2019
Selective serotonin reuptake inhibitors and benzodiazepines in panic disorder: A meta-analysis of common side effects in acute treatment
Quagliato LA, Cosci F, Shader RI, Silberman EK, Starcevic V, Balon R, Dubovsky SL, Salzman C, Krystal JH, Weintraub SJ, Freire RC, Nardi AE, Benzodiazepines I. Selective serotonin reuptake inhibitors and benzodiazepines in panic disorder: A meta-analysis of common side effects in acute treatment. Journal Of Psychopharmacology 2019, 33: 1340-1351. PMID: 31304840, DOI: 10.1177/0269881119859372.Peer-Reviewed Original ResearchConceptsSelective serotonin reuptake inhibitorsSerotonin reuptake inhibitorsMore adverse effectsPD treatmentPanic disorderReuptake inhibitorsRisk factorsClinical trialsAdverse effectsCochrane Central RegisterAdverse event ratesCommon side effectsShort-term treatmentClass of drugsWeb of ScienceAbnormal ejaculationLibido reductionDry mouthAdverse eventsCentral RegisterPharmacologic treatmentSSRI treatmentAcute treatmentControlled TrialsPrimary outcome
2016
RANDOMIZED TRIAL OF D‐CYCLOSERINE ENHANCEMENT OF COGNITIVE‐BEHAVIORAL THERAPY FOR PANIC DISORDER
Otto MW, Pollack MH, Dowd SM, Hofmann SG, Pearlson G, Szuhany KL, Gueorguieva R, Krystal JH, Simon NM, Tolin DF. RANDOMIZED TRIAL OF D‐CYCLOSERINE ENHANCEMENT OF COGNITIVE‐BEHAVIORAL THERAPY FOR PANIC DISORDER. Depression And Anxiety 2016, 33: 737-745. PMID: 27315514, PMCID: PMC5958622, DOI: 10.1002/da.22531.Peer-Reviewed Original ResearchConceptsCognitive behavioral therapyBenzodiazepine usePanic disorderDCS augmentationMulticenter trialD-cycloserineRecent multicenter trialPanic Disorder Severity ScaleExposure-based cognitive-behavioral therapySessions of treatmentStudy pillsPrimary outcomeRandomized trialsBaseline severityPrimary diagnosisAugmentation effectTreatment responseTreatment endpointBooster sessionsSeverity ScaleRole of severityBehavioral therapyDCS efficacyBeneficial effectsPilot study
2009
Efficacy of D-Cycloserine for Enhancing Response to Cognitive-Behavior Therapy for Panic Disorder
Otto MW, Tolin DF, Simon NM, Pearlson GD, Basden S, Meunier SA, Hofmann SG, Eisenmenger K, Krystal JH, Pollack MH. Efficacy of D-Cycloserine for Enhancing Response to Cognitive-Behavior Therapy for Panic Disorder. Biological Psychiatry 2009, 67: 365-370. PMID: 19811776, DOI: 10.1016/j.biopsych.2009.07.036.Peer-Reviewed Original ResearchConceptsCognitive behavior therapyExposure-based cognitive behavior therapyD-cycloserinePanic disorderTherapeutic learningPanic Disorder Severity ScaleInternal sensationsManualized cognitive behavior therapyPlacebo-controlled augmentation trialD-cycloserine augmentationLarge effect sizesExposure interventionDCS administrationPill placeboAnxiety disordersDSM-IV criteriaSession 3Global ImpressionEffect sizePrimary outcome measureClinician Global ImpressionDisordersParticipantsLearningSignificant adverse effects
2004
Impaired GABA Neuronal Response to Acute Benzodiazepine Administration in Panic Disorder
