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Critical notes on the locus coeruleus hypothesis of panic disorder

Published online by Cambridge University Press:  18 September 2015

J.A. den Boer  and
H.G.M. Westenberg
J.A. den Boer*
Affiliation:
Afdeling Biologische Psychiatrie AZU, Heidelberglaan 100, 3584 CX Utrecht
H.G.M. Westenberg
Affiliation:
Afdeling Biologische Psychiatrie AZU, Heidelberglaan 100, 3584 CX Utrecht
*
Universitair Hoofddocent Klinische en Biologische Psychiatrie, Academisch Ziekenhuis Utrecht, Postbus 85500, 3508 GA Utrecht
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Summary

One of the theories on the biology of panic disorder which received much attention is the locus coeruleus hypothesis. This hypothesis states that there exists an episodic overactivity of noradrenergic systems in panic disorder. Experiments with yohimbine form the cornerstone of this theory, and additional supporting evidence is provided by challenge studies with isoproterenol and treatment studies with clonidine. These studies are critically reviewed and it is argued that based upon the studies with yohimbine one cannot conclude that there is a specific noradrenergic abnormality in panic disorder, since yohimbine also affects dopaminergic and serotoninergic neurons in the brain.

In an alternative theory on the relationship between noradrenaline and anxiety it is postulated that increases in anxiety, irrespective of the diagnostic category, are related to increases in locus coeruleus activity.

Keywords

panic disorderlocus coeruleusnoradrenalineyohimbineisoproterenolclonidinepaniekstoornislocus coeruleusnoradrenalineyohimbineisoproterenolClonidine
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 5 , Issue 3 , September 1993 , pp. 48 - 54
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 1993

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