Megestrol attenuates the hormonal response to CCK-4–induced panic attacks.

Raedler, Thomas J.; Jahn, Holger; Goedeken, Birgit; Gescher, Dorothee M.; Kellner, Michael; Wiedemann, Klaus

Progestational hormones may have anxiolytic properties. CCK-4 (cholecystokinin tetrapeptide) can be used pharmacologically to induce panic attacks both in normal controls and patients suffering from panic disorder. In this study we compared the effects of pretreatment with the progestational hormone megestrol and placebo on CCK-4–induced panic attacks and stress hormone release in healthy male controls. Using a double-blind balanced design, we pretreated 10 medically and psychiatrically healthy male controls with placebo or megestrol 160 mg at 11 p.m. and 8 a.m. (σ=320 mg) prior to the experiment. Following 1 h of rest, 12 blood samples were drawn between 1000 h and 1300 h and analyzed for ACTH and cortisol levels. At 1100 h, subjects received an intravenous injection of 50 µg CCK-4. Clinical ratings were performed at 1045 h and 1110 h, and included the Acute Panic Inventory (API), International Diagnostic Checklist (IDCL), as well as a visual analog scale (VAS) for anxiety and tension. CCK-4 significantly increased anxiety and tension. Pretreatment with megestrol showed no significant effect on clinical ratings. Baseline ACTH and cortisol levels, as well as ACTH and cortisol levels after administration of CCK-4, were significantly reduced after pretreatment with megestrol. In a sample of healthy male controls, pretreatment with megestrol had a profound effect on the hypothalamic–pituitary–adrenal (HPA) axis, whereas the clinical effects on panic attacks were weak. Further studies in a larger sample of subjects, including both females and patients suffering from panic disorder, seem warranted. Depression and Anxiety 23:139–144, 2006. © 2006 Wiley-Liss, Inc.

PROGESTATIONAL hormones; CHOLECYSTOKININ; TRANQUILIZING drugs; PANIC attacks; PANIC disorders; ANXIETY; HYDROCORTISONE; ADRENOCORTICOTROPIC hormone

Depression & Anxiety (1091-4269), 2006, Vol 23, Issue 3, p139

1091-4269

Academic Journal

10.1002/da.20147