Cortisol response to diazepam: its relationship to age, dose, duration of treatment, and presence of generalized anxiety disorder

Pomara, Nunzio; Willoughby, Lisa M.; Sidtis, John J.; Cooper, Thomas B.; Greenblatt, David J.

doi:10.1007/s00213-004-1974-8

Cited by 48 publications

(32 citation statements)

References 45 publications

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“…Thus, our findings also suggest that elevated cortisol levels reflect an anxious state and are not dependent upon the duration of the anxiety disorder. As reported by Tafet et al (2005) and Pomara et al (2005) we expect that with successful treatment of GAD, cortisol levels will normalize and GAD-associated symptoms will attenuate.…”

Section: Discussionmentioning

confidence: 77%

“…For instance, GAD patients who underwent cognitive behavioral therapy showed reductions in anxiety symptoms and cortisol levels after 24 weeks compared with GAD patients who did not receive treatment (Tafet et al, 2005), and elderly adults with GAD also showed reductions in anxiety symptoms and plasma cortisol levels following acute and chronic diazepam treatment (Pomara et al, 2005). These studies suggest that elevated cortisol levels may reflect an anxious state and can be attenuated with treatment.…”

Section: Discussionmentioning

confidence: 96%

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Salivary cortisol is associated with diagnosis and severity of late-life generalized anxiety disorder

Mantella

Butters

Amico

et al. 2008

Psychoneuroendocrinology

191

151

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SummaryAge-associated alterations in hypothalamic-pituitary-adrenal (HPA) axis functioning may make individuals more susceptible to HPA dysregulation in the context of mood and anxiety disorders. Little to no research has been done to examine HPA axis function in generalized anxiety disorder (GAD), particularly in late-life GAD, the most prevalent anxiety disorder in the elderly. The study sample consisted of 71 GAD subjects and 40 nonanxious comparison subjects over 60 years of age. We examined the hypotheses that elderly individuals with GAD will have elevated salivary cortisol levels compared to nonanxious subjects, and that elevated cortisol levels in GAD will be associated with measures of symptom severity. We report that late-life GAD is characterized by elevated basal salivary cortisol levels, with higher peak cortisol levels and larger areas under the curve, compared to nonanxious subjects. Additionally, severity of GAD as measured by the GAD Severity Scale and the Penn State Worry Questionnaire are positively correlated with cortisol levels. These data demonstrate HPA axis dysfunction in late-life GAD and suggest the need for additional research on the influence of aging on HPA axis function in mood and anxiety disorders.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 96%

Salivary cortisol is associated with diagnosis and severity of late-life generalized anxiety disorder

Mantella

Butters

Amico

et al. 2008

Psychoneuroendocrinology

191

151

View full text Add to dashboard Cite

show abstract

“…Additionally, severity of GAD, as measured by psychometric instruments, was positively correlated with cortisol levels [114] . Also Tafet et al [115] and Pomara et al [116] observed that patients with GAD presented increased levels of circulating cortisol (Table 5). Tafet et al [115] reported that cognitive therapy (CT) was effective in improving distressful clinical symptoms of GAD and in recovering psychoneuroendocrinological functions of these subjects.…”

Section: Childhood Stressful Events Hpa Axis and Gadmentioning

confidence: 92%

“…In fact, after a maximum of 24 sessions of CT, a significant decrease in the Hamilton Anxiety Rating Scale and a significant decrease in previously increased levels of circulating cortisol were observed [115] . Pharmacological therapy also showed its efficacy in the treatment of GAD: reductions of anxiety symptoms and plasma cortisol levels were reported after acute and chronic diazepam treatment, even if independent of GAD status and drug dosage [116] . On the other hand, other studies failed to show aberrant adrenocortical activity in GAD: similar 24 h urinary cortisol levels [117] and plasma cortisol levels [118] were observed in GAD patients and healthy controls (Table 5).…”

Section: Childhood Stressful Events Hpa Axis and Gadmentioning

confidence: 99%

Childhood stressful events, HPA axis and anxiety disorders

Faravelli

Sauro²,

Godini³

et al. 2012

WJP

144

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Anxiety disorders are among the most common of all mental disorders and their pathogenesis is a major topic in psychiatry, both for prevention and treatment. Early stressful life events and alterations of hypothalamic pituitary adrenal (HPA) axis function seem to have a significant role in the onset of anxiety. Existing data appear to support the mediating effect of the HPA axis between childhood traumata and posttraumatic stress disorder. Findings on the HPA axis activity at baseline and after stimuli in panic disordered patients are inconclusive, even if stressful life events may have a triggering function in the development of this disorder. Data on the relationship between stress, HPA axis functioning and obsessive-compulsive disorder (OCD) are scarce and discordant, but an increased activity of the HPA axis is reported in OCD patients. Moreover, normal basal cortisol levels and hyperresponsiveness of the adrenal cortex during a psychosocial stressor are observed in social phobics. Finally, abnormal HPA axis activity has also been observed in generalized anxiety disordered patients. While several hypothesis have attempted to explain these findings over time, currently the most widely accepted theory is that early stressful life events may provoke alterations of the stress response and thus of the HPA axis, that can endure during adulthood, predisposing individuals to develop psychopathology. All theories are reviewed and the authors conclude that childhood life events and HPA abnormalities may be specifically and transnosographically related to all anxiety disorders, as well as, more broadly, to all psychiatric disorders.

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“…Some studies in humans have found no differences in CORT levels between GAD patients and nonanxious controls (Hoehn-Saric, McLeod, Lee, & Zimmerli, 1991;Pomara, Willoughby, Sidtis, Cooper, & Greenblatt, 2005). Others, however, have found differences: children with GAD showed significantly less CORT suppression by dexamethasone than did healthy children, suggesting HPA-axis hyperactivity among children with this diagnosis (Pfeffer, Altemus, Heo, & Jiang, 2007).…”

Section: Face Validitymentioning

confidence: 99%

Contextual conditioning in rats as an animal model for generalized anxiety disorder

Luyten

Vansteenwegen

Kuyck

et al. 2011

Cogn Affect Behav Neurosci

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Animal models of psychiatric disorders are important translational tools for exploring new treatment options and gaining more insight into the disease. Thus far, there is no systematically validated animal model for generalized anxiety disorder (GAD), a severely impairing and difficult-to-treat disease. In this review, we propose contextual conditioning (CC) as an animal model for GAD. We argue that this model has sufficient face validity (there are several symptom similarities), predictive validity (it responds to clinically effective treatments), and construct validity (the underlying mechanisms are comparable). Although the refinement and validation of an animal model is a never-ending process, we want to give a concise overview of the currently available evidence. We suggest that the CC model might be a valuable preclinical tool to enhance the development of new treatment strategies and our understanding of GAD.

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Cortisol response to diazepam: its relationship to age, dose, duration of treatment, and presence of generalized anxiety disorder

Cited by 48 publications

References 45 publications

Salivary cortisol is associated with diagnosis and severity of late-life generalized anxiety disorder

Salivary cortisol is associated with diagnosis and severity of late-life generalized anxiety disorder

Childhood stressful events, HPA axis and anxiety disorders

Contextual conditioning in rats as an animal model for generalized anxiety disorder

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