Panic Spells Are Traced to Chemical in the Brain

NY Times ^ | January 27, 2004 | ANAHAD O'CONNOR

[neverdem]

Sudden heart-pounding panic attacks are most likely caused by abnormalities in the brain, new evidence suggests, reinforcing earlier research on animals.

People with panic disorder, according to scientists at the National Institutes of Health, have drastic reductions of a type of serotonin receptor, called 5-HT1A, in three areas of the brain. The findings, reported last week in The Journal of Neuroscience, lend credence to the suspicion that serotonin dysfunction plays a role in the disorder.

"This provides evidence for what we've been telling patients all along," said Dr. Dennis S. Charney, chief of the mood and anxiety disorders research program at the institutes and an author of the paper. "Panic disorder is due to a specific abnormality in the brain, not a weakness in character."

About 2.4 million Americans have the disease, which can leave its victims living in constant fear of attacks that might plunge them into outbursts of worry and thoughts of impending death. Experts have compared it to being stalked by a lion. The episodes, often resembling a heart attack and known to strike at any time, can be so terrifying that some associate them with the place that they occurred — the subway or the grocery store, for example — and will refuse to go there again.

Traditionally, the biological basis of the disease has been poorly understood. But some of the best drug treatments are serotonin enhancers, which have hinted at the chemical messenger's involvement for some time. Also supporting that theory is research on mice. When a gene for serotonin receptors is eliminated, the animals have a greater risk of anxiety.

In the latest study, scientists used brain images to peer at serotonin receptors in humans. The subjects, 16 people with panic disorder and 15 who did not have the disorder were injected with small quantities of a benign radioactive tracer that latched onto the receptors, allowing the researchers to count them and pinpoint their locations.

The disparity was marked. Subjects in the panic group averaged a third fewer receptors in areas known as the anterior and posterior cingulates. The group members were also deficient in the the raphe, which has connections to a region that processes emotion.

Dr. Alexander Neumeister, a research psychiatrist at the National Institute of Mental Health and an author of the study, said there was a strong likelihood that the receptor deficiencies were genetic. But he also cautioned that he could not rule out the possibility that the depletions were actually a result, rather than a cause, of the disorder.

"We don't know if this was there before these people were ill," he said. "The next step is to study people who have a history of panic disorder in their families but are asymptomatic. Then we can determine which comes first."

The illness, which most commonly begins between late adolescence and the mid-30's, is just one in a group of anxiety-inducing ailments that are relatively widespread. About 19 million Americans are afflicted by one of the diseases; obsessive-compulsive disorder, post-traumatic stress disorder and specific phobias are among the more well known.

One expert, Dr. Michael Liebowitz, a professor of clinical psychiatry at Columbia, who did not participate in the study, said the findings were significant but needed to be replicated.

"There are still a few issues, like whether this is something that is specific to panic disorder or something in anxiety disorder in general," Dr. Liebowitz said.

Still, said Jerilyn Ross, president of the Anxiety Disorders Association of America, the research sheds some light on the biological underpinnings of the disorder and may lift some of its stigma. Almost 75 percent of people with panic disorder do not receive treatment, she said. Some, she added, are dismissed by doctors who think they are hypochondriacs.

"Anxiety, even in the mental health system is often overlooked," Ms. Ross said. "So a study like this reinforces the fact that it is real and should be taken seriously."

[neverdem]

FWIW

[neverdem]

Ping

[barker]

Bump for later read and research. I suffer from anxiety attacks and they're no fun.

[realpatriot71]

It makes sense.

[VaBthang4]

Ping Howard Dean!

[umgud]

bump

[Freedom2specul8]

Hi Barker! Long time no see...

There's a lot of info on 5-HT1A
http://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=5-HT1A&btnG=Google+Search

[nuconvert]

"he could not rule out the possibility that the depletions were actually a result, rather than a cause, of the disorder."

Well, that's pretty important.

[BCrago66]

Interesting. But unless one believes either that the mind is ghost-like or a distinct Cartesian substance, moods such as anxiety have to express themselves somehow in the physical processes of the brain. That does not necessarily mean that anxiety is completely outside a person's volitional capacity, nor does it mean that the only therpay for anxiety disorder is drugs. But anyway, this is really important research.

[Timesink]

Another fascinating report from the distinguished medical journal DUH!

[neverdem]

Another fascinating report from the distinguished medical journal DUH!

Would you care to expound on the DUH of the Slimes' Health and Science Sections which is well written for a lay readership. Do you believe they are politicized, or do you just hate the paper, or do you hate New York?

[TheEaglehasLanded]

bttt

[GEC]

Been there, done that.

Hopefully, I won't have to do many more.

[Clinging Bitterly]

I have been through a couple bouts with that over the past ten years or so, and a sibling went through it over the same time and my mom had it for years. And you're right about it not being any fun. I went through the whole gamut, from heartburn pills, diet changes, ER visits, EKGs and even a full bore treadmill test (as a guy who is way too sedentary, I found it pleasantly invigorating once I got my wind) in the process of getting it licked, and there it was, all in my head (and it's actually sort of comforting knowing it's there instaed of where my head was making me think it was, because at 35, I was way too young for that sort of thing).

Over the time I tried a few different medicines, and eventually found something that stopped them virtually overnight. And when the time came to stop taking the medicine, that was an ordeal in itself. It's been about four years now, and there are still the occasional aftereffects from that but right now I have to say I am doing better than I was 20 years ago, a time when I didn't have a hint anything was wrong.

Hang in there. The different medicines don't all work exactly alike, and it'll take some time and experimentation to get to the one that's right for you. In the process, research the side effects of whatever is proposed, particularly those associated with withdrawal. They are downplayed by the makers of those pharmaceuticals, but you need to be prepared for them, to know what to expect, they can be as terrifying as that which they are intended to cure, and if you are affected, it can be a fairly long term that you'll be dealing with them. In my case, my doctor had no idea what was going on (that's how much the drug makers downplay it), and was ready to diagnose an unrelated illness. My own research led to an explanation, and having that knowledge made it easier to bear.

[Ronzo]

Sudden heart-pounding panic attacks are most likely caused by abnormalities in the brain

In other news....

After years of painstaking research, scientist have discovered that water is wet. Also, in an unrelated development, it was confirmed that Abraham Lincoln, was, in fact, a president of the United States.

Stay tuned for more late breaking stories...

[Clinging Bitterly]

>> There's a lot of info on 5-HT1A

5HT1A Serotonin Receptor Agonists Inhibit Plasmodium falciparum by Blocking a Membrane Channel

"Fascinating read.....couldn't put it down!"
- Dave in Eugene

[Salamander]

And it's just about the only "truth" in the whole article.....:)

[Yaelle]

What about phobias? When in the throes of a phobia, it is kind of like a panic reaction that is out of proportion to the "threat" by the fear. It would be nice to have something to counteract a phobia with.

[neverdem]

What about phobias? When in the throes of a phobia, it is kind of like a panic reaction that is out of proportion to the "threat" by the fear. It would be nice to have something to counteract a phobia with.

To the best of my understanding, phobias are the result of reactions to certain stimuli. Panic attacks, aka as panic disorder, apparently has researchers attempting to distinguish between those who have known phobias, and those who don't, the latter being those who have unexplained reactions by their autonomic nervous systems in routine situations. We'll see. This is interesting to some folks.