Abstract
Introduction: Data on basal hypothalamo-pituitary-adrenomedullary (HPA) function over controlled treatment trials with serotonergic drugs in anxiety disorders are still rare. Methods: 29 patients with panic disorder participating in a 10 week randomized, controlled trial (paroxetine vs. placebo with exercise or relaxation; N=60) collected urine for cortisol excretion over 3 consecutive nights before start and before termination of the treatment episode. Urinary cortisol was measured by radioimmunoassay. Efficacy measures were the Clinical Global Impression Scale (CGI) and the Panic and Agoraphobia Scale (P). 83% were female (p < .05 vs. males). 55% received additional aerobic exercise, and 45% relaxation. 55% received paroxetine treatment, and 45% placebo. Significantly fewer males received placebo treatment (p < .05). Results: All subjects improved significantly. Cortisol excretion did not differ between treatment groups or at pre-/post measurements. Females showed a significantly higher variability of cortisol excretion compared to males, at pre-(p < .005) and post (p=.015) assessments. Males displayed a trend to lower basal HPA function at end of treatment (p=.08). HPA variability after treatment showed a trend to be higher in the paroxetine (p=.052) -who clinically improved significantly better- compared to the placebo group. No relationship between HPA activity and treatment response or with exercise was detected. Discussion: HPA function shows significant gender differences, with females having a higher HPA function variability. Future studies on HPA function in treatment trials should address gender and medication effects.
Keywords: Panic disorder, cortisol, HPA axis, paroxetine, gender, antidepressants
Current Pharmaceutical Design
Title: Nocturnal Urinary Cortisol Excretion Over a Randomized Controlled Trial with Paroxetine vs. Placebo Combined with Relaxation Training or Aerobic Exercise in Panic Disorder
Volume: 14 Issue: 33
Author(s): D. Wedekind, A. Sprute, A. Broocks, G. Huther, K. Engel, P. Falkai and B. Bandelow
Affiliation:
Keywords: Panic disorder, cortisol, HPA axis, paroxetine, gender, antidepressants
Abstract: Introduction: Data on basal hypothalamo-pituitary-adrenomedullary (HPA) function over controlled treatment trials with serotonergic drugs in anxiety disorders are still rare. Methods: 29 patients with panic disorder participating in a 10 week randomized, controlled trial (paroxetine vs. placebo with exercise or relaxation; N=60) collected urine for cortisol excretion over 3 consecutive nights before start and before termination of the treatment episode. Urinary cortisol was measured by radioimmunoassay. Efficacy measures were the Clinical Global Impression Scale (CGI) and the Panic and Agoraphobia Scale (P). 83% were female (p < .05 vs. males). 55% received additional aerobic exercise, and 45% relaxation. 55% received paroxetine treatment, and 45% placebo. Significantly fewer males received placebo treatment (p < .05). Results: All subjects improved significantly. Cortisol excretion did not differ between treatment groups or at pre-/post measurements. Females showed a significantly higher variability of cortisol excretion compared to males, at pre-(p < .005) and post (p=.015) assessments. Males displayed a trend to lower basal HPA function at end of treatment (p=.08). HPA variability after treatment showed a trend to be higher in the paroxetine (p=.052) -who clinically improved significantly better- compared to the placebo group. No relationship between HPA activity and treatment response or with exercise was detected. Discussion: HPA function shows significant gender differences, with females having a higher HPA function variability. Future studies on HPA function in treatment trials should address gender and medication effects.
Export Options
About this article
Cite this article as:
Wedekind D., Sprute A., Broocks A., Huther G., Engel K., Falkai P. and Bandelow B., Nocturnal Urinary Cortisol Excretion Over a Randomized Controlled Trial with Paroxetine vs. Placebo Combined with Relaxation Training or Aerobic Exercise in Panic Disorder, Current Pharmaceutical Design 2008; 14 (33) . https://dx.doi.org/10.2174/138161208786848757
DOI https://dx.doi.org/10.2174/138161208786848757 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Can Targeting the Incretin Pathway Dampen RAGE-Mediated Events in Diabetic Nephropathy?
Current Drug Targets Partial Dopamine Receptor Agonists as Newer Atypical Antipsychotics:Intrinsic Activity Appropriate for Treatment of Schizophrenic Patients
Central Nervous System Agents in Medicinal Chemistry Hepatocyte Growth Factor and Insulin-like Growth Factor-1 based Cellular Therapies for Oxidative Stress Injury
Current Stem Cell Research & Therapy Editorial [Hot Topic: The Medicinal Chemistry of Hybrid-Based Drugs Targeting Multiple Sites of Action (Guest Editors: Jose Marco-Contelles, & Elena Soriano)]
Current Topics in Medicinal Chemistry Synergistic Two-Way Interactions of Dietary Polyphenols and Dietary Components on the Gut Microbial Composition: Is There a Positive, Negative, or Neutralizing Effect in the Prevention and Management of Metabolic Diseases?
Current Protein & Peptide Science The Effects of Tryptophan Catabolites on Negative Symptoms and Deficit Schizophrenia are Partly Mediated by Executive Impairments: Results of Partial Least Squares Path Modeling
CNS & Neurological Disorders - Drug Targets Oral Agents in Multiple Sclerosis
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry Nose to Brain Drug Delivery System: A Comprehensive Review
Drug Delivery Letters Genetically Modified Mice Models for Alzheimers Disease
Current Topics in Medicinal Chemistry Comparison of Midwifery Consultation and Fluoxetine on IVF Outcomes in Depressed Infertile Women: A Clinical Trial Research Study
Current Women`s Health Reviews Editorial [Hot topic: NKT Cell Therapy (Guest Editor: Masashi Emoto)]
Current Immunology Reviews (Discontinued) Epidermal Cell Proliferation in Calorie-Restricted Aging Rats
Current Aging Science Modulation of Ornithine Decarboxylase Activity by Phenolics Based Structurally Related Compounds Synthesized on Steroidal and Non-Steroidal Skeleton and their Radical Scavenging Action
Current Bioactive Compounds Application of Molecule-Ion Interactions Between Cyclodextrins and Ions in Inorganic Nanochemistry
Current Organic Chemistry The Role of Autophagy on the Survival of Dopamine Neurons
Current Topics in Medicinal Chemistry Analysis of the Drug Release Profiles from Formulations Based on Micro and Nano Systems
Current Analytical Chemistry Meet Our Editorial Board Member
Current Alzheimer Research Glycolipids as Immune Modulatory Tools
Mini-Reviews in Medicinal Chemistry A Structural Perspective on the Modulation of Protein-Protein Interactions with Small Molecules
Current Topics in Medicinal Chemistry TRP Channels as Targets for Therapeutic Intervention in Obesity: Focus on TRPV1 and TRPM5
Current Topics in Medicinal Chemistry