控制。本研究的结果不支持惊恐障碍患者5-HT 2受体超敏的假设，但不能得出其他5-HT受体亚型参与的结论。
In order to evaluate serotonin (5-HT) function in panic disorder, a double blind placebo controlled study was conducted with ritanserin, a specific 5-HT2receptor antagonist, and fluvoxamine, a selective 5-HT reuptake inhibitor, in 60 patients with panic disorder. Patients were treated for 8 weeks with 150 mg fluvoxamine, 20 mg ritanserin or placebo; these dose levels were reached after 1 week. In addition, as an index of 5-HT function in panic disorder, plasma concentration of β-endorphin, cortisol and 5-hydroxyindolacetic-acid (5-HIAA) were measured. Furthermore, 5-HT uptake in blood platelets was assessed. Noradrenergic function was assessed by measuring plasma MHPG concentration. In addition, plasma melatonin concentration was measured. Treatment with fluvoxamine resulted in a profound reduction in the number of panic attacks, followed by a decrease in avoidance behavior. Treatment with ritanserin appeared to be ineffective. During treatment no significant changes were observed in plasma concentrations of β-endorphin, cortisol, 5-HIAA and MHPG. With respect to 5-HT kinetics in blood platelets, a substantial increase in Kmwas observed after treatment with fluvoxamine, whereas Vmaxdecreased. After treatment with fluvoxamine, plasma concentration of melatonin was significantly increased, which suggests that melatonin synthesis is in part under serotonergic control. The findings of the present study do not support the hypothesis that 5-HT2receptors are supersensitive in patients suffering from panic disorder, but allow no conclusions about the involvement of other 5-HT receptor subtypes.