1
|
Li J, Li R, Li D, Zhang J, Luo X, Zhang Y. Serum BDNF levels and state anxiety are associated with somatic symptoms in patients with panic disorder. Front Psychiatry 2023; 14:1168771. [PMID: 37533888 PMCID: PMC10393281 DOI: 10.3389/fpsyt.2023.1168771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 07/03/2023] [Indexed: 08/04/2023] Open
Abstract
Background We aimed to explore the predictive role of serum BDNF and anxiety-related variables in changes in somatic symptoms post-escitalopram treatment in panic disorder (PD) patients. Methods Ninety PD patients and 99 healthy controls (HCs) were enrolled. PD patients received an 8-week escitalopram treatment. All patients were administered the Panic Disorder Severity Scale-Chinese Version (PDSS-CV) and State-Trait Anxiety Inventory (STAI) to assess panic and anxiety-related symptoms, respectively. Patient Health Questionnaire 15-item scale (PHQ-15) was performed to measure somatic symptoms, and the blood sample was collected to detect serum BDNF levels in all participants. We performed partial correlation analysis and multiple linear regression to explore correlates of PHQ-15 and predictors of PHQ-15 changes post-escitalopram treatment after controlling for age, gender, education levels (set as a dummy variable), the current duration, comorbid AP, and/or GAD. Results Compared to HCs, PD patients had lower serum BDNF levels and higher PHQ-15 scores that could be improved post-escitalopram treatment. Lower baseline STAI state (b = -0.07, p = 0.004), and PDSS-CV scores (b = -0.25, p = 0.007), but higher baseline serum BDNF levels (b = 0.35, p = 0.007) contributed to the prediction of PHQ-15 changes post-escitalopram treatment. Conclusion State anxiety, serum BDNF levels, and panic severity could predict changes in somatic symptoms post-escitalopram treatment, our results highlighted that serum BDNF could serve as a biological indicator for improving somatic symptoms in PD patients.
Collapse
Affiliation(s)
- Jiaxin Li
- Unit of Bipolar Disorder, Tianjin Anding Hospital, Tianjin, China
| | - Ru Li
- Unit of Bipolar Disorder, Tianjin Anding Hospital, Tianjin, China
| | - Dazhi Li
- Unit of Bipolar Disorder, Tianjin Anding Hospital, Tianjin, China
| | - Jian Zhang
- Unit of Bipolar Disorder, Tianjin Anding Hospital, Tianjin, China
| | - Xingguang Luo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Yong Zhang
- Unit of Bipolar Disorder, Tianjin Anding Hospital, Tianjin, China
| |
Collapse
|
2
|
Aydogan S, Uguz F, Yakut E, Bayman MG, Gezginc K. The course and clinical correlates of panic disorder during the postpartum period: a naturalistic observational study. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2021; 43:6-11. [PMID: 33111774 PMCID: PMC7861186 DOI: 10.1590/1516-4446-2020-1050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 07/18/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate the course of panic disorder and its demographic and clinical correlates during the postpartum period. METHODS Data were collected from 38 consecutive postpartum women diagnosed with panic disorder. Psychiatric assessments were carried out on the first day after delivery and at 6-8 weeks postpartum. During the first assessment, the Panic and Agoraphobia Scale (PAS), Hospital Anxiety and Depression Scale (HADS), Coping Orientation to Problems Experienced (COPE), Multidimensional Scale of Perceived Social Support (MSPSS), and Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) were administered to the participants. PAS was also administered at the second assessment. RESULTS The mean PAS score reduced significantly from baseline to the second assessment. Logistic regression analysis indicated that a shorter duration of panic disorder independently predicted a ≥ 50-point decrease in the severity of panic symptoms during the postpartum period. CONCLUSION These findings suggest that patients with a short duration of illness may experience significant alleviation in the severity of panic symptoms during the postpartum period.
