Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait.Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function.Agoraphobia: Obsessive, persistent, intense fear of open places.Anxiety Disorders: Persistent and disabling ANXIETY.Phobic Disorders: Anxiety disorders in which the essential feature is persistent and irrational fear of a specific object, activity, or situation that the individual feels compelled to avoid. The individual recognizes the fear as excessive or unreasonable.Sodium Lactate: The sodium salt of racemic or inactive lactic acid. It is a hygroscopic agent used intravenously as a systemic and urinary alkalizer.Tetragastrin: L-Tryptophyl-L-methionyl-L-aspartyl-L-phenylalaninamide. The C-terminal tetrapeptide of gastrin. It is the smallest peptide fragment of gastrin which has the same physiological and pharmacological activity as gastrin.Clonazepam: An anticonvulsant used for several types of seizures, including myotonic or atonic seizures, photosensitive epilepsy, and absence seizures, although tolerance may develop. It is seldom effective in generalized tonic-clonic or partial seizures. The mechanism of action appears to involve the enhancement of GAMMA-AMINOBUTYRIC ACID receptor responses.Alprazolam: A triazolobenzodiazepine compound with antianxiety and sedative-hypnotic actions, that is efficacious in the treatment of PANIC DISORDERS, with or without AGORAPHOBIA, and in generalized ANXIETY DISORDERS. (From AMA Drug Evaluations Annual, 1994, p238)Diagnostic and Statistical Manual of Mental Disorders: Categorical classification of MENTAL DISORDERS based on criteria sets with defining features. It is produced by the American Psychiatric Association. (DSM-IV, page xxii)Psychiatric Status Rating Scales: Standardized procedures utilizing rating scales or interview schedules carried out by health personnel for evaluating the degree of mental illness.Psychoanalytic Therapy: A form of psychiatric treatment, based on Freudian principles, which seeks to eliminate or diminish the undesirable effects of unconscious conflicts by making the patient aware of their existence, origin, and inappropriate expression in current emotions and behavior.Cognitive Therapy: A direct form of psychotherapy based on the interpretation of situations (cognitive structure of experiences) that determine how an individual feels and behaves. It is based on the premise that cognition, the process of acquiring knowledge and forming beliefs, is a primary determinant of mood and behavior. The therapy uses behavioral and verbal techniques to identify and correct negative thinking that is at the root of the aberrant behavior.Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function.Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence.Depressive Disorder, Major: Marked depression appearing in the involution period and characterized by hallucinations, delusions, paranoia, and agitation.Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature.Anti-Anxiety Agents: Agents that alleviate ANXIETY, tension, and ANXIETY DISORDERS, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. ADRENERGIC BETA-ANTAGONISTS are commonly used in the symptomatic treatment of anxiety but are not included here.Implosive Therapy: A method for extinguishing anxiety by a saturation exposure to the feared stimulus situation or its substitute.Anxiety: Feeling or emotion of dread, apprehension, and impending disaster but not disabling as with ANXIETY DISORDERS.Allylglycine: An inhibitor of glutamate decarboxylase and an antagonist of GAMMA-AMINOBUTYRIC ACID. It is used to induce convulsions in experimental animals.Anxiety, Separation: Anxiety experienced by an individual upon separation from a person or object of particular significance to the individual.Stress Disorders, Post-Traumatic: A class of traumatic stress disorders with symptoms that last more than one month. There are various forms of post-traumatic stress disorder, depending on the time of onset and the duration of these stress symptoms. In the acute form, the duration of the symptoms is between 1 to 3 months. In the chronic form, symptoms last more than 3 months. With delayed onset, symptoms develop more than 6 months after the traumatic event.Repression-Sensitization: Defense mechanisms involving approach and avoidance responses to threatening stimuli. The sensitizing process involves intellectualization in approaching or controlling the stimulus whereas repression involves unconscious denial in avoiding the stimulus.Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.Hyperventilation: A pulmonary ventilation rate faster than is metabolically necessary for the exchange of gases. It is the result of an increased frequency of breathing, an increased tidal volume, or a combination of both. It causes an excess intake of oxygen and the blowing off of carbon dioxide.Obsessive-Compulsive Disorder: An anxiety disorder characterized by recurrent, persistent obsessions or compulsions. Obsessions are the intrusive ideas, thoughts, or images that are experienced as senseless or repugnant. Compulsions are repetitive and seemingly purposeful behavior which the individual generally recognizes as senseless and from which the individual does not derive pleasure although it may provide a release from tension.Paroxetine: A serotonin uptake inhibitor that is effective in the treatment of depression.Alcohol-Induced Disorders: Disorders stemming from the misuse and abuse of alcohol.Serotonin Uptake Inhibitors: Compounds that specifically inhibit the reuptake of serotonin in the brain.Dysthymic Disorder: Chronically depressed mood that occurs for most of the day more days than not for at least 2 years. The required minimum duration in children to make this diagnosis is 1 year. During periods of depressed mood, at least 2 of the following additional symptoms are present: poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self esteem, poor concentration or difficulty making decisions, and feelings of hopelessness. (DSM-IV)Fear: The affective response to an actual current external danger which subsides with the elimination of the threatening condition.Interview, Psychological: A directed conversation aimed at eliciting information for psychiatric diagnosis, evaluation, treatment planning, etc. The interview may be conducted by a social worker or psychologist.Imipramine: The prototypical tricyclic antidepressant. It has been used in major depression, dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. It has less sedative effect than some other members of this therapeutic group.Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent.Relaxation Therapy: Treatment to improve one's health condition by using techniques that can reduce PHYSIOLOGICAL STRESS; PSYCHOLOGICAL STRESS; or both.Personality Inventory: Check list, usually to be filled out by a person about himself, consisting of many statements about personal characteristics which the subject checks.Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication.Somatoform Disorders: Disorders having the presence of physical symptoms that suggest a general medical condition but that are not fully explained by a another medical condition, by the direct effects of a substance, or by another mental disorder. The symptoms must cause clinically significant distress or impairment in social, occupational, or other areas of functioning. In contrast to FACTITIOUS DISORDERS and MALINGERING, the physical symptoms are not under voluntary control. (APA, DSM-V)Hypocapnia: Clinical manifestation consisting of a deficiency of carbon dioxide in arterial blood.Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Alkalosis, Respiratory: A state due to excess loss of carbon dioxide from the body. (Dorland, 27th ed)Antidepressive Agents, Tricyclic: Substances that contain a fused three-ring moiety and are used in the treatment of depression. These drugs block the uptake of norepinephrine and serotonin into axon terminals and may block some subtypes of serotonin, adrenergic, and histamine receptors. However the mechanism of their antidepressant effects is not clear because the therapeutic effects usually take weeks to develop and may reflect compensatory changes in the central nervous system.Respiration Disorders: Diseases of the respiratory system in general or unspecified or for a specific respiratory disease not available.Electronystagmography: Recording of nystagmus based on changes in the electrical field surrounding the eye produced by the difference in potential between the cornea and the retina.Psychopharmacology: The study of the effects of drugs on mental and behavioral activity.Psychoanalytic Theory: Conceptual system developed by Freud and his followers in which unconscious motivations are considered to shape normal and abnormal personality development and behavior.Psychotherapy, Group: A form of therapy in which two or more patients participate under the guidance of one or more psychotherapists for the purpose of treating emotional disturbances, social maladjustments, and psychotic states.Psychophysiologic Disorders: A group of disorders characterized by physical symptoms that are affected by emotional factors and involve a single organ system, usually under AUTONOMIC NERVOUS SYSTEM control. (American Psychiatric Glossary, 1988)

