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Research Article| Volume 22, ISSUE 9, P1127-1136, September 1987

Plasma MHPG levels in lactate and isoproterenol anxiety states

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      Abstract

      It has been claimed that an increase in brain noradrenergic activity plays a role in panic disorder and that enhanced noradrenergic activity may be reflected by plasma levels of MHPG. We investigated plasma MHPG levels in panic disorder patients at baseline and during lactate- and isoproterenol-induced anxiety states. These infusions and 5% dextrose infusions were given to 10 panic disorder patients and 9 healthy control subjects. Each subject received all three infusions, double-blind, in random order, and at 1-week intervals. When compared to controls, plasma free MHPG levels in panic patients were not elevated at baseline, during lactate or isoproterenol infusions, at the point of panic, or up to 20 min after the onset of panic. MHPG values were also not elevated in subjects who panicked compared to those who did not. MHPG values were significantly lower in three patients who failed to panic with isoproterenol, but the patient panickers had MHPG values similar to those of controls. Significant correlations between MHPG levels and anxiety ratings were infrequent and could be accounted for by chance alone. These results did not support the noradrenergic model for panic anxiety states induced by lactate or isoproterenol.
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      References

        • Bonn JA
        • Harrison J
        • Rees WL
        Lactate-induced anxiety: Therapeutic applications.
        Br J Psychiatry. 1971; 119: 468-471
        • Boulenger JP
        • Uhde TW
        • Wolff III, EA
        • Post RM
        Increased sensitivity to caffeine in patients with panic disorders: Preliminary evidence.
        Arch Gen Psychiatry. 1984; 41: 1067-1071
        • Carr DB
        • Sheehan DV
        • Surman OS
        • Coleman JH
        • Greenblatt DJ
        • Heninger GR
        • Jones KJ
        • Levine PH
        • Watkins WD
        Neuroendocrine correlates of lactate-induced anxiety and their response to chronic alprazolam therapy.
        Am J Psychiatry. 1986; 143: 483-494
        • Charney DS
        • Heninger GR
        • Redmond Jr, DE
        Yohimbine induced anxiety and increased noradrenergic function in humans: Effects of diazepam and clonidine.
        Life Sci. 1983; 33: 19-29
        • Charney DS
        • Galloway MP
        • Heninger GR
        The effects of caffeine on plasma MHPG, subjective anxiety, autonomic symptoms and blood pressure in healthy humans.
        Life Sci. 1984; 35: 135-144
        • Charney DS
        • Heninger GR
        • Breier A
        Noradrenergic function in panic anxiety: Effects of yohimbine in healthy subjects and patients with agoraphobia and panic disorder.
        Arch Gen Psychiatry. 1984; 41: 751-763
        • Crawley JN
        • Maas JW
        • Roth RH
        Evidence against specificity of electrical stimulation of the nucleus locus coeruleus in activating the sympathetic nervous system in the rat.
        Brain Res. 1980; 183: 301-311
        • Fink M
        • Taylor MA
        • Volavka J
        Anxiety precipitated by lactate.
        N Engl J Med. 1970; 281: 1129
        • Hamilton M
        The assessment of anxiety states by rating.
        Br J Med Psychol. 1959; 32: 50
        • Hamlin CL
        • Lydiard RB
        • Martin D
        • Dackis CA
        • Pottash AC
        • Sweeney D
        • Gold MS
        Urinary excretion of noradrenaline metabolite decreased in panic disorder.
        Lancet. 1983; ii: 740-741
        • Holmberg G
        • Gershon S
        Autonomic and psychiatric effects of yohimbine hydrochloride.
        Psychopharmacologia. 1961; 2: 93-106
        • Hyemdahl P
        • Sjoquist B
        • Daleskog M
