Brain Chemical Receptor Effects in Patients With Panic Disorder and Post-Traumatic Stress Disorder

NCT00025974 | Completed

• 2 other identifiers: 02000202-M-0002
• Study Type: observational
• Target: 230
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to examine how certain brain chemicals work in patients with Panic Disorder (PD) and Post-Traumatic Stress Disorder (PTSD) with and without major depressive disorder (MDD). Brain chemicals that regulate emotion, anxiety, sleep, stress hormones, and other body functions bind to serotonin (5-HT1A) and benzodiazepine (BZD) receptors. Evidence suggests that 5-HT1A and BZD receptor function is abnormal in patients with PD, PTSD, and depression. This study will use positron emission tomography (PET) scans to examine BZD and 5-HT1A receptor binding potential in patients with PD and patients with PTSD with and without co-morbid MDD, as well as in healthy volunteers. This study will also determine the effects of the stress hormone cortisol on 5-HT1A and BZD receptors. The current emotional state and psychiatric, medical, and family history of potential participants will be evaluated during an initial telephone interview. After entering the study, participants will be asked questions about general mood, degree of nervousness, and behavior. A physical examination, an electrocardiogram (EKG), and tests of intelligence and cognition will be given. Urine, blood, and saliva samples will be taken. Women will be given pregnancy tests and tests to determine menstrual phase and time of ovulation. All volunteers will undergo magnetic resonance imaging (MRI) and PET scans of the brain. ...

Conditions

Panic Disorder; Posttraumatic Stress Disorder; Major Depressive Disorder

Keywords

PET; 5-HT1A Receptors; Benzodiazepine Receptors; Panic Disorder; PTSD; Serotonin Type 1A Receptors; Post-Traumatic Stress Disorder; Major Depression; Anxiety; Depression; Healthy Volunteer; HV; Normal Control

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• ANXIETY DISORDERS SAMPLES:
• Eighty four subjects (ages 18-50) with anxiety disorders (PD and PTSD) will be selected who additionally meet criteria for one of 4 subgroups:
• A) PD, Currently Depressed (n=27):
• As defined by DSM-IV criteria for PD, and still symptomatic as defined by at least 1 panic attack/week or a CGI score of at least 4, and current HDRS score in the mild-moderately-to-severely depressed range (greater than 15).
• Patients are requested to meet the DSM-IV criteria for a single or recurrent episode of major depressive disorder.
• In case of comorbid depression it will be ensured that PD had an earlier onset than the depressive disorder.
• B) PD, Currently Not Depressed (n=27):
• Defined as having symptomatic PD with at least 1 panic attack/week or a CGI score of at least 4 and never having had experienced a depressive episode meeting DSM-IV criteria for major depressive disorder or dysthymia, OR a period of at least six months with no more than one clinically significant symptom, and during which time subjects were not taking an AD agent, with Hamilton Depression Rating Scale (HDRS; 25 item) scores in the non-depressed range (less than or equal to 7) will be selected.
• C) PTSD, Currently Depressed (n=15):
• As defined by DSM-IV with a duration of illness at least three months.
• Patients must score greater than or equal to 50 on Clinician-Administered PTSD Scale (CAPS-2) as a measure of PTSD symptom severity.
• Patients are requested to meet the DSM-IV criteria for a single or recurrent episode of major depressive disorder.
• Current HDRS score is in the mild-moderately-to-severely depressed range (greater than or equal to 15).
• In case of comorbid depression it will be ensured that PTSD had an earlier onset than the depressive disorder.
• D) PTSD, Currently Not Depressed (n=15):

You may not qualify if:

• Patients and controls must exhibit no or only moderate alcohol use.
• Subjects with current or previous regular (greater than 4 weeks) of BZDs and excessive use of alcohol (greater than 8 ounce/day for men and greater than six ounces /day for women) in the past or present are ineligible to participate, as they may produce a down-regulation of the BZD receptor that may confound the results.
• Postmenopausal female subjects.
• Subjects beyond age 50 are excluded to reduce the biological heterogeneity encompassed by the MDD and anxiety disorders criteria.
• Subjects whose first anxiety disorder episode arose temporally after other major medical or psychiatric conditions will also be excluded.
• In addition to the above criteria, subjects undergoing the serotonin transporter scan will also be excluded if they have taken the recreational drug ecstasy within 3 weeks prior to scan or for regular use in the past.

Sponsors & Collaborators

• National Institute of Mental Health (NIMH): lead

Study Sites (1)

National Institutes of Health Clinical Center, 9000 Rockville Pike

Bethesda, Maryland, 20892, United States

Location

Related Publications (3)

• Azmitia EC, Whitaker-Azmitia PM. Awakening the sleeping giant: anatomy and plasticity of the brain serotonergic system. J Clin Psychiatry. 1991 Dec;52 Suppl:4-16.

  PMID: 1752858 BACKGROUND

• Sprouse JS, Aghajanian GK. Responses of hippocampal pyramidal cells to putative serotonin 5-HT1A and 5-HT1B agonists: a comparative study with dorsal raphe neurons. Neuropharmacology. 1988 Jul;27(7):707-15. doi: 10.1016/0028-3908(88)90079-2.

  PMID: 2901680 BACKGROUND

• Chaput Y, de Montigny C. Effects of the 5-hydroxytryptamine receptor antagonist, BMY 7378, on 5-hydroxytryptamine neurotransmission: electrophysiological studies in the rat central nervous system. J Pharmacol Exp Ther. 1988 Jul;246(1):359-70.

  PMID: 2839669 BACKGROUND

MeSH Terms

Conditions

Panic Disorder; Stress Disorders, Post-Traumatic; Depressive Disorder, Major; Anxiety Disorders; Depression

Condition Hierarchy (Ancestors)

Mental Disorders; Stress Disorders, Traumatic; Trauma and Stressor Related Disorders; Depressive Disorder; Mood Disorders; Behavioral Symptoms; Behavior

Study Design

• Study Type: observational
• Sponsor Type: NIH

Study Record Dates

• First Submitted: November 2, 2001
• First Posted: November 5, 2001
• Study Start: October 31, 2001
• Study Completion: July 21, 2008
• Last Updated: July 2, 2017

Record last verified: 2008-07-21

Locations

US (1)