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*  Scared - Anxiety - Panic Disorders - Forum Forum , Diseases & Conditions , Anxiety - Panic Disorders , Scared Select A Location. ****** Top of the Forum ... Try not to hit the panic button until you are checked out. Don't let it get into a cycle in your head, imagine the best..and ... I do know how easy it is to work yourself into quite a bad panic thinking such things. there is much to say for a 'good' ... Well when I get my anxiety it's not like a panic attack, it's pretty constant. I do notice that if I'm doing something and ...

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*  Meds just seemed to Stop Working - Anxiety - Panic Disorders - Forum Forum , Diseases & Conditions , Anxiety - Panic Disorders , Meds just seemed to Stop Working ... about 2yrs ago the panic returned and we upped the dose to 15mg of lexapro. 1 yr ago we had to up the dose again to 20mf ... 1 month ago we switched meds to Luvox CR 150mg with no real change in fact I think the panic was worse. So we upped the dose of ... Has anyone used Effexor ER for panic?? But part of the problem is that I have a degree in biology and was looking at medical ...

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Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed.). New York: Guilford. ... Clum, G. A., Clum, G. A., & Surls, R. (1993). A meta-analysis of treatments for panic disorder. Journal of Consulting and ... This naturalistic study compared 16 panic disorder patients who were daily BZ users with 16 age- and education-matched, ... 1993). Alprazolam and exposure alone and combined in panic disorder with agoraphobia: A controlled study in London and Toronto ...

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Panic Disorder Severity Scale: The Panic Disorder Severity Scale is a questionnaire developed for measuring the severity of panic disorder. The clinician-administered PDSS is intended to assess severity and considered a reliable tool for monitoring of treatment outcome.Panic and Agoraphobia Scale: The Panic and Agoraphobia Scale (PAS) is a rating scale developed for measuring severity of agoraphobia with or without panic attacks.Bandelow B.Social anxiety disorderClaustrophobia: Claustrophobia is the fear of having no escape and being in closed or small space or room It is typically classified as an anxiety disorder and often results in panic attack, and can be the result of many situations or stimuli, including elevators crowded to capacity, windowless rooms, and even tight-necked clothing. The onset of claustrophobia has been attributed to many factors, including a reduction in the size of the amygdala, classical conditioning, or a genetic predisposition to fear small spaces.CCK-4ClonazepamAlprazolamSchizophreniaRichard Bromfield: Richard Bromfield, Ph.D.Cognitive behavioral treatment of eating disorders: Cognitive behavioral therapy (CBT) is derived from both the cognitive and behavioral schools of psychology and focuses on the alteration of thoughts and actions with the goal of treating various disorders. The cognitive behavioral treatment of eating disorders emphasizes the minimization of negative thoughts about body image and the act of eating, and attempts to alter negative and harmful behaviors that are involved in and perpetuate eating disorders.Mental disorderBipolar disorderBrexpiprazoleAnxiolytic: An anxiolytic (also antipanic or antianxiety agent) is a medication or other intervention that inhibits anxiety. This effect is in contrast to anxiogenic agents, which increase anxiety.Interoceptive exposure: Interoceptive exposure is a cognitive behavioral therapy technique used in the treatment of panic disorder. It refers to carrying out exercises that bring about the physical sensations of a panic attack, such as hyperventilation and high muscle tension, and in the process removing the patient's conditioned response that the physical sensations will cause an attack to happen.Hypervigilance: Hypervigilance is an enhanced state of sensory sensitivity accompanied by an exaggerated intensity of behaviors whose purpose is to detect threats. Hypervigilance is also accompanied by a state of increased anxiety which can cause exhaustion.AllylglycineMaternal bond: A maternal bond or motherly bond is generally the relationship between a mother and her child.Oneirology: Oneirology (; from Greek [oneiron, "dream"; and -λογία], ["the study of") is the scientific study of [[dream]s. Current research seeks correlations between dreaming and current knowledge about the functions of the brain, as well as understanding of how the brain works during dreaming as pertains to memory formation and mental disorders.Comorbidity: In medicine, comorbidity is the presence of one or more additional disorders (or diseases) co-occurring with a primary disease or disorder; or the effect of such additional disorders or diseases. The additional disorder may also be a behavioral or mental disorder.Hyperventilation syndromeRelationship obsessive–compulsive disorder: In psychology, relationship obsessive–compulsive disorder (ROCD) is a form of obsessive-compulsive disorder focusing on intimate relationships (whether romantic or non-romantic). Such obsessions can become extremely distressing and debilitating, having negative impacts on relationships functioning.ParoxetineSelective serotonin reuptake inhibitorDysthymiaFear conditioning: Fear conditioning is a behavioral paradigm in which organisms learn to predict aversive events. It is a form of learning in which an aversive stimulus (e.ImipramineRelaxation (psychology): Relaxation in psychology, is the emotional state of a living being, of low tension, in which there is an absence of arousal that could come from sources such as anger, anxiety, or fear. According to the Oxford dictionaryOxford Dictionary (2014).Martin Weaver: Martin Weaver is a psychotherapist, author and media writerHypocapnia: Hypocapnia or hypocapnea also known as hypocarbia, sometimes incorrectly called acapnia, is a state of reduced carbon dioxide in the blood. Hypocapnia usually results from deep or rapid breathing, known as hyperventilation.Respiratory alkalosisKetipramine: Ketipramine (G-35,259), also known as ketimipramine or ketoimipramine, is a tricyclic antidepressant (TCA) that was tested in clinical trials for the treatment of depression in the 1960s but was never marketed. It differs from imipramine in terms of chemical structure only by the addition of a ketone group, to the azepine ring, and is approximately equivalent in effectiveness as an antidepressant in comparison.ElectronystagmographyInternational Psychopharmacology Algorithm Project: The International Psychopharmacology Algorithm Project (IPAP) is a non-profit corporation whose purpose is to "enable, enhance, and propagate" use of algorithms for the treatment of some Axis I psychiatric disorders.Paul Ferdinand Schilder: Paul Ferdinand Schilder (February 15, 1886, Vienna – December 7, 1940, New York City) was an Austrian psychiatrist, psychoanalyst, researcher and author of numerous scientific publications. He was a pupil of Sigmund Freud.Psychodermatology: Psychodermatology is the treatment of skin disorders using psychological and psychiatric techniques. It is a subspecialty of dermatology.

