New Support for "A Hypothetical Explanation of Panic Disorder," German Journal of Psychiatry, 2001

Doktor DynaSoar targeting at
Fri Dec 12 20:43:54 EST 2003

"An Explanation" and "one possible source" are very different things.
There are other, well understood, sources of PD.

On Thu, 11 Dec 2003 16:03:58 -0600, James Michael Howard
<jmhoward at> wrote:

} Further Support of An Explanation of Panic Disorder: 
} "A Hypothetical Explanation of Panic Disorder," German Journal of Psychiatry
} 2001; 4: 40-42.  
} Panic Disorder may result from reduced dehydroepiandrosterone (DHEA) and is
} Analogous to Acquired Immune Deficiency Syndrome
} Copyright 2003, James Michael Howard, Fayetteville, Arkansas, U.S.A.
} Panic disorder is characterized by hyperprolactinemia and increased cortisol
} among some other characteristics.  In my 2001, explanation of panic disorder
} (PD) I used these characteristics to demonstrate that PD may result from reduced
} DHEA.  I had also produced an explanation of acquired immune deficiency syndrome
} (AIDS) also dependent upon pathogenesis resulting from low DHEA.  I did not
} think to compare similarities in PD and AIDS at the time.  Because I have
} recently revisited my explanation of AIDS (2003), these similarities have
} attracted my attention.  These similarities support my explanation of both.
} Here are how they supported my explanation of each other.
} It is my hypothesis from 1985 that vulnerability to the AIDS virus results from
} low DHEA.  (The term "HIV" did not exist at that time.)  DHEA is, indeed, very
} low in AIDS.  The first mention of low DHEA in AIDS appeared in 1989.
} Furthermore, I soon suggested that I think the symptoms of AIDS actually result
} from loss of DHEA; I suggest "acquired immune deficiency syndrome" should be
} "HIV-induced DHEA deficiency syndrome."  AIDS is characterized by low numbers of
} CD4+ lymphocytes, hyperprolactinemia, and increased cortisol and so is panic
} disorder.
} According to my explanation of panic disorder, hyperprolactinemia results from
} lack of feedback of sufficient levels of DHEA to inhibit prolactin production.
} Prolactin is known to stimulate DHEA, so it occurred to me that, perhaps, DHEA
} inhibited prolactin when DHEA reached certain levels.  Now, the background
} source of DHEA, DHEA sulfate (DHEAS) is quite high in panic disorder.  So, I
} made the hypothesis that DHEA is not being made from DHEAS so prolactin remains
} high during panic attacks.  
} DHEA and DHEAS reach very low levels in AIDS so feedback inhibition of prolactin
} should also fail in AIDS.  Hyperprolactinemia is frequently reported in AIDS and
} is sometimes connected with severity of AIDS.  I will not explain this in detail
} here, but the ratio of cortisol to DHEA is very important.  (In 1985, I
} suggested that cortisol evolved to counteract the effects of DHEA.  I think this
} ratio determines the "fight or flight" mechanism.)  Cortisol produces negative
} effects, especially when prolonged and in excessive amounts.  Cortisol is high
} in panic disorder and AIDS.  Fasting significantly increases DHEAS and cortisol
} and reduces CD4 cells and "The percentage of CD4 cells was negatively correlated
} with cortisol concentrations during fasting." (Am J Clin Nutr. 1997
} Jul;66(1):147-52).  Fasting should increase the probability of panic disorder
} and this is the case.  Fasting increases cholecystokinin which is known to
} trigger panic disorders and increase cortisol.  
} AIDS is characterized by low levels of CD4+ cells.  Panic attacks are also
} characterized with significantly lowered CD4+ cells compared to normals
} (Neuropsychobiology. 1992;26(1-2):23-6).  I suggest the similarity here is
} significant.  CD4+ cells are reduced in situations that reduce DHEA, increase
} cortisol, and prolactin.  These pathologies, as well as fasting, produce
} similarities in response.  This response, if prolonged or profound, may be the
} basis of significant morbidity and mortality.  I suggest these are all
} subordinate disturbances in dehydroepiandrosterone homeostasis.
} This is also available at 

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