Noradrenergic function in panic anxiety. Effects of yohimbine in healthy subjects and patients with agoraphobia and panic disorder.
Noradrenergic function in panic anxiety. Effects of yohimbine in healthy subjects and patients with agoraphobia and panic disorder.
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DOI：
10.1001/archpsyc.1984.01790190025003
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发表时间：
1984-08
影响因子：
--
通讯作者：
D. Charney;G. Heninger;A. Breier
中科院分区：
文献类型：
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作者：
D. Charney;G. Heninger;A. Breier
育亨宾是一种α2-肾上腺素能受体拮抗剂，可以增加去甲肾上腺素的功能。20名健康受试者和39名患有广场恐惧症和恐慌症的非药物患者接受了育亨宾的治疗。给药后，在4小时内检测去甲肾上腺素代谢物3-甲氧基-4-羟基苯甘醇(MHPG)、血压、脉率、主观感觉评分和躯体症状的变化。与健康受试者相比，育亨宾在所有患者组患者的焦虑、紧张、心悸、潮热和寒潮、躁动、震颤、勃起和坐位收缩血压方面的增加显著增加。育亨宾诱导的血浆MHPG水平升高与患者的焦虑和紧张情绪以及报告的恐慌症发作频率之间存在显着相关性。与健康受试者和恐慌症发作频率较低的患者相比，经历频繁恐慌症发作(每周大于2.5次)的患者对育亨宾的血浆MHPG反应显著更高。这些观察结果支持一种假说，即在与恐慌相关的焦虑状态下，增强的去甲肾上腺素能功能的敏感性增加，并表明频繁惊恐发作的患者可能存在突触前去甲肾上腺素能神经元调节受损。
Yohimbine, an alpha 2-adrenergic receptor antagonist that increases noradrenergic function, was administered to 20 healthy subjects and 39 drug-free patients with agoraphobia and panic attacks. Following drug administration, changes in plasma levels of the norepinephrine metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG), BP, pulse rate, and subjective ratings of feelings and somatic symptoms were examined during a four-hour period. Yohimbine produced significantly greater increases in patient-rated anxiety, nervousness, palpitations, hot and cold flashes, restlessness, tremors, piloerection, and sitting systolic BP in the total patient group compared with healthy subjects. There were significant correlations between the yohimbine-induced rise in plasma MHPG level and patient-rated anxiety and nervousness and the frequency of reported panic attacks. Patients experiencing frequent panic attacks (greater than 2.5 per week) had a significantly greater plasma MHPG response to yohimbine than the healthy subjects and patients having less frequent panic attacks. These observations support a hypothesis of increased sensitivity to augmented noradrenergic function in anxiety states associated with panic, and they suggest that impaired presynaptic noradrenergic neuronal regulation may exist in patients with frequent panic attacks.