(1/507) Excess of high activity monoamine oxidase A gene promoter alleles in female patients with panic disorder.

A genetic contribution to the pathogenesis of panic disorder has been demonstrated by clinical genetic studies. Molecular genetic studies have focused on candidate genes suggested by the molecular mechanisms implied in the action of drugs utilized for therapy or in challenge tests. One class of drugs effective in the treatment of panic disorder is represented by monoamine oxidase A inhibitors. Therefore, the monoamine oxidase A gene on chromosome X is a prime candidate gene. In the present study we investigated a novel repeat polymorphism in the promoter of the monoamine oxidase A gene for association with panic disorder in two independent samples (German sample, n = 80; Italian sample, n = 129). Two alleles (3 and 4 repeats) were most common and constituted >97% of the observed alleles. Functional characterization in a luciferase assay demonstrated that the longer alleles (3a, 4 and 5) were more active than allele 3. Among females of both the German and the Italian samples of panic disorder patients (combined, n = 209) the longer alleles (3a, 4 and 5) were significantly more frequent than among females of the corresponding control samples (combined, n = 190, chi2 = 10.27, df = 1, P = 0.001). Together with the observation that inhibition of monoamine oxidase A is clinically effective in the treatment of panic disorder these findings suggest that increased monoamine oxidase A activity is a risk factor for panic disorder in female patients.  (+info)

(2/507) Plasma anti-serotonin and serotonin anti-idiotypic antibodies are elevated in panic disorder.

