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 |

- Author Guidelines
- Bentham Author Support Services (BASS)
- 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
-
Urinary Metabolite Profiles May be Predictive of Cognitive Performance under Conditions of Acute Sleep Deprivation
Current Metabolomics Estimation of Affinity of HLA-A*0201 Restricted CTL Epitope Based on the SCORE Function
Protein & Peptide Letters Corticotropin Releasing Factor (CRF) Receptor Signaling in the Central Nervous System: New Molecular Targets
CNS & Neurological Disorders - Drug Targets New Potential Targets to Modulate Neutrophil Function in Inflammation
Mini-Reviews in Medicinal Chemistry Current Understanding of the Mechanisms by which Membrane-Active Peptides Permeate and Disrupt Model Lipid Membranes
Current Topics in Medicinal Chemistry Structural Chromosome Abnormalities Associated with Obesity: Report of Four New Subjects and Review of Literature
Current Genomics Bispidine as a Privileged Scaffold
Current Topics in Medicinal Chemistry From Peptides to Small Molecules: An Intriguing but Intricated Way to New Drugs
Current Medicinal Chemistry Donepezil Derivatives Targeting Amyloid-β Cascade in Alzheimer's Disease
Current Alzheimer Research Ameliorative Effects of Baicalein on an Amyloid-β Induced Alzheimer's Disease Rat Model: A Proteomics Study
Current Alzheimer Research Targets and Patented Drugs for Chemotherapy of Chagas Disease in the Last 15 Years-Period
Recent Patents on Anti-Infective Drug Discovery Small Diverse Antioxidant Functionalities for Oxidative Stress Disease Drug Discovery
Mini-Reviews in Medicinal Chemistry Basal Ganglia Enlarged Perivascular Spaces are Linked to Cognitive Function in Patients with Cerebral Small Vessel Disease
Current Neurovascular Research Advances in Whole Genome Sequencing Technology
Current Pharmaceutical Biotechnology Intracranial MR Dynamics in Clinically Diagnosed Alzheimers Disease: The Emerging Concept of “Pulse Wave Encephalopathy”
Current Alzheimer Research Control of Neuropathic Pain by Immune Cells and Opioids
CNS & Neurological Disorders - Drug Targets Updated Indicators to Evaluate Harmful Drug Use, in Particular, Poly-Drug Use
Current Drug Research Reviews Mast Cell Tryptase β as a Target in Allergic Inflammation: An Evolving Story
Current Pharmaceutical Design The Bioinorganic Chemistry of Methimazole Based Soft Scorpionates
Current Bioactive Compounds A Comprehensive Review on Recent Developments in the Field of Biological Applications of Potent Pyrazolines Derived from Chalcone Precursors
Letters in Drug Design & Discovery