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Effects of yohimbine and hydrocortisone on panic symptoms, autonomic responses, and attention to threat in healthy adults

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Abstract

Rationale

Research in rodents and non-human primates implicates the noradrenergic system and hypothalamic–pituitary–adrenal axis in stress, anxiety, and attention to threat. Few studies examine how these two neurochemical systems interact to influence anxiety and attention in humans.

Objective

The objective of this paper is to examine the effects of exogenous yohimbine and hydrocortisone, as well as their combination (Y + H), on panic symptoms and attention to social threat cues.

Methods

Thirty-two healthy adults underwent a pharmacological challenge in which they were blindly randomized to either yohimbine, hydrocortisone, Y + H, or placebo. Thirty minutes after drug infusion, attention to threat was measured using the dot probe task, a visual attention task that presents angry, happy, and neutral faces and measures the degree of attention allocated towards or away from the emotional faces. Panic and autonomic measures were assessed before and 30 min after drug infusion.

Results

There was a significant increase in panic symptoms in the yohimbine and Y + H groups, but not in the hydrocortisone or placebo groups. Yohimbine resulted in a greater increase in panic symptoms than Y + H. On the dot probe task, the placebo group exhibited an attention bias to angry faces, whereas this bias was absent after yohimbine. When collapsing across groups, increased panic symptoms was associated with less attention to angry faces.

Conclusions

Exogenous hydrocortisone may attenuate noradrenergic-induced panic symptoms. The inverse relationship between panic symptoms and attention to angry faces extends prior research demonstrating attention modulation by stressful conditions.

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Acknowledgements

The experiments conducted in this study comply with the current laws of the United States.

None of the authors have a financial relationship with the organization that sponsored the research.

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Authors and Affiliations

  1. Department of Psychiatry, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, 3901 Greenspring Ave., Baltimore, MD, 21211, USA

    Roma A. Vasa

  2. Mood and Anxiety Disorders Program, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, 20892-2670, USA

    Daniel S. Pine, Meena Vythilingam & Carlos Collin

  3. Department of Psychology, University of California, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095, USA

    Carrie L. Masten

  4. Departments of Psychiatry, Neuroscience, Pharmacology and Biological Chemistry, Mount Sinai School of Medicine, New York, NY, 10029, USA

    Dennis S. Charney

  5. Clinical Neuroscience Division, Yale University School of Medicine, West Haven, CT, 06516, USA

    Alexander Neumeister

  6. School of Psychology, University of Southampton, Highfield, Southhampton, SO17 1BJ, UK

    Karin Mogg & Brendan P. Bradley

  7. Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, MD, 21287-3325, USA

    Maggie Bruck

  8. Department of Psychology, University of Michigan, 530 Church St, Ann Arbor, MI, 48109-1043, USA

    Christopher S. Monk

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  1. Roma A. Vasa
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  2. Daniel S. Pine
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  11. Christopher S. Monk
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Correspondence to Roma A. Vasa.

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Grant support: NIMH Intramural Research Program

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Vasa, R.A., Pine, D.S., Masten, C.L. et al. Effects of yohimbine and hydrocortisone on panic symptoms, autonomic responses, and attention to threat in healthy adults. Psychopharmacology 204, 445–455 (2009). https://doi.org/10.1007/s00213-009-1475-x

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