Collapse
Affiliation(s)
- Semra Aydogan
- Department of Psychiatry, University of Necmettin Erbakan, Meram Faculty of Medicine Konya, Konya, Turkey
| | - Faruk Uguz
- Department of Psychiatry, University of Necmettin Erbakan, Meram Faculty of Medicine Konya, Konya, Turkey
| | - Eda Yakut
- Department of Psychiatry, University of Health Sciences, Konya Training, Research Hospitals, Konya, Turkey
| | - Melike G. Bayman
- Department of Psychiatry, University of Health Sciences, Konya Training, Research Hospitals, Konya, Turkey
| | - Kazim Gezginc
- Department of Obstetrics and Gynecology, University of Necmettin Erbakan, Meram Faculty of Medicine, Konya, Turkey
| |
Collapse
|
3
|
Effects of Cytochrome P450 2C19 Genetic Polymorphisms on Responses to Escitalopram and Levels of Brain-Derived Neurotrophic Factor in Patients With Panic Disorder. J Clin Psychopharmacol 2019; 39:117-123. [PMID: 30742590 DOI: 10.1097/jcp.0000000000001014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE/BACKGROUND The purpose of this study was to examine the relationships between ytochrome P450 family 2 subfamily C member 19 (CYP2C19) polymorphisms, brain-derived neurotrophic factor (BDNF) plasma levels, and treatment responses to escitalopram in Chinese patients with panic disorder (PD). METHODS/PROCEDURES Ninety patients with PD were administered the Panic Disorder Severity Scale-Chinese Version (PDSS-CV) and Hamilton Anxiety Scale (HAMA-14) from baseline to 8 weeks. Escitalopram treatment (10 mg/d) was administered for 8 consecutive weeks. Three CYP2C19 metabolizers, including extensive metabolizers, intermediate metabolizers, and poor metabolizers (PMs), and 5 CYP2C19 genotypes were detected by polymerase chain reaction-genotyping microarray analysis. Baseline plasma BDNF levels were tested using human BDNF enzyme-linked immunosorbent assay kits. FINDINGS/RESULTS Our findings showed no significant differences in demographic data, baseline PDSS-CV scores, or HAMA-14 scores between the 3 CYP2C19 metabolizer groups (P's > 0.05). Repeated-measures analysis showed a significant reduction in PDSS-CV (F = 221.49, df = 3, P < 0.001) and HAMA-14 (F = 260.47, df = 3, P < 0.001) scores over 8 weeks in PD patients. In addition, patients with PMs had a greater reduction in HAMA-14 scores (F = 2.14, P = 0.049) than did those with extensive metabolizers and intermediate metabolizers. Moreover, our findings showed that patients with *2/*2 genotypes had a greater reduction in PDSS-CV scores than did those with other genotypes (F = 2.14, df = 12, P = 0.015). IMPLICATIONS/CONCLUSIONS Our study provides preliminary evidence of the effects of CYP2C19 PMs on treatment responses to escitalopram in Chinese PD patients, but no significant correlation between treatment responses and BDNF levels was found.
Collapse
|
4
|
Zugliani MM, Cabo MC, Nardi AE, Perna G, Freire RC. Pharmacological and Neuromodulatory Treatments for Panic Disorder: Clinical Trials from 2010 to 2018. Psychiatry Investig 2019; 16:50-58. [PMID: 30696238 PMCID: PMC6354041 DOI: 10.30773/pi.2018.12.21.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/29/2018] [Accepted: 12/21/2018] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Treatment for panic disorder (PD) have evolved, although there is still a strong unmet need for more effective and tolerable options. The present study summarizes and discusses recent evidence regarding the pharmacological and neuromodulatory treatment of PD. METHODS MEDLINE, Cochrane Library, PsycINFO and Thomson Reuters's Web of Science were searched for clinical trials published between 2010 and 2018. We included all prospective experimental studies including randomized controlled trials (RCT) and other clinical trials with more than 10 patients. RESULTS Only 11 articles met the inclusion criteria, including 4 RCT, 3 open clinical trials and 5 comparative clinical trials. RCT demonstrated efficacy of transcranial magnetic stimulation (TMS) in only one of two trials. Neither pindolol nor d-fenfluramine were effective in blocking flumazenil-induced panic attacks. Augmentation with quetiapine was not superior to placebo. Open trials indicated that escitalopram, vortioxetine and TMS may be effective. Comparative trials did not demonstrate superiority from any drug, but confirmed tranylcypromine, paroxetine, clonazepam and alprazolam as effective options. CONCLUSION The current study confirmed the efficacy of tranylcypromine, paroxetine, clonazepam, alprazolam and escitalopram. Vortioxetine and TMS, with duration of 4 or more weeks, also seems to be effective. Quetiapine, pindolol and d-fenfluramine were not considered effective compounds.