Goddard AW, Mason GF, Appel M, Rothman DL, Gueorguieva R, Behar KL, Krystal JH. Impaired GABA Neuronal Response to Acute Benzodiazepine Administration in Panic Disorder. American Journal Of Psychiatry 2004, 161: 2186-2193. PMID: 15569888, DOI: 10.1176/appi.ajp.161.12.2186.Peer-Reviewed Original ResearchConceptsGamma-aminobutyric acidPanic disorder patientsAcute benzodiazepine administrationCortical GABA levelsBenzodiazepine administrationGABA levelsPanic disorderDisorder patientsNeuronal responsesOccipital cortex GABA levelsTransmitter gamma-aminobutyric acidChronic benzodiazepine treatmentGABA neuronal functionHuman panic disorderTrait-like abnormalitiesGABA synthetic enzymeHealthy comparison subjectsStress-induced releaseCerebral cortexBenzodiazepine treatmentMedication administrationGABA responsesHealthy subjectsPathogenic factorsHuman anxiety disordersFamily Psychopathology and Magnitude of Reductions in Occipital Cortex GABA Levels in Panic Disorder
Goddard AW, Mason GF, Rothman DL, Behar KL, Petroff O, Krystal JH. Family Psychopathology and Magnitude of Reductions in Occipital Cortex GABA Levels in Panic Disorder. Neuropsychopharmacology 2004, 29: 639-640. PMID: 14973435, DOI: 10.1038/sj.npp.1300374.Peer-Reviewed Original ResearchConceptsOccipital cortex GABA levelsGABA levelsMagnitude of reductionPanic disorderFamily psychopathology
2001
Reductions in Occipital Cortex GABA Levels in Panic Disorder Detected With 1H-Magnetic Resonance Spectroscopy
Goddard AW, Mason GF, Almai A, Rothman DL, Behar KL, Petroff OA, Charney DS, Krystal JH. Reductions in Occipital Cortex GABA Levels in Panic Disorder Detected With 1H-Magnetic Resonance Spectroscopy. JAMA Psychiatry 2001, 58: 556-561. PMID: 11386984, DOI: 10.1001/archpsyc.58.6.556.Peer-Reviewed Original ResearchConceptsOccipital cortex GABA levelsCortical GABA levelsGABA levelsGamma-aminobutyric acidPanic disorderOccipital cortex GABA concentrationsSex-matched control subjectsGABA neuronal functionHuman panic disorderMeasures of illnessPatient-control pairsBrain GABA levelsDSM-IV criteriaPreclinical evidenceMedication historyControl subjectsUnmedicated patientsGABA functionMajor depressionCurrent diagnosisNeuronal functionGABA concentrationPatientsReference limitsDisorders
1996
Noradrenergic mechanisms in stress and anxiety: I. preclinical studies
Bremner J, Krystal J, Southwick S, Charney D. Noradrenergic mechanisms in stress and anxiety: I. preclinical studies. Synapse 1996, 23: 28-38. PMID: 8723133, DOI: 10.1002/(sici)1098-2396(199605)23:1<28::aid-syn4>3.0.co;2-j.Peer-Reviewed Original ResearchConceptsPost-traumatic stress disorderBrain regionsNoradrenergic brain systemsMultiple subcortical areasConsiderable preclinical evidenceLocus coeruleusBrain systemsNeural mechanismsStress disorderTarget brain regionsBehavioral manifestationsBrain functionPanic disorderStress exposureChronic stress resultsTurnover of norepinephrineSubcortical areasAnxietyPsychiatric disordersNoradrenergic systemLong-term alterationsNoradrenergic mechanismsNoradrenergic neuronsNorepinephrine releasePreclinical evidenceNoradrenergic mechanisms in stress and anxiety: II. Clinical studies
Bremner J, Krystal J, Southwick S, Charney D. Noradrenergic mechanisms in stress and anxiety: II. Clinical studies. Synapse 1996, 23: 39-51. PMID: 8723134, DOI: 10.1002/(sici)1098-2396(199605)23:1<39::aid-syn5>3.0.co;2-i.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderBlood pressureNoradrenergic functionHeart rateNoradrenergic systemClinical studiesAdrenergic receptorsPanic disorderAnxiety disordersGrowth hormone responseMeasurement of norepinephrineNorepinephrine responseNoradrenergic mechanismsBaseline norepinephrineNoradrenergic responsivenessPharmacological challengeCatecholaminergic functionHormone responseTraumatic remindersPatientsAcute stressorStress disorderNorepinephrineBaseline measuresConsistent findingThe biological basis of panic disorder.