The psychoneuroimmunology of panic disorder is relatively unexplored. Alterations within brain stress systems that secondarily influence the immune system have been documented. A recent report indicated elevations of serotonin (5-HT) and ganglioside antibodies in patients with primary fibromyalgia, a condition with documented associations with panic disorder. In line with our interest in dysregulated 5-HT systems in panic disorder (PD), we wished to assess if antibodies directed at the 5-HT system were elevated in patients with PD in comparison to healthy volunteers. Sixty-three patients with panic disorder and 26 healthy volunteers were diagnosed by the SCID. Employing ELISA, we measured anti-5-HT and 5-HT anti-idiotypic antibodies (which are directed at 5-HT receptors). To include all subjects in one experiment, three different batches were run during the ELISA. Plasma serotonin anti-idiotypic antibodies: there was a significant group effect [patients > controls (p = .007)] and batch effect but no interaction. The mean effect size for the three batches was .76. Following Z-score transformation of each separate batch and then combining all scores, patients demonstrated significantly elevated levels of plasma serotonin anti-idiotypic antibodies. Neither sex nor age as covariates affected the significance of the results. There was a strong correlation between anti-serotonin antibody and serotonin anti-idiotypic antibody measures. Plasma anti-serotonin antibodies: there was a significant diagnosis effect [patients > controls (p = .037)]. Mean effect size for the three batches was .52. Upon Z-score transformation, there was a diagnosis effect with antibody elevations in patients. Covaried for sex and age, the result falls below significance to trend levels. The data raise the possibility that psychoimmune dysfunction, specifically related to the 5-HT system, may be present in PD. Potential interruption of 5-HT neurotransmission through autoimmune mechanisms may be of pathophysiologic significance in certain patients with panic disorder. It remains to be demonstrated if the peripheral autoimmunity is representative of CNS 5-HT neuronal alterations. Replication appears warranted.  (+info)

(3/507) A cost-effective approach to the use of selective serotonin reuptake inhibitors in a Veterans Affairs Medical Center.

In light of the tremendous expansion in the number of selective serotonin reuptake inhibitors available to the clinician, the Pharmacy and Therapeutics Committee of the Denver Veterans Affairs Medical Center considered the advantages and disadvantages of fluoxethine, paroxetine, and sertraline, to determine which agent or agents would be carried on the formulary. The committed recommended sertraline as the preferred agent for the treatment of depression, panic disorders, and obsessive-compulsive disorders. The purpose of this retrospective study was to assess the economic outcome of that decision. The study population consisted of patients at the medical center who were receiving selective serotonin reuptake inhibitors during January through March of 1994 and those were receiving these agents between September 1995 and January 1996. The expanded collection period in 1995-96 was due to a relatively new medical center policy to offer 90-day fills on medication to reduce costs. The extended collection period assured a 100% sample of patients receiving these agents. The 1994 fluoxetine to sertraline dosage equivalency ratio was 20 mg:55.6 mg, based on average daily doses of fluoxetine and sertraline of 32.7 and 90.9 mg, respectively. The cost to the medical center for an average daily dose of fluoxetine was $1.86; sertraline cost $1.22 per day. The 1996 fluoxetine to sertraline dosage equivalency ratio (20 mg:51.3 mg) had not changed significantly since 1994, indicating that the dose of 20 mg of fluoxetine remained very close to a 50-mg dose of sertraline. The average daily doses of fluoxetine and sertraline (34.9 mg and 89.7 mg, respectively) were not significantly different than the 1994 doses. Only 33 patients had been prescribed paroxetine (average daily dose, 32.4 mg). On the basis of these values, the average daily cost of fluoxetine to the medical center was $2.01, compared with $1.18 for sertraline and $1.24 for paroxetine. This $0.83 per patient per day drug acquisition cost difference between fluoxetine and sertraline results in a drug cost reduction of $302,674 per year.  (+info)

(4/507) The effects of clonazepam on quality of life and work productivity in panic disorder.

