A kinetic analysis of platelet monoamine oxidase activity in patients with panic attacks.

A kinetic analysis of platelet monoamine oxidase (MAO) was performed in 22 patients with panic disorder and 14 normal controls, using tyramine as a substrate. Patients and controls did not differ significantly for either Km or Vmax, when same sex contrasts were carried out. The results do not support some studies that have shown elevated MAO activity in patients with panic attacks. The reasons for the discrepancies between previous studies and the present one are explored.

Platelet monoamine oxidase activity in panic disorder.

Platelet monoamine oxidase (MAO) activity was studied in 21 patients meeting Research Diagnostic Criteria for panic disorder and in 12 healthy controls. Platelet MAO activity in females in both patient and control groups tended to be higher than that in males, but the results did not reach statistical significance. Platelet MAO activity was significantly decreased in panic disorder patients compared to controls.

Some biochemical correlates of panic attacks with agoraphobia and their response to a new treatment.

Thirty-two patients with chronic debilitating agoraphobia and panic attacks participated in a comparative study of the triazolobenzodiazepine alprazolam and the anti-inflammatory agent ibuprofen. After a 2-week placebo washout period, patients were randomly assigned to 8 weeks of treatment with alprazolam (2 to 6 mg/day) or ibuprofen (0.8 to 2.4 g/day). Medication was identically packaged and patients were blind to the treatment condition, but investigators were aware of which medication was dispensed. Alprazolam recipients (mean daily dose: 5.4 mg) improved markedly with respect to physician and patient global rating of disease severity, frequency and severity of panic attacks, and phobic anxiety target symptoms on the 90-Item Hopkins Symptom Check List. Ibuprofen recipients (mean daily dose: 2.13 g) experienced significantly less clinical improvement than patients on alprazolam. After 8 weeks of treatment, ibuprofen patients were crossed over to alprazolam, while the original alprazolam group continued on that drug. The daily dosage ceiling was increased to 10 mg. In the ensuing 4 weeks (mean daily alprazolam dose: 6.3 mg), all patients achieved comparably marked clinical improvement relative to baseline. Pretreatment plasma concentrations of platelet factor 4 and beta-thromboglobulin--two measures of platelet turnover and release--were significantly elevated in patients relative to normal controls. The elevated platelet factor 4 and beta-thromboglobulin normalized during treatment with both drugs. Alprazolam appears to produce rapid and specific clinical improvement in patients with severe agoraphobia and panic attacks and deserves further evaluation under double-blind conditions.

Platelet monoamine oxidase activity and trace acid levels in plasma of agoraphobic patients.

Platelet monoamine oxidase activity and plasma trace acid levels in 29 patients classified as agoraphobics was estimated. MAO activity towards p-tyramine and beta-phenylethylamine was found to be significantly higher in agoraphobics than in non-agoraphobic depressed patients and healthy controls. In addition plasma p-hydroxyphenylacetic acid levels were low in both agoraphobic and depressed patient groups. All patients were also assessed by Spielberger State Anxiety and the short form of the Beck Depression Inventory scales. No significant correlations could be found between platelet MAO activity or plasma trace acid levels and the psychological scores.

A study of the catabolism of trace amines in mentally disordered individuals with particular reference to agoraphobic patients with panic attacks.

Platelet MAO activity toward several trace amine substrates and the plasma levels of some trace acids have been investigated. Compared to controls, the agoraphobic patients were found to have significantly increased MAO activity. The substrate specificity in some of the patients appeared to be altered. The plasma levels of p-HPA and m-HPA were significantly lower than those of the control groups.

Comparison of biochemical properties of platelet monoamine oxidase in mentally disordered and healthy individuals.

We have investigated some biochemical properties of platelet monoamine oxidase (MAO) isolated from chronic schizophrenic and agoraphobic patients, nonschizophrenic institutional controls, and healthy volunteers. The enzyme activity level in the healthy population was reasonably constant over at least a 6-week period. High correlations were found between MAO activity assessed for different substrates (p-tyramine, beta-phenylethylamine, and tryptamine). Some heterogeneity of the platelet MAO may exist, however, at least in some of the chronic schizophrenics, since the substrate specificities were changed and the Km values reduced. The half-life of the enzyme at 58 degrees C was 2-3 minutes and the transition temperature derived from Arrhenius plots was 16-17 degrees C with respect to beta-phenylethylamine. Platelet MAO from chronic schizophrenics was not significantly different from control values with respect to temperature effects. SDS-polyacrylamide gel electrophoresis of the 3H-pargyline-MAO adduct revealed that the subunit of platelet MAO is a single band protein with a molar individuals. The adjacent structure of the flavine site of the platelet MAO was chromatographically identical to the penta-peptide isolated from MAOs from other tissues. The response of platelet MAO to thimerosal, a new differential type A MAO inhibitor, could be distinguished not only from type A MAO isolated from human placenta, but also from type B MAO isolated from bovine liver.