Collapse
Affiliation(s)
- Morena M. Zugliani
- Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariana C. Cabo
- Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Antonio E. Nardi
- Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Giampaolo Perna
- Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
- Department of Clinical Neurosciences, Villa San Benedetto Menni, Hermanas Hospitalarias, FoRiPsi, Albese con Cassano, Italy
| | - Rafael C. Freire
- Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
5
|
Quagliato LA, Freire RC, Nardi AE. Risks and benefits of medications for panic disorder: a comparison of SSRIs and benzodiazepines. Expert Opin Drug Saf 2018; 17:315-324. [DOI: 10.1080/14740338.2018.1429403] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Laiana A. Quagliato
- Laboratory of Panic & Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael C. Freire
- Laboratory of Panic & Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Antonio E. Nardi
- Laboratory of Panic & Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
6
|
Watanabe T, Ueda M, Ishiguro S, Hayashi Y, Aoki A, Shinozaki M, Kato K, Akiyama K, Shimoda K. Early Improvement and Marriage Are Determinants of the 12-Month Treatment Outcome of Paroxetine in Outpatients with Panic Disorder. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2017; 15:382-390. [PMID: 29073750 PMCID: PMC5678480 DOI: 10.9758/cpn.2017.15.4.382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/22/2017] [Accepted: 03/18/2017] [Indexed: 01/06/2023]
Abstract
Objective In this study, we investigated the determinants of remission and discontinuation of paroxetine pharmacotherapy in outpatients with panic disorder (PD). Methods Subjects were 79 outpatients diagnosed with PD who took 10-40 mg/day of paroxetine for 12 months. The candidate therapeutic determinants included the serotonin transporter gene-linked polymorphic region and the -1019C/G promoter polymorphism of the serotonin receptor 1A as genetic factors, educational background and marital status as environmental factors, and early improvement (EI) at 2 weeks as a clinical factor were assessed. The Clinical Global Impression scale was used to assess the therapeutic effects of the pharmacotherapy. Results Cox proportional hazards regression was performed to investigate the significant predictive factors of remission and discontinuation. EI was only a significant predictive factor of remission. EI was a significant predictive factor of remission (hazard ratio [HR], 2.709; 95% confidence interval [CI], 1.177-6.235). Otherwise, EI and marital status were significant predictive factors of the discontinuation. EI (HR, 0.266; 95% CI, 0.115-0.617) and being married (HR, 0.437; 95% CI, 0.204-0.939) were considered to reduce the risk of treatment discontinuation. In married subjects, EI was a significant predictive factor of the discontinuation (HR, 0.160; 95% CI, 0.045-0.565). However, in unmarried subjects, EI was not a significantly predictive factor for the discontinuation. Conclusion EI achievement appears to be a determinant of PD remission in paroxetine treatment. In married PD patients, EI achievement also appears to reduce a risk of discontinuation of paroxetine treatment.
Collapse
Affiliation(s)
- Takashi Watanabe
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Mikito Ueda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Shin Ishiguro
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Yuki Hayashi
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Akiko Aoki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Masataka Shinozaki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Kazuko Kato
- Mental Health Clinic SAKURA-RA, Utsunomiya, Japan
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| |
Collapse
|
7
|
Perna G, Caldirola D. Management of Treatment-Resistant Panic Disorder. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2017; 4:371-386. [PMID: 29238651 PMCID: PMC5717132 DOI: 10.1007/s40501-017-0128-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Purpose of Review Management of treatment-resistant (TR) panic disorder (PD) is an unresolved issue. In this paper, we provide a brief summary of previous findings, an updated (2015-2017) systematic review of pharmacological/non-pharmacological studies, and our personal perspective on this topic. RECENT FINDINGS Recent Findings We found a very limited number of recent findings. Quetiapine extended-release augmentation has not been found to be beneficial, in comparison to placebo, in non-responders to previously recommended pharmacotherapy. In non-responders to cognitive behavioral therapy (CBT), switching to paroxetine/citalopram has been found to be more effective than continuing CBT. Acceptance and commitment therapy (ACT) has shown some improvement in patients' resistance to previous psychological/pharmacological interventions compared with a waiting-list condition. SUMMARY Summary Previous and recent findings regarding the treatment of TR PD suffer from several methodological limitations. Available studies provide insufficient evidence to support the use of medications alternative to the recommended medications; the efficacy of ACT needs confirmation with more rigorous methodology. Prolonged pharmacotherapy may produce significant improvement in patients with unsatisfactory response to short-term pharmacotherapy, while switching to pharmacotherapy may help non-responders to CBT. We discuss our personal perspective on the definition of "treatment resistance" as it relates to PD and provide personalized intervention strategies to increase favorable clinical outcomes based on our clinical expertise and review of experimental studies on the pathophysiology of PD.