Although panic disorder has been associated with impaired quality of life (QOL) and financial dependence, no prior study has examined whether a clinical intervention will improve these outcomes. This study examines the effects of clinically titrated doses of clonazepam versus placebo on QOL and work productivity (WP) in patients with panic disorder. QOL and WP were measured in conjunction with a randomized, double-blind, placebo-controlled trial. The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and Work Productivity and Impairment questionnaire were used to assess QOL and WP, respectively. Baseline assessments were obtained before randomizing patients to receive clinically titrated doses of clonazepam or placebo. Follow-up assessments were obtained after 6 weeks of therapy with the test drug or at premature termination from the study. Improvement on the SF-36 Mental Health Component Summary scale was more than twice as great with clonazepam than with placebo (P = 0.03). Clonazepam patients improved (P < 0.05) on all five measures of mental health-related QOL, and both measures of physical health-related QOL, and both measures of WP. Placebo patients improved on three of five measures of mental health-related QOL, but on no other measures. Patients with marked improvements on clinical measures of panic disorder severity, especially avoidance and fear of the main phobia, showed the greatest gains on the SF-36 Mental Health Component Summary scale. Clinically titrated doses of clonazepam significantly improved mental health-related QOL and WP in panic disorder patients. Lesser improvements were obtained with placebo.  (+info)

(5/507) Do family physicians treat older patients with mental disorders differently from younger patients?

OBJECTIVE: To determine whether there are differences between family physicians' beliefs and treatment intentions regarding older patients with mental disorders and younger patients with similar disorders. Such differences might contribute to older adults' lower rates of mental health service use. DESIGN: Mailed survey. SETTING: Primary care practices in and around Kingston, Ont. PARTICIPANTS: Questionnaires were mailed to 294 general practitioners listed in the 42nd Annual Canadian Medical Directory. Of the 285 eligible physicians, 115 (40%) completed and returned questionnaires. MAIN OUTCOME MEASURES: Physicians' ratings of preparedness to identify and treat, likelihood of treating, likelihood of using each of five different treatment methods, likelihood of referral, preferences for six referral options, and treatment effectiveness with respect to hypothetical older and younger patients with panic disorder or dysthymia. RESULTS: Physicians reported being less prepared to identify and treat older patients than younger patients. In addition, physicians reported being significantly less likely to treat and to refer older patients than younger patients. Finally, physicians reported that both psychotherapy alone, and in combination with pharmacotherapy, were less effective for older patients than for younger patients. CONCLUSIONS: In addition to other possible reasons for older adults' low rates of mental health service use, this study suggests that family physicians' beliefs and treatment intentions could be contributing factors. Changes in medical education aimed at replacing inaccurate beliefs with accurate information regarding older patients might be one way to increase rates of use in this underserved age group, because family physicians play a key role in the mental health care of older adults.  (+info)

(6/507) Theory and technique in psychodynamic treatment of panic disorder.

The authors elaborate psychodynamic factors that are relevant to the treatment of panic disorder. They outline psychoanalytic concepts that were employed to develop a psychodynamic approach to panic disorder, including the idea of unconscious mental life and the existence of defense mechanisms, compromise formations, the pleasure principle, and the transference. The authors then describe a panic-focused psychodynamic treatment based on a psychodynamic formulation of panic. Clinical techniques used in this approach, such as working with transference and working through, are described. Finally, a case vignette is employed to illustrate the relevance of these factors to panic disorder and the use of this treatment.(The Journal of Psychotherapy Practice and Research 1999; 8:234-242)  (+info)

(7/507) Serotonin and drug-induced therapeutic responses in major depression, obsessive-compulsive and panic disorders.

The therapeutic effectiveness of antidepressant drugs in major depression was discovered by pure serendipity. It took over 20 years before the neurobiological modifications that could mediate the antidepressive response were put into evidence. Indeed, whereas the immediate biochemical effects of these drugs had been well documented, their antidepressant action generally does not become apparent before 2 to 3 weeks of treatment. The different classes of antidepressant treatments were subsequently shown to enhance serotonin neurotransmission albeit via different pre- and postsynaptic mechanisms. Clinical trials based on this hypothesis led to the development of treatment strategies producing greater efficacy and more rapid onset of antidepressant action; that, is lithium addition and pindolol combination, respectively. It is expected that the better understanding recently obtained of the mechanism of action of certain antidepressant drugs in obsessive-compulsive and panic disorders will also lead to more effective treatment strategies for those disorders.  (+info)

(8/507) Dose response of adrenocorticotropin and cortisol to the CCK-B agonist pentagastrin.

