Panic disorder and cardiovascular/cerebrovascular problems: results from a community survey

Article Abstract:

An increased rate of death from cardiovascular and cerebrovascular disorders has been noted in men who also have panic disorder. Panic disorder is characterized by severe anxiety, heart palpitations, chest pain, choking, and sweating. A variety of explanations has been provided to account for this association. From a sampling of 5,034 individuals living in or around the New Haven, Connecticut area who were a part of the Epidemiologic Catchment Area program, a study of risks and rates of mental disorders based on random sampling, 60 subjects were identified with diagnosed panic disorder. No medical or laboratory tests were performed (patients reported their own medical histories), and although the initial sample was large, the number of individuals with panic attacks was small, which are factors that suggest the results should be interpreted cautiously. With these limitations in mind, the authors report that the risk of stroke in the panic disorder group was over twice the risk for patients with other psychiatric disorders or no psychiatric disorder. Individuals with panic disorder also had a higher risk of high blood pressure and heart attack compared with those without psychiatric disorders. Possible mechanisms to account for these associations are discussed; these include rupture of an artery in the brain or the loosening of a blood clot during a panic episode. Although this study is limited by design, these findings indicate that this phenomenon needs attention. Further research to replicate the results and to clarify the mechanisms involved is recommended. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Cardiovascular diseases, Complications and side effects, Risk factors, Stroke (Disease), Stroke

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Abnormal melatonin response to 5-methoxypsoralen in dementia

Article Abstract:

Abnormalities in the production of melatonin, a hormone secreted by the pineal gland, have been associated with abnormal psychiatric conditions. Low night-time secretions are involved in depressive disorders and impaired melatonin production has been connected with Alzheimer's disease. This study consisted of 39 healthy elderly adults and three other groups with 13 subjects in each. The individuals in these three groups were classified as either demented, depressed or schizophrenic. Blood levels of melatonin were measured before and three hours after an oral 40mg dose of 5-methoxypsoralen and the reaction of all four groups was noted. This drug is known to induce a gradual but dramatic surge of melatonin when given to humans in the morning or evening. The results of the study are limited by the size of the group, the fact that subjects were not closely matched, and the wide variety of baseline melatonin concentrations associated with a wide range of body measurement characteristics such as weight and height. The result indicated a blunted response to 5-methoxypsoralen in the group of demented patients. Baseline levels of melatonin and age did not vary widely in this group and thus those two variables were not responsible for the differences. The researchers have linked these results with previous studies that observed a dramatic reduction of nocturnal melatonin in Alzheimer's disease patients. It was suggested that this decrease in melatonin indicated a neuropathological abnormality involving the function of the pineal gland. No relationships were found between the other groups and abnormal melatonin response to the drug.

Research, Dementia, Pineal gland

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Plasma concentrations of melatonin in panic disorder

Article Abstract:

Melatonin is a hormone produced in the pineal gland that is known to follow a circadian rhythm, meaning its blood levels fluctuate throughout the 24-hour period. Melatonin synthesis is thought to be affected by intense stress. An association has been found between melatonin levels and affective disorders. Previous studies have indicated that blood plasma levels of melatonin are lower in panic disorder patients than normal control subjects; however most of these patients were taking benzodiazepine and antidepressant drugs for their panic condition, and benzodiazepines have been found to suppress nocturnal levels of melatonin. To further investigate this association, seven patients with panic disorder were assessed and compared with eight normal control subjects. Five of the panic disorder patients had never taken drugs for their panic disorders. Hourly collections of blood samples were taken for all subjects from 10:00 p.m. to 8:00 a.m.; none of the subjects had received drug treatment for seven days before these measurements. When the data were assessed, the panic disorder patients who had never received drug treatments had significantly higher levels of melatonin in their blood during the second half of the night (from 4:00 a.m. to 7:00 a.m.) than the other subjects (normal controls and panic disorder patients formerly treated with medications). In general, these results substantiate prior studies and further support a role for melatonin in the biochemical mechanism of panic disorder. (Consumer Summary produced by Reliance Medical Information, Inc.)

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