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Research Article| Volume 30, ISSUE 3, P247-256, August 01, 1991

Higher postdexamethasone serum cortisol levels in agoraphobic than in nonagoraphobic panic disorder patients

  • Peter Westberg
    Affiliations
    From the Departments of Psychiatry/Neurochemistry (PW, KM, PL) and Pharmacology (EE), University of Göteberg, Göteberg, Sweden.
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  • Kjell Modigh
    Affiliations
    From the Departments of Psychiatry/Neurochemistry (PW, KM, PL) and Pharmacology (EE), University of Göteberg, Göteberg, Sweden.
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  • Pia Lisjö
    Affiliations
    From the Departments of Psychiatry/Neurochemistry (PW, KM, PL) and Pharmacology (EE), University of Göteberg, Göteberg, Sweden.
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  • Elias Eriksson
    Correspondence
    Address reprint requests to Elias Eriksson, Department of Pharmacology, University of Göteborg, P.O.B. 33031, S-400 33 Göteborg, Sweden.
    Affiliations
    From the Departments of Psychiatry/Neurochemistry (PW, KM, PL) and Pharmacology (EE), University of Göteberg, Göteberg, Sweden.
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DOI:https://doi.org/10.1016/0006-3223(91)90109-Y
Higher postdexamethasone serum cortisol levels in agoraphobic than in nonagoraphobic panic disorder patients
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      Abstract

      The dexamethasone suppresion test (DST) was performed in panic disorder (PD) patients with (n = 32) or without (n = 31) agoraphobia and in normal controls (n = 49). Postdexamethasone serum cortisol levels were significantly higher in agoraphobic PD patients (105.3 ± 19.3 nmol/L) both when compared to PD patients withput agoraphobia (47.3 ± 7.7 nmol/L; p < 0.01) and when compared to healthy controls (51.7 ± 8.3 nmol/L; p < 0.01). The rate of nonsuppressors (i.e., subjects displaying postdexamethasone cortisol levels > 138 nmol/L) was 28% and 3% in agoraphobic and nonagoraphobic PD patients, respectively, and 12% in controls. In patients, the postdexamethasone cortisol levels did not correlate with the number of panic attacks per week, baseline anxiety as measured using the Hamilton Anxiety Scale, depressive symptoms as measured using the Montgomery-Åsberg Depression scale, or duration of illness. Data from eight patients in whom a second DST was performed after treatment with imipramine or clomipramine for three months indicate that a marked reduction of the number of anxiety attacks is not necessarily accompanied by a normalization of pathological DST. In conclusion, it is suggested that the elevated postdexamethasone cortisol levels sometimes observed in agoraphobic PD patients are more closely related to the agoraphobic behavior than to the panic attacks per se.
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      Article info

      Publication history

      Received in revised form: February 23, 1991
      Received: May 24, 1990

      Footnotes

      ☆This study was supported by grants from the Swedish Medical Research Council (04752 and 08668), the Swedish Society of Medicine, and by CIBA-GEIGY Pharma Division, Sweden.

      Identification

      DOI: https://doi.org/10.1016/0006-3223(91)90109-Y

      Copyright

      © 1991 Published by Elsevier Inc.

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