Cholecystokinin (CCK) is an abundant neurotransmitter in brain. Its functional significance in humans is incompletely understood, but it may modulate activity in the hypothalamic-pituitary-adrenal (HPA) axis. To explore this hypothesis, we examined the effects of varying doses (0 to 0.8 microgram/kg) of the CCK-B agonist pentagastrin on adrenocorticotropin (ACTH) and cortisol release in healthy human subjects. We also examined anxiety, heart rate (HR), and blood pressure (BP) responses. Pentagastrin induced large (up to 520% increase over baseline), significant and very rapid, dose-dependent elevations in ACTH and cortisol levels. Significant elevations in HR and BP were seen at all doses, without clear dose-response relationships. Anxious distress and symptom responses were also somewhat dose dependent; but hormonal responses were more robustly linked to pentagastrin dose than to these subjective measures. The HPA axis response to the CCK-B agonist pentagastrin may be a direct pharmacological effect. Further work is needed to determine the mechanisms and the physiological significance of CCK-mediated modulation of the human neuroendocrine stress axis.  (+info)


  • Agoraphobia first came to light in 1872 when Dr. Westphal first described manâ s fear of suffering panic attacks and finding it hard to escape given situations when immersed in his/her surroundings or performing such tasks like traveling, socializing and being in crowded places. (
  • History of agoraphobia patients suffers sudden panic attacks when they find themselves traveling to places where they develop a fear that getting help would be too difficult to get. (
  • In most cases the treatment methods for patients with panic disorders and agoraphobia are always somewhat similar because of the close relationship between the two conditions. (
  • Experts have since also developed the so called Exposure treatment, this causes many patients with agoraphobia and panic disorders to have a long lasting relief. (
  • Agoraphobia, clinically defined as the fear of anxiety and panic brought about by situations that one cannot easily escape from, is said to develop from another anxiety disorder called Panic Disorder. (
  • Although Panic Disorder often accompanies Agoraphobia, Agoraphobia may also be diagnosed without it. (
  • Studies have shown that a baby or a child who exhibits negative behaviors towards new situations, unknown surroundings, and unfamiliar people may be at higher risk of developing an anxiety disorder such as Agoraphobia. (
  • Xanax and the extended-release formulation, Xanax XR, are also used in the treatment of panic disorder, which appears as unexpected panic attacks and may be accompanied by a fear of open or public places called agoraphobia. (
  • Panic and agoraphobia are some of the worst emotions that a human being can ever experience. (
  • People with panic disorder and agoraphobia can learn, through therapy, how to get better, step by step, until panic attacks no longer occur. (
  • We use gentle cognitive-behavioral therapy, which research indicates is the most effective and fastest way to overcome panic, with or without agoraphobia. (
  • This situation is not an improvement over panic and agoraphobia. (
  • For some people, panic disorder may include agoraphobia - avoiding places or situations that cause you anxiety because you fear not being able to escape or get help if you have a panic attack. (


