Anxiety and mood (대한불안의학회지)
- Volume 2 Issue 2
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- Pages.101-107
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- 2006
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- 2586-0151(pISSN)
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- 2586-0046(eISSN)
The Effect of Paroxetine on Symptom Improvement and Change of Heart Rate Variability of the Patients with Panic Disorder
Paroxetine이 공황장애 환자의 증상 개선과 HRV 양상 변화에 미치는 영향
- Ahn, Joo-Yeun (Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
- Yu, Bum-Hee (Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine)
- Received : 2006.09.27
- Accepted : 2006.10.16
- Published : 2006.10.31
Abstract
Object : Since autonomic nerve system dysfunction was known as the mechanism of panic disorder, many researchers used heart rate variability (HRV) as means of measuring autonomic nerve function of patients with panic disorder. We aimed to examine the effect of paroxetine medication for 3 months on symptom improvement and change of heart rate variability of the patients with panic disorder. Methods : The subjects were patients with panic disorder who visited the psychiatric outpatient clinic of Samsung Medical Center in Seoul. We included panic disorder patients who were aged from 20 to 50 and in normal BMI range (from 18 to 30) to minimize the effect of age and weight on HRV data. We excluded the patients with EKG abnormalities, hypertension or other major psychiatric disorders. They took 20-40 mg paroxetine medication a day for 3 months. Alprazolam was used only during the first month to control the acute panic symptoms and was tapered off after that. We measured the acute panic inventory (API), Hamilton rating scale for anxiety and depression (HAM-A & HAM-D), Spielberger state-trait anxiety inventory (STAIS, STAIT), and Beck depression inventory (BDI) in order to assess clinical improvement of the patients. And we measured time and frequency domain HRV in the resting, standing and cognitive stress states to assess the change of HRV. All measurements were done before and after paroxetine treatment. Result : After paroxetine medication, patients showed significant improvement in all psychiatric scales. In time domain of HRV, standard deviations of all R-R intervals (SDNN) were significantly increased in all states. In frequency domain of HRV, the ratio of high frequency to total power (HF/TP) in the standing state was significantly increased. Conclusion : After 3 months paroxetine medication, panic disorder patients showed significant clinical improvement and change in HRV data such as SDNN in all states and HF/TP ratio in the standing state. This result suggests that paroxetine medication is effective for the improvement of autonomic nerve system dysfunction in panic disorder patients.