Collapse
Affiliation(s)
- Giampaolo Perna
- Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, FoRiPsi, Hermanas Hospitalarias, Albese con Cassano, 22032 Como, Italy
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, 6200 The Netherlands
- Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, Miami University, Miami, FL 33136-1015 USA
| | - Daniela Caldirola
- Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, FoRiPsi, Hermanas Hospitalarias, Albese con Cassano, 22032 Como, Italy
| |
Collapse
|
8
|
Chen K, Wang N, Zhang J, Hong X, Xu H, Zhao X, Huang Q. Is the Val66Met polymorphism of the brain-derived neurotrophic factor gene associated with panic disorder? A meta-analysis. Asia Pac Psychiatry 2017; 9. [PMID: 26687639 DOI: 10.1111/appy.12228] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 11/08/2015] [Indexed: 02/05/2023]
Abstract
Although emerging evidence has suggested an association between the Val66Met (rs6265) polymorphisms in brain-derived neurotrophic factor (BDNF) gene and the panic disorder, the conclusion is inclusive given the mixed results. This meta-analysis reviewed and analyzed the recent studies addressing the potential association between the Val66Met polymorphisms and panic disorder susceptibility. Related case-control studies were retrieved by database searching and selected according to established inclusion criteria. Six articles were identified, which explored the association between the BDNF Val66Met polymorphism and panic disorder. Statistical analyses revealed no association for the allele contrast and the dominant model. However, the recessive model showed a significant association between the BDNF Val66Met polymorphism and panic disorder (odds ratio = 1.26, 95% confidence interval = 1.04-1.52, z = 2.39, P = 0.02). Despite of some limitations, this meta-analysis suggests that the Val66Met polymorphism of BDNF gene is a susceptibility factor for panic disorder.
Collapse
Affiliation(s)
- Kaiyuan Chen
- Mental Health Center, Shantou University Medical College, Shantou, Guangdong Province, China
| | - Na Wang
- Mental Health Center, Zhengzhou Ninth People's Hospital, Zhengzhou, Henan Province, China
| | - Jie Zhang
- Mental Health Center, Shantou University Medical College, Shantou, Guangdong Province, China
| | - Xiaohong Hong
- Mental Health Center, Shantou University Medical College, Shantou, Guangdong Province, China
| | - Haiyun Xu
- Mental Health Center, Shantou University Medical College, Shantou, Guangdong Province, China
| | - Xiaofeng Zhao
- Clinical Pharmacology Base, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Qingjun Huang
- Mental Health Center, Shantou University Medical College, Shantou, Guangdong Province, China
| |
Collapse
|
9
|
Kang HJ, Bae KY, Kim SW, Shin IS, Hong YJ, Ahn Y, Jeong MH, Yoon JS, Kim JM. Effects of Escitalopram on Anxiety in Patients with Acute Coronary Syndrome: A Randomized Controlled Trial. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2017; 15:126-131. [PMID: 28449559 PMCID: PMC5426500 DOI: 10.9758/cpn.2017.15.2.126] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 08/12/2016] [Accepted: 08/13/2016] [Indexed: 12/31/2022]
Abstract
Objective There are no evidence-based practices for treating anxiety in patients with acute coronary syndrome (ACS). Thus, we investigated the effects of escitalopram on anxiety in this population. Methods We enrolled 217 patients with ACS who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for depressive disorders into a randomized double-blind placebo-controlled study. Patients received either escitalopram or placebo over a 24-week period. Anxiety symptoms were evaluated using the Hospital Anxiety and Depression Scale-anxiety subscale (HADS-A). A HADS-A score >7 was classified as an anxiety disorder. Baseline evaluations included sociodemographic and clinical characteristics, such as depressive symptoms, cardiovascular risk factors, and current cardiac status. Results Independent of improvements in depression and without any differences in safety profiles, escitalopram treatment was significantly more efficacious in treating and reducing anxiety than placebo over a 24-week period. Conclusion Escitalopram can be recommended as an effective and safe treatment option for anxiety in patients with ACS.