Krystal JH, Deutsch DN, Charney DS. The biological basis of panic disorder. The Journal Of Clinical Psychiatry 1996, 57 Suppl 10: 23-31; discussion 32-3. PMID: 8917129.Peer-Reviewed Original ResearchConceptsPanic disorderMultiple neuronal systemsRelated brain regionsFunctional imaging studiesOvert historyPharmacologic mechanismsTreatment optionsPharmacologic challengePanicogenic agentPreclinical investigationsNeurochemical substratesPanic attacksChallenge studiesBrain regionsImaging studiesAnatomical basisNeuronal systemsAnxiety disordersDisordersHeritable predispositionBiological basisFurther evidence
1995
Effects of the benzodiazepine antagonist flumazenil in PTSD
Randall P, Bremner J, Krystal J, Nagy L, Heninger G, Nicolaou A, Charney D. Effects of the benzodiazepine antagonist flumazenil in PTSD. Biological Psychiatry 1995, 38: 319-324. PMID: 7495926, DOI: 10.1016/0006-3223(94)00306-n.Peer-Reviewed Original ResearchConceptsVisual analogue rating scaleAdministration of flumazenilAnxiety symptomsCrossover study designBenzodiazepine antagonist flumazenilGABAA receptor complexBenzodiazepine/GABAA receptor complexPanic disorder patientsAnalogue rating scalesFlumazenil administrationPTSD Symptom ScaleIntravenous infusionAntagonist flumazenilGABAA antagonistHealthy controlsClinical studiesDisorder patientsSymptom ScaleFlumazenilPanic disorderPanic attacksVietnam combat veteransStudy designRating ScalePTSD symptomsRelationship of Panic Disorder to Posttraumatic Stress Disorder-Reply
Southwick S, Krystal J, Charney D. Relationship of Panic Disorder to Posttraumatic Stress Disorder-Reply. JAMA Psychiatry 1995, 52: 77-78. DOI: 10.1001/archpsyc.1995.03950130077012.Peer-Reviewed Original Research
1994
Alcohol Dependence May Be the Missing Link Between Posttraumatic Stress Disorder and Panic-Reply
Krystal J, Southwick S, Charney D. Alcohol Dependence May Be the Missing Link Between Posttraumatic Stress Disorder and Panic-Reply. JAMA Psychiatry 1994, 51: 430-430. DOI: 10.1001/archpsyc.1994.03950050090014.Peer-Reviewed Original ResearchPanic disorderPTSD symptomsΑ2-adrenergic antagonistMajor psychiatric disordersPosttraumatic stress disorderAcute alcoholOpiate withdrawalMajor depressionNoradrenergic systemHealthy subjectsPsychiatric disordersClinical reportsAlcohol consumptionPatientsPanic attacksAlcohol dependenceSubstance abuseStress disorderNeurobiological significanceAnxiety disordersDisordersSymptomsPTSDWithdrawalLittle evidence
1993
Abnormal Noradrenergic Function in Posttraumatic Stress Disorder
Southwick SM, Krystal JH, Morgan CA, Johnson D, Nagy LM, Nicolaou A, Heninger GR, Charney DS. Abnormal Noradrenergic Function in Posttraumatic Stress Disorder. JAMA Psychiatry 1993, 50: 266-274. PMID: 8466387, DOI: 10.1001/archpsyc.1993.01820160036003.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderYohimbine-induced panic attacksUncontrollable stressStress disorderYohimbine-induced increasesSystolic blood pressureSubgroup of patientsHealthy male subjectsCore PTSD symptomsCardiovascular effectsBlood pressureMale patientsPathophysiological relationshipNoradrenergic functionPreclinical dataNeurobiological sequelaeHealthy subjectsHeart rateNeuronal regulationPanic disorderMale subjectsNeuronal functionPanic attacksPatientsYohimbine hydrochlorideLong-Term Outcome of Panic Disorder After Short-Term Imipramine and Behavioral Group Treatment
NAGY L, KRYSTAL J, CHARNEY D, MERIKANGAS K, WOODS S. Long-Term Outcome of Panic Disorder After Short-Term Imipramine and Behavioral Group Treatment. Journal Of Clinical Psychopharmacology 1993, 13: 16-24. PMID: 8098050, DOI: 10.1097/00004714-199302000-00003.Peer-Reviewed Original ResearchConceptsMonths of treatmentLong-term outcomesTime of admissionTime of dischargeEfficacy of treatmentPanic attack frequencyDSM-III diagnosesBehavioral treatment programBehavioral group treatmentNonpharmacological therapiesTerm outcomesMajor depressionAntipanic medicationSame doseLow doseLifetime diagnosisTreatment durationPatientsPanic disorderPanic attacksAttack frequencyImipramineTreatment programBehavioral therapyImpairment ratings
