The Relation between Heart Rate Variability and Pharmacotherapy in Patients with Panic Disorder / 신경정신의학

ABSTRACT

OBJECTIVES: This study was designed to evaluate relation between 6 weeks pharmacotherapy and the alteration of autonomic nervous system in patient with panic disorder. METHODS: The subjects were patients (n=44) who met DSM-IV criteria for panic disorder with or without agoraphobia. They were measured Anxiety Disorder Inventory Schedule-Panic attack & agoraphobia (ADIS-P & A), Clinical Global Impression (CGI) Hamilton Rating Scale for depression (HAM-D), Panic Disorder Severity Scale (PDSS) and heart rate variability (HRV) before and after 6 weeks pharmacotherapy. We prescribed paroxetine primarily and benzodiazepine (clonazepam, alprazolam) in case needed. For analysis, we performed paired sample t-test, partial correlation, stepwise multiple regression. RESULTS: After 6 weeks pharmacotherapy, a assessed clinical inventories significant improved. In HRV, patients showed stabilized sympathetic activity (LF, Normalized LF, log_LF), increased parasympathetic activity (Normalized HF). There were significant correlation between symptom improvement with parasympathetic components and symptom aggravation with sympathetic components. Multiple regression analysis showed that Normalized HF and TP were best explanatory variables of symptom improvement. CONCLUSION: This study suggests that 6 weeks pharmacotherapy is related to the alteration of autonomic nervous system and clinical improvement.