Collapse
Affiliation(s)
- Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Kyung-Yeol Bae
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea
| | - Jin-Sang Yoon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| |
Collapse
|
10
|
Personalized medicine in panic disorder: where are we now? A meta-regression analysis. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.pmip.2016.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
11
|
Abstract
Many aspects of long-term pharmacological treatments for anxiety disorders (AnxDs) are still debated. We undertook an updated systematic review of long-term pharmacological studies on panic disorder (PD), generalized anxiety disorder (GAD), and social anxiety disorder (SAD). Relevant studies dating from January 1, 2012 to August 31, 2015 were identified using the PubMed database and a review of bibliographies. Of 372 records identified in the search, five studies on PD and 15 on GAD were included in the review. No studies on SAD were found. Our review confirms the usefulness of long-term pharmacological treatments for PD and GAD and suggests that they can provide further improvement over that obtained during short-term therapy. Paroxetine, escitalopram, and clonazepam can be effective for long-term treatment of PD. However, further studies are needed to draw conclusions about the long-term benzodiazepine use in PD, particularly for the possible cognitive side-effects over time. Pregabalin and quetiapine can be effective for long-term treatment of GAD, while preliminary suggestions emerged for agomelatine and vortioxetine. We did not find any evidence for determining the optimal length and/or dosage of medications to minimize the relapse risk. Few investigations have attempted to identify potential predictors of long-term treatment response. Personalized treatments for AnxDs can be implemented using predictive tools to explore those factors affecting treatment response/tolerability heterogeneity, including neurobiological functions/clinical profiles, comorbidity, biomarkers, and genetic features, and to tailor medications according to each patient's unique features.
Collapse
|
12
|
Yu ST, Kim MK, Kim B, Yoo E, Lee JY, Lee KS, Choe AY, Yook KH, Choi TK, Lee SH. The Effects of 5-HTR1A Polymorphism on Cingulum Connectivity in Patients with Panic Disorder. Psychiatry Investig 2013; 10:399-406. [PMID: 24474990 PMCID: PMC3902159 DOI: 10.4306/pi.2013.10.4.399] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 01/29/2013] [Accepted: 02/04/2013] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Serotonin-1A receptors (5-HTR1A) is suggested to be involved in the etiology of several psychiatric disorders including panic disorder (PD). A few imaging studies have suggested the alterations of the cingulum bundle in PD. The objective of this study is to examine the structural changes of cingulum related to the 5-HTR1A polymorphism rs6295 in the patients with PD. METHODS Thirty-two right-handed patients with PD [11 men, 21 women; 40.34±13.17 (mean±SD) age] who met the diagnostic criteria in Structured Clinical Interview for DSM-IV were examined by means of MRI at 3 Tesla. We divided the patients with PD into CC genotype group and non CC genotype group (GG/CG genotype group) of the 5-HTR1A rs6295 polymorphism to compare the cingulum white matter connectivity. RESULTS Tract-based spatial statistics showed significantly increased fractional anisotropy (FA) values in cingulate gyrus process of left cingulum in 5-HTR1A CC genotype compared to GG/CG genotype in PD. Significant positive correlations were shown between the Albany Panic and Phobia Questionnaire (APPQ) interoceptive fear subscale scores, the Anxiety Sensitivity Inventory-Revised fear of publicly observable anxiety reaction subscale scores and FA values of cingulate gyrus process of left cingulum in 5-HTR1A rs6295 GG/CG genotype group. In CC genotype group, APPQ total, APPQ agoraphobia subscale and APPQ social phobia subscale scores also showed significant positive correlations with FA values of hippocampal process of right cingulum. CONCLUSION This preliminary study suggests that 5-HTR1A polymorphism may be associated with the cingulum white matter connectivity in PD.
Collapse
Affiliation(s)
- Seung Taek Yu
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Min-Kyoung Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Borah Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Eunhye Yoo
- Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Jun-Yeob Lee
- Department of Psychiatry, CHA Gumi Medical Center, CHA University, Gumi, Republic of Korea
| | - Kang Soo Lee
- Department of Psychiatry, CHA Gangnam Medical Center, CHA University, Seoul, Republic of Korea
| | - Ah Young Choe
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Ki-Hwan Yook
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Tai Kiu Choi
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| |
Collapse
|