1992
Noradrenergic neuronal dysregulation in panic disorder: the effects of intravenous yohimbine and clonidine in panic disorder patients
Charney DS, Woods SW, Krystal JH, Nagy LM, Heninger GR. Noradrenergic neuronal dysregulation in panic disorder: the effects of intravenous yohimbine and clonidine in panic disorder patients. Acta Psychiatrica Scandinavica 1992, 86: 273-282. PMID: 1333719, DOI: 10.1111/j.1600-0447.1992.tb03266.x.Peer-Reviewed Original ResearchConceptsPanic disorder patientsDisorder patientsPanic disorderIntravenous yohimbineHealthy subjectsYohimbine-induced panic attacksClonidine-induced decreaseYohimbine-induced increasesGrowth hormone responseNeuronal dysregulationCardiovascular effectsPlasma MHPGPatientsPlasma 3Hormone responseNeuronal functionPanic attacksClonidineHuman dataDisordersYohimbineHuman anxietySubgroupsFear statesFunctional regulationControlled Trial of Alprazolam Supplementation During Imipramine Treatment of Panic Disorder
WOODS S, NAGY L, KOLESZAR A, KRYSTAL J, HENINGER G, CHARNEY D. Controlled Trial of Alprazolam Supplementation During Imipramine Treatment of Panic Disorder. Journal Of Clinical Psychopharmacology 1992, 12: 32-38. PMID: 1552038, DOI: 10.1097/00004714-199202000-00006.Peer-Reviewed Original ResearchControlled Trial of Alprazolam Supplementation During Imipramine Treatment of Panic Disorder.
WOODS S, NAGY L, KOLESZAR A, KRYSTAL J, HENINGER G, CHAEY D. Controlled Trial of Alprazolam Supplementation During Imipramine Treatment of Panic Disorder. Current Opinion In Cardiology 1992, 7: 32. DOI: 10.1097/00001573-199202000-00006.Peer-Reviewed Original ResearchEffects of age and alcoholism on the prevalence of panic disorder
Krystal JH, Leaf PJ, Bruce ML, Charney DS. Effects of age and alcoholism on the prevalence of panic disorder. Acta Psychiatrica Scandinavica 1992, 85: 77-82. PMID: 1546554, DOI: 10.1111/j.1600-0447.1992.tb01447.x.Peer-Reviewed Original ResearchConceptsPanic disorderPanic disorder prevalenceEpidemiologic Catchment Area studyCatchment Area StudyImpact of alcoholismEffect of ageNeurodevelopmental hypothesisPrevalence ratesAlcohol abuseDisorder prevalenceDisorder ratesAlcoholism historyElderly peopleYoung individualsEffects of agingPrevalenceDisordersEarly declineAlcoholismPreliminary supportAge
1991
Characteristics of panic attack subtypes: Assessment of spontaneous panic, situational panic, sleep panic, and limited symptom attacks
Krystal J, Woods S, Hill C, Charney D. Characteristics of panic attack subtypes: Assessment of spontaneous panic, situational panic, sleep panic, and limited symptom attacks. Comprehensive Psychiatry 1991, 32: 474-480. PMID: 1778074, DOI: 10.1016/0010-440x(91)90026-9.Peer-Reviewed Original ResearchConceptsNumber of symptomsPanic attacksLimited symptom attacksDSM-IIIPanic attack subtypesDSM-III criteriaSpontaneous panic attacksSleep panicSpontaneous panicPanic disorderAwake stateDiagnostic significanceSymptomsPanic attack severityWeekly frequencyAttack severitySubtypesDescriptive characteristicsSeverityBehavioral, biochemical, and cardiovascular responses to the benzodiazepine receptor antagonist flumazenil in panic disorder
Woods S, Charney D, Silver J, Krystal J, Heninger G. Behavioral, biochemical, and cardiovascular responses to the benzodiazepine receptor antagonist flumazenil in panic disorder. Psychiatry Research 1991, 36: 115-127. PMID: 1850142, DOI: 10.1016/0165-1781(91)90124-8.Peer-Reviewed Original ResearchConceptsAntagonist flumazenilAnxiolytic effectsBenzodiazepine receptor antagonist flumazenilReceptor antagonist flumazenilDose of flumazenilVisual analog scaleBenzodiazepine receptor functionBZR inverse agonistsSignificant anxiolytic effectSeparate test daysPlacebo capsulesBlood pressureAnalog scaleCardiovascular responsesDisorder patientsHeart rateFlumazenilCrossover designPanic patientsPanic disorderPlasma cortisolBaseline levelsPanic attacksPlaceboReceptor function