Copeptin response to panic provocation with CO2 in healthy adults

• Published in: Journal of psychiatric research 2023-09, Vol.165, p.225-232
• Main Authors: Müller, Jana Christina, Walter, Charlotte, Leibold, Nicole, Wiedemann, Klaus, Kellner, Michael, Demiralay, Cüneyt
• Format: Article
• Language: English
• Subjects: CO2; Copeptin; HPA-axis; Panic provocation; Stress regulation
• ISSN: 0022-3956; 1879-1379
• DOI: 10.1016/j.jpsychires.2023.07.006

Repeated panic attacks are the core symptom of panic disorder and severely stressful for patients. Additional to the psychological response, the physiological symptoms are an important aspect of the experienced panic. However, data on the extent of hypothalamic-pituitary-adrenal (HPA)-axis activation during panic attacks is inconsistent. Therefore, in the present study, we aimed at investigating the stress-axis activity in more detail by including Copeptin (CoP) as a stable surrogate parameter for the vasopressinergic hypothalamic activity during experimentally induced panic attacks in healthy adults (N = 21). During a placebo-controlled panic challenge with 35% CO2 compared to normal air inhalation, we measured CoP and the peripheral effector hormones Adrenocorticotropic Releasing Hormone (ACTH) and cortisol in plasma along with the psychological response to panic anxiety. We analyzed hormonal secretion patterns, their correlations and individual panic ratings over time and explored differences between female and male participants. We found a significant CO2-induced increase of CoP plasma levels and psychological panic symptoms after CO2-administration, while no positive correlations of CoP levels with the peripheral HPA-axis hormones and with panic symptoms were present. No differences between female and male participants concerning their psychological response nor their baseline CoP levels, the release of CoP or its increase during the experiment were found. CoP could be a sensitive indicator for an organism's physiologic acute hypothalamic response during stress and panic attacks. •We explored HPA-axis activity during a placebo-controlled panic challenge with CO2 in healthy adults.•Including Copeptin (CoP) as a marker for the hypothalamic activity goes beyond traditional markers.•A CO2-induced increase of CoP plasma levels and psychological symptoms was found.•No differences between female and male participants.•CoP could be an indicator for the acute hypothalamic response during panic attacks.