        • Eliasson K
        A comparison of noradrenaline, MHPG and VMA in plasma as indicators of sympathetic nerve activity in man.
        Acta Physiol Scand. 1982; 115: 507-509
        • Jimerson D
        • Ballenger J
        • Lake C
        • Post R
        • Goodwin F
        • Kopin I
        Plasma and CSF MHPG in normals.
        Psychopharmacol Bull. 1981; 17: 86-87
        • Jimerson DC
        • Markey SP
        • Oliver JA
        • Kopin IJ
        Simultaneous measurement of plasma 4-hydroxy-3-methoxyphenylethylene glycol and 3,4-dihydroxyphenylethylene glycol by gas chromatography mass spectrometry.
        Biomed Mass Spectrom. 1981; 8: 256-259
        • Kaitin KI
        • Bliwise DL
        • Gleason C
        • Nino-Murcia G
        • Dement WC
        • Libet B
        Sleep disturbance produced by electrical stimulation of the locus coeruleus in a human subject.
        Biol Psychiatry. 1986; 21: 710-716
        • Kelly D
        • Mitchell-Heggs N
        • Sherman D
        Anxiety and the effects of sodium lactate assessed clinically and physiologically.
        Br J Psychiatry. 1971; 119: 129-141
        • Ko GN
        • Elsworth JD
        • Roth RH
        • Rifkin BG
        • Leigh H
        • Redmond Jr, DE
        Panic-induced elevation of plasma MHPG levels in phobic-anxious patients: Effects of clonidine and imipramine.
        Arch Gen Psychiatry. 1983; 40: 425-430
        • Kopin IJ
        Avenues of investigation for the role of catecholamines in anxiety.
        Psychopathology. 1984; 17: 83-97
        • Liebowitz MR
        • Fyer AJ
        • Gorman JM
        • Dillon D
        • Appleby IL
        • Levy G
        • Anderson S
        • Levitt M
        • Palij M
        • Davies SO
        • Klein DF
        Lactate provocation of panic attacks: I. Clinical and behavioral findings.
        Arch Gen Psychiatry. 1984; 41: 764-770
        • Pitts Jr, FN
        • McClure Jr, JN
        Lactate metabolism in anxiety neurosis.
        N Engl J Med. 1967; 277: 1328-1336
        • Pohl R
        • Rainey Jr, JM
        • Ortiz A
        • Balon R
        • Singh H
        • Berchou R
        Isoproterenol anxiety states.
        Psychopharmacol Bull. 1985; 21: 424-427
        • Rainey Jr, JM
        • Pohl R
        • Williams M
        • Knitter E
        • Freedman R
        • Ettedgui E
        A comparison of lactate and isoproterenol anxiety states.
        Psychopathology. 1984; 17: 74-82
        • Rainey Jr, JM
        • Ettedgui E
        • Pohl R
        • Balon R
        • Weinberg P
        • Yelonek S
        • Berchou R
        The beta-receptor: Isoproterenol anxiety states.
        Psychopathology. 1984; 17: 40-51
        • Redmond Jr, DE
        New and old evidence for the involvement of a brain norepinephrine system in anxiety.
        in: Fann WE Karacan I Porkorny AD Williams RL Phenomenology and Treatment of Anxiety. Spectrum Books, New York1979: 153-203
        • Spielberger C
        • Gorsuch R
        • LuShene R
        Manual for the State-Trait Anxiety Inventory (Self-evaluation Questionnaire). Consultant Psychologists Press, Palo Alto1970
        • Spitzer R
        • Endicott J
        • Robins E
        Research Diagnostic Criteria (RDC)for a Selected Group of Functional Disorders.
        3rd ed. New York State Psychiatric Institute, New York1978
        • Uhde TW
        • Siever LJ
        • Post RM
        • Jimerson DC
        • Boulenger JP
        • Buchsbaum MS
        Relationship of plasma-free MHPG to anxiety and psychophysical pain in normal volunteers.
        Psychopharmacol Bull. 1982; 18: 129-132
        • Uhde TW
        • Boulenger JP
        • Siever L
        • Vittone B
        • Jimerson DC
        • Post R
        Panic disorder: Drug challenge strategies.
        in: Syllabus and Scientific Proceedings of the American Psychiatric Association 137th Annual Meeting, Los Angeles, May 5–111984