Experimental induction of panic-like symptoms in patients with postural tachycardia syndrome

Research output: Contribution to journalArticle

Abstract

Patients with postural tachycardia syndrome (POTS) might be misdiagnosed with panic disorder due to shared clinical features. The first aim of our study was to investigate the relationship between symptoms of POTS and panic disorder. The second aim was to delineate clinical features distinguishing symptoms of POTS from panic disorder. A total of 11 patients with POTS and 11 control subjects participated in an IRB-approved, prospective, placebo-controlled study. The experimentally induced panic-like symptoms of POTS were systematically studied using the Acute Panic Inventory (API) questionnaire. The participants answered the questionnaire after each placebo infusion and after each of the three provoking stimuli: head-up tilt test (HUT), isoproterenol infusion (ISI), and sodium lactate infusion (SLI). API responses were summed for each subject at each time point of administration. Individual API symptoms and summed responses were analyzed for statistical significance. All patients with POTS developed symptoms of orthostatic intolerance during HUT. Pharmacologically induced symptoms subjectively mimicked spontaneous symptoms in 5 of 11 patients during ISI and in none of 11 patients during SLI. In contrast, API scores in these patients reached panic threshold in 0 of 11 following HUT, in 4 of 11 following ISI and in 4 of 11 following SLI. Individual symptoms analysis revealed that significant increase in scores was limited to the somatic symptoms of palpitations, dyspnea, and twitching or trembling. In conclusion, the symptoms of POTS are phenomenologically different and clinically distinguishable from panic disorder symptoms.

Original languageEnglish (US)
Pages (from-to)371-377
Number of pages7
JournalClinical Autonomic Research
Volume16
Issue number6
DOIs
StatePublished - Dec 1 2006
Externally publishedYes

Fingerprint

Postural Orthostatic Tachycardia Syndrome
Panic
Panic Disorder
Sodium Lactate
Isoproterenol
Equipment and Supplies
Head
Orthostatic Intolerance
Placebos
Research Ethics Committees
Diagnostic Errors
Dyspnea

Keywords

  • Acute panic inventory
  • Autonomic nervous system
  • Head-up tilt
  • Isoproterenol
  • Postural tachycardia
  • Sodium lactate

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Clinical Neurology

Cite this

Experimental induction of panic-like symptoms in patients with postural tachycardia syndrome. / Khurana, Ramesh.

In: Clinical Autonomic Research, Vol. 16, No. 6, 01.12.2006, p. 371-377.

Research output: Contribution to journalArticle

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