Biomedical subjects

J Pecknold

Publications and source records attributed to J Pecknold.

7 recordsLinked to original sources

PubMed1996

Cardiovascular, neuroendocrine, and monoaminergic responses to psychological stressors: possible differences between remitted panic disorder patients and healthy controls.

Both clinical symptomatology and stress research suggest that panic attacks might be partially attributable to exaggerated psychophysiological responses to environmental stressors. In the present study, we aimed to explicitly test this idea by measuring the physiological responses to a mild psychological stressor in both healthy controls (n = 8) and fully remitted, medication-free panic disorder patients (n = 8). One hour before the stressor, former patients, compared to healthy controls, exhibited higher diastolic blood pressure. From a blood sample taken 30 min before the stressor, patients, compared to controls, had lower paroxetine platelet binding site densities. During the stressor, patients, compared to controls, had greater increases in plasma levels of cortisol. These preliminary findings suggest that remitted panic disorder patients might have disturbed physiological responses to mild psychological stressors. These disturbances might be related to the development of future episodes.

Adult↗

PubMed1994

Studies of a neurochemical link between depression, anxiety, and stress from [3H]imipramine and [3H]paroxetine binding on human platelets.

We measured platelet [3H]imipramine and [3H]paroxetine binding in patients with major depression (n = 11), dysthymia (n = 9), generalized anxiety (n = 18) and panic disorder (n = 10), and in healthy controls (n = 13). The [3H]imipramine binding capacity (Bmax) was lower in all patient groups; [3H]paroxetine binding was reduced in anxiety disorders, however, decreases in depression and dysthymia were not significant. There were no differences in the affinity constant (Kd) for either radioligand. We also examined the effects of examination stress on platelet binding in medical students. Compared to after vacation, when binding was similar to controls, [3H]imipramine (n = 19) and [3H]paroxetine (n = 14) Bmax values were significantly decreased during examinations and similar to patient values. Examinations were also associated with an increase in plasma cortisol levels. These findings suggest that there is a neurochemical link between depression, anxiety, and stress, and that disturbances in neurochemical functioning may be associated with specific symptomatology, independent of psychiatric diagnosis.

Adult↗

PubMed1994

A double-blind, placebo-controlled, multicenter study with alprazolam and extended-release alprazolam in the treatment of panic disorder.

This is a double-blind, placebo-controlled, flexible-dose, multicenter, 6-week study comparing regular alprazolam (compressed tablet, CT), given four times per day, and extended release alprazolam (XR), given once in the morning. The aim of the XR preparation is to offer less frequent dosing and to reduce interdose anxiety. Of the intent-to-treat group of 209 patients, 184 completed 3 weeks of medication and were evaluated according to protocol. There was a completer rate for the 6 weeks of 94% (CT), 97% (XR), and 87% (placebo). On global measures, Hamilton Rating Scale for Anxiety, phobia rating, and work disability measures, both active treatment groups were equally effective and significantly more efficacious than the placebo cell on endpoint MANOVA analysis. On analysis of the panic factor with endpoint data, both active treatment groups were equally effective throughout the 6-week trial and significantly more efficacious than the placebo group. Drowsiness occurred more frequently with CT alprazolam (86% of patients) than with the XR preparation (79%) or placebo (49%).

Adult↗

PubMed1993

Medication discontinuation in panic disorder.

This paper addresses current issues associated with medication discontinuation in panic disorder, with specific focus on one of the most frequently used medication classes for this indication, the benzodiazepines. The majority of patients, when slowly tapered, are able to discontinue the benzodiazepines without a great deal of difficulty, particularly after short-term therapy. Patients treated with long-term therapy at high therapeutic doses may experience greater difficulty with discontinuation. If patients are adequately prepared and if discontinuation is conducted slowly and gradually, discontinuation symptoms, if they occur, are transient, mild to moderate, and generally tolerable. However, return of the original condition (relapse) during discontinuation can greatly complicate clinical management.

Alprazolam↗

PubMed1990

Long term efficacy and withdrawal of zopiclone: a sleep laboratory study.

The purpose of this study was to evaluate the short, intermediate, and long-term (8 weeks) effectiveness, as well as the withdrawal effects of zopiclone 7.5 mg. Eleven chronic insomniacs participated in the study where both EEG sleep recordings and a subjective rating scale were used to evaluate drug effects. Zopiclone significantly decreased total wake time and nocturnal awakenings, and increased total sleep time and sleep efficiency. These effects were apparent from first treatment night and tolerance to the hypnotic effect did not develop over the 8 weeks of treatment. The subjective sleep questionnaire data showed significantly decreased sleep latency time but otherwise were consistent with the sleep laboratory findings. Zopiclone decreased the percentage of Stage 1 sleep but did not significantly alter the percentage of Stage 2 sleep, slow wave sleep or REM sleep. The withdrawal of zopiclone was associated with a return of sleep variables towards pre-treatment baseline values. Although 2 patients dropped out, 1 with a marked rebound insomnia and daytime anxiety during the first week of withdrawal, the other because of side-effects and poor hypnotic efficiency, no evidence of rebound insomnia was seen on the sleep EEG or subjective questionnaire data in the study population.

Adult↗

PubMed1987

Past and current thyroid function in subjects with panic disorder.

Disturbances in thyroid function can result in symptoms similar to those occurring in patients with anxiety disorders, especially panic disorder. An association between thyroid illness and panic and phobic disorders has been suggested, but few studies have directly investigated this issue. To assess this possible relationship, the authors measured indices of thyroid function in 165 subjects who had a current DSM-III diagnosis of panic disorder, either with or without phobic avoidance. These subjects reported a higher prevalence of thyroid illness by history compared with the prevalence of thyroid illness in the general population; however, less than 1% of all subjects had current thyroid dysfunction. The presence of a major depressive episode (MDE) was unrelated to current thyroid function, although subjects with MDE reported a higher prevalence of thyroid disease by history. Indices of thyroid function were not correlated with the severity of panic attacks or phobias.

Adult↗

PubMed1981

Phenelzine and exposure in the treatment of phobias.

A double-blind study was carried out on 40 agoraphobic and socially phobic patients, matched, then randomly assigned to one of four treatment groups; phenelzine-exposure, phenelzine-no exposure, placebo-exposure, and placebo-no exposure. Exposure consisted of encouraging the patient to face the phobic situation a predetermined number of times. Assessments, made at the beginning and end of 8 weeks of therapy and 8 weeks thereafter, showed that the phobia ratings of groups decreased significantly. The combined exposure group improved significantly more than the combined no exposure group during treatment. At 8 weeks follow-up there was some deterioration in the phenelzine-exposure and placebo-no exposure groups. Exposure, with or without phenelzine, was the superior treatment modality. The antiphobic effect of phenelzine was not supported, although it seemed to reduce subjective anxiety during exposure experiences. The possibility that effect of phenelzine is dose-related is discussed.

Adolescent↗