  • During these bouts of panic attacks, adrenalines are expressed in great amounts for a number of minutes causing the person to have this classical term of â flight or fightâ condition. (
  • The main objective of this therapy is to disintegrate the various sub clinical and residual agoraphobic avoidance and not mainly the treatment of what causes the panic attacks. (
  • 1. First, we cut off the panic attacks by giving people the control they need to stop them. (
  • We use a combination of proven methods, techniques, and strategies that help develop the feeling of being in control that it takes to stop the panic attacks. (
  • It is imperative that the person with panic follows through with CBT past the point that their panic attacks are cut off. (
  • The brain must "overlearn" the cognitive strategies that prevent panic attacks from happening. (
  • Thus, not only must the panic attacks go, but we must make sure that THE SYMPTOMS surrounding the attack LEAVE PERMANENTLY, TOO. (
  • I have seen too many people who no longer experience panic "attacks", but now have a fairly constant level of anxiety and nervousness most all the time. (
  • Without the threat of attacks, the person falls into a state of constant worrying, thus having the symptoms of generalized anxiety disorder or GAD. (
  • You do not want panic attacks to come back. (
  • For example, it is quite common for people with panic to have spent years and years and thousands of dollars in pursuit of an answer to these painful, very real, traumatic attacks. (
  • Panic attacks can be very frightening. (
  • When panic attacks occur, you might think you're losing control, having a heart attack or even dying. (
  • Many people have just one or two panic attacks in their lifetimes, and the problem goes away, perhaps when a stressful situation ends. (
  • But if you've had recurrent, unexpected panic attacks and spent long periods in constant fear of another attack, you may have a condition called panic disorder. (
  • Although panic attacks themselves aren't life-threatening, they can be frightening and significantly affect your quality of life. (
  • Panic attacks typically begin suddenly, without warning. (
  • You may have occasional panic attacks or they may occur frequently. (
  • Panic attacks have many variations, but symptoms usually peak within minutes. (
  • One of the worst things about panic attacks is the intense fear that you'll have another one. (
  • Panic attacks, while intensely uncomfortable, are not dangerous. (
  • But panic attacks are hard to manage on your own, and they may get worse without treatment. (
  • Panic attacks may start off by coming on suddenly and without warning, but over time, they're usually triggered by certain situations. (
  • Some research suggests that your body's natural fight-or-flight response to danger is involved in panic attacks. (
  • Left untreated, panic attacks and panic disorder can affect almost every area of your life. (
  • You may be so afraid of having more panic attacks that you live in a constant state of fear, ruining your quality of life. (

anxiety disorders

  • Xanax is a tranquilizer used in the short-term relief of symptoms of anxiety or the treatment of anxiety disorders. (
  • Our distinct specialty is to work with people with anxiety disorders. (
  • Our psychologists and staff members have suffered with anxiety disorders and know what it's like to experience these life-restricting problems themselves When you come to the Anxiety Disorders Clinic, you don't have to worry that your therapist will understand what you're saying. (


  • 2. Then, we work on the anxiety that causes the physical symptoms that go along with panic. (
  • If you have panic attack symptoms, seek medical help as soon as possible. (
  • Because panic attack symptoms can also resemble other serious health problems, such as a heart attack, it's important to get evaluated by your health care provider if you aren't sure what's causing your symptoms. (
  • Symptoms of panic disorder often start in the late teens or early adulthood and affect more women than men. (
  • If you've had signs or symptoms of a panic attack, make an appointment with your primary care provider. (


  • A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. (


  • You may fear having a panic attack so much that you avoid situations where they may occur. (
  • Many of the same reactions occur in a panic attack. (


  • Anxiety disorder is marked by unrealistic worry or excessive fears and concerns. (
  • Panic brings up feelings of dying, fears of losing control, and fears of completely going crazy. (


  • Remember, CBT is a relatively short-term therapy -- don't try to shorten it down so much that you risk recycling panic or developing GAD. (



  • People experiencing their first panic attack feel they are about to die, in many cases. (
  • We are experiencing similar rates of success for people who complete the panic/agoraphobic program. (


  • Only your doctor can diagnose panic disorder and best advise you about treatment. (


  • Panic is a very real, chronic condition, that responds well to active cognitive-behavioral emotive therapy. (


  • If it is overlearned (i.e., it becomes a conditioned habit in the emotional brain), then panic cannot recycle or redirect toward GAD. (


  • 3. We make sure the cognitive-behavioral therapy is "overlearned" and thus, is literally "conditioned" into the brain so that the control over the panic and anxiety cycle becomes automatic, like a habit. (


  • You may feel fatigued and worn out after a panic attack subsides. (


  • This step is essential because panic has a tendency to recycle or come back later in life if it is not permanently stopped. (