Urinary norepinephrine excretion in panic and phobic disorders

Abstract

Morning urinary norepinephrine (NE) was assessed in 36 patients suffering from panic and phobic disorders according to DSM III. Urinary NE excretion was significantly higher in this group than in a normal control one. Phobic patients excreted lower levels of NE than panic ones. No significant association was found between urinary NE levels and anxiety scores according to Zung's Anxiety Status Inventory or Wittenborn Psychiatric Rating Scale. The NE increase is interpreted as reflecting a sympathetic nervous system hyperactivity in anxiety. A concomitant effect upon NE metabolism of benzodiazepine withdrawal cannot be discarded since the group of patients previously medicated showed the highest NE excretion.

Urinary Excretion of Cortisol, Norepinephrine, Testosterone, and Melatonin in Panic Disorder

“…The increase in norepinephrine and epinephrine excretion in urine is consistent with other studies (Nesse eta!.. 1985;Dajas et al. 1986: Kuboki et al, 1992.…”

The Association of Urinary 5-Hydroxyindoleacetic Acid and Vanillylmandelic Acid in Patients with Generalized Anxiety

“…The possible involvement of 5-HT in generalized anxiety is suggested by various pharmaco logical investigations. Many patients with G A D respond favorably to the 5-HT 1A agonists buspirone [3] and gepirone [4], and to the 5-HT and norepinephrine (NE) reup take blocker, imipramine [5], The 5-HT 2 antagonist ritanserin appears to be effective at reducing general anxi ety [6], The 5-HT agonist, m-chlorophenylpiperazine (m-CPP), causes anxiety in panic patients and healthy con trols [7,8].There are also substantial data implicating NE in volvement in anxiety [9-23], However, not all studies of catecholamines in G A D show differences between G A D patients and controls [ 17,22,24], There are additonal data from investigations of panic disorder suggesting abnormalities of 5-HT [1,2], and NE metabolism [1,20,[25][26][27][28][29][30] may be involved in some way with the pathophysiology of anxiety. It is unclear whether these biochemical findings in panic disorder are true for G A D .…”