Objective: The aim of this study was to examine the effect of rapid tryptophan depletion (RTD) combined with a panicogenic challenge in patients with panic disorder who had responded to treatment with cognitive behavioural therapy (CBT). We hypothesised that RTD (compared with the control drink) would result in an increase in anxiety symptoms when provoked by a panicogenic challenge with the benzodiazepine antagonist, flumazenil.
Methods: Nine patients with panic disorder who had responded to CBT received a tryptophan-free amino acid drink on one occasion and a control drink on the other in a double-blind crossover design. In addition, they received flumazenil and placebo infusions on each day.
Results: Our hypothesis regarding the effects of RTD was supported by findings of a significant interaction between RTD and flumazenil on measures from visual analogues scales (total) and the Spielberger State Anxiety inventory. A somewhat unexpected finding was that in this group of CBT responders, the panicogenic effect of flumazenil was not completely blocked by treatment. This meant that although four of the nine subjects (44%) reported a panicogenic effect of flumazenil on the RTD day, this was not significantly different from the rate of panic attacks in response to flumazenil on the control day.
Conclusion: We suggest that the partial return of symptoms in response to flumazenil reflects a vulnerability to RTD in this group of panic disorder patients who had responded to treatment with CBT.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00213-009-1696-z | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Childhood trauma and dissociation in patients with panic disorder, obsessive-compulsive disorder, and borderline personality disorder. Part 2: Therapeutic effectiveness of combined cognitive behavioural therapy and pharmacotherapy in treatment-resistant inpatients.
Neuro Endocrinol Lett
December 2024
Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, Czech Republic.
Introduction: PAdverse Childhood Experiences (ACEs) are associated with an increased risk of mental health issues in general, but their relationship with panic disorder (PD) and obsessive-compulsive disorder (OCD) has received less attention compared to borderline personality disorder (BPD). Dissociative experiences are significant predictors of increased symptoms, reduced treatment adherence, and poor prognosis in several psychiatric conditions, including PD, OCD, and BPD; still, their impact remains underexplored. This part of the study focuses on the overall efficiency of psychotherapeutic programs on treatment-resistant patients diagnosed with PD, OCD, and BPD (or combined), as well as the relationship between ACEs, dissociation rates, and treatment results.
View Article and Find Full Text PDFChildhood trauma and dissociation in patients with panic disorder, obsessive-compulsive disorder, and borderline personality disorder. Part 1: Relationships between demographic, clinical, and psychological factors.
Neuro Endocrinol Lett
December 2024
Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, Czech Republic.
Introduction: Panic disorder (PD), obsessive-compulsive disorder (OCD), and borderline personality disorder (BPD) are associated with various psychosocial factors that may influence their onset and psychopathology. Dissociation encompasses a wide range of manifestations, from benign experiences to severe mental health issues. Research comparing childhood trauma and dissociation, general psychopathology, and the onset of the disorder among patients with PD, OCD, and BPD has not yet been published.
View Article and Find Full Text PDFBroadening the conceptualization of panic disorder to include the fear presentation of avoidant/restrictive food intake disorder: The legacy of panic control therapy.
Behav Res Ther
December 2024
Rogers Behavioral Health, Research Center, Oconomowoc WI & Philadelphia PA, 34700 Valley Rd, Oconomowoc, WI, 53066, USA. Electronic address:
The presentation of avoidant/restrictive food intake disorder (ARFID) characterized by fear of aversive consequences of eating (fear-ARFID) has both phenomenological and mechanistic similarities to panic disorder. In this narrative review, we propose a shared model of the pathogenesis of the two disorders, centered on interoceptive sensitivity as the key maintenance mechanism. We review the evidence that fear-ARFID, which involves restrictive eating motivated by a desire to avoid aversive events (e.
View Article and Find Full Text PDFEffects of Moringa oleifera extract on biochemical and histological parameters of sodium valproate induced lungs damage.
J Mol Histol
December 2024
Faculty of Engineering, Department of Chemistry, Istanbul University- Cerrahpaşa, Avcilar, Istanbul, Türkiye.
Sodium valproate- a salt of valproic acid (VPA), is an anticonvulsant used in the treatment of epilepsy and a range of psychiatric conditions that include panic attacks, anxiety, post-traumatic stress, migraine and bipolar disorder etc. VPA can cause direct damage to many tissues due to accumulation of toxic metabolites. Nowadays, phytochemicals are amongst the best options for the treatment of diseases.
View Article and Find Full Text PDFEarly-Phase Intervention With Traditional Japanese Acupuncture and Moxibustion for Fibromyalgia: A Case Report.
Cureus
November 2024
Department of Traditional Medicine, Toho University, Tokyo, JPN.
Fibromyalgia (FM) is a common chronic pain with no established treatment. Acupuncture is an expected treatment for FM though a diagnosis of FM tends to be delayed, and the advantage is still unclear in early-phase intervention with acupuncture treatment for FM. A 51-year-old woman with panic disorder presented with a four-month history of whole-body pain and was diagnosed with FM.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!