Psychiatr. praxi. 2023;24(1):13-17 | DOI: 10.36290/psy.2023.001

Panic disorder and autonomic nervous system

MUDr. Jozef Višňovský¹, prof. MUDr. Ján Praško Pavlov, CSc.^{1, 2, 3, 4}, MUDr. Jakub Vaněk¹, MUDr. Jonáš Boček¹, MUDr. Vlastimil Nesnídal¹, PhDr. Marie Ocisková^{1, 4}

¹ Klinika psychiatrie, Lékařská fakulta, Univerzita Palackého v Olomouci

² Katedra psychologických vied, Fakulta sociálnych vied a zdravotnictva, Univerzita Konštantína Filozofa v Nitre, Slovenská republika

³ Katedra psychoterapie, IPVZ Praha

⁴ Jessenia, a. s. - Rehabilitační nemocnice Beroun, AKESO holding, MINDWALK, s. r. o., Beroun

Panic disorder negatively affects the patient's quality of life. Somatic manifestations of massive anxiety characterize the disorder. These are closely related to the autonomic nervous system (ANS), which influences the body's responses to external and internal stimuli. The article aims to map the connection between panic disorder and the autonomic nervous system and the possibilities of therapeutic intervention. Sources for this review article were drawn from the PubMed and Web of Science databases, published between 1991 and 2022. Additional information was obtained from the sources of the articles used in the primary selection. Marked somatic and cardiovascular symptoms are characteristic features of panic attacks. Patients with panic disorder may exhibit autonomic dysfunction and reduced heart rate variability (HRV). Intense anxiety and general arousal levels reduce vagus nerve tone and increase sympathetic activity, causing an overall decrease in HRV compared to control groups. Evaluation of the impact of panic disorder treatment on HRV requires further studies. Preliminarily, it seems that antidepressants reduce HRV or have a negligible effect, and on the contrary, after successful cognitive-behavioural therapy, there is an improvement in the regulation of neuro-cardiac control assessed by HRV. In patients with panic disorder, the function of the autonomic nervous system is impaired. Successful treatment with CBT can have a beneficial effect on the regulation of the ANS. Further research is needed to evaluate the effectiveness of biofeedback, aerobic exercise, and psychotropic drugs.

Keywords: panic disorder, autonomic nervous system, pharmacotherapy, psychotherapy, cognitive­‑behavioural therapy.

Accepted: March 27, 2023; Published: April 11, 2023  Show citation