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| Brief Title † | Psychopharmacology of Fear-Potentiated Startle in Humans | ||||||||
| Official Title † | Psychopharmacology of Fear-Potentiated Startle in Humans | ||||||||
| Brief Summary | The purpose of this study is to understand the effects of the drug alprazolam (Xanax ) on anxiety. To understand the effect of anxiety-relieving drugs on fear and anxiety, researchers often have participants anticipate unpleasant stimuli. Anticipating unpleasant stimuli increases or potentiates a simple reflex called the startle reflex. The so-called fear-potentiated startle reflex (FPS) effect may be blocked or reduced by anxiety-relieving drugs. Evidence suggests that the FPS can be mediated by two mechanisms that regulate the phasic- and sustained enhancement of startle. This study will elicit phasic and sustained FPS in participants by having them anticipate moderately painful stimuli that are administered predictably and unpredictably. The main goal of this study is to assess the affect of alprazolam on the phasic and sustained enhancement of startle. This study comprises two pilot experiments and a main study. Participants in the study will be screened with a psychiatric history, physical examination, electrocardiogram (EKG), and blood and urine tests. Participants will four testing sessions separated by 5 to 10 days. At each session, participants will be given one of two doses of alprazolam, diphenhydramine, or placebo (an inactive pill). Questionnaires and other tests will be performed. |
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| Detailed Description | A lack of adequate experimental models of emotional reactions to aversive stimuli is an impediment to furthering our understanding of the psychopharmacology of fear and anxiety in humans. Finding procedures that enable us to test putative anxiety-relieving agents would greatly facilitate this type of research. The startle reflex is an ideal tool for such an endeavor. The so-called fear-potentiated startle reflex (FPS) has clear face validity, well-defined neuronal system, and cross-species generalization. In addition, in rodents the fear-potentiated startle reflex effect is blocked or reduced by drugs that are anxiolytic in humans. However, the few psychopharmacological studies conducted so far in humans have yielded inconsistent results. One possibility is that prior studies have not employed optimal designs to test the effects of anxiolytics. Our previous studies in anxious individuals and patients with anxiety disorders, as well as animal studies, suggest that the potentiation of startle by aversive states can be mediated by two distinct psychological and neurobiological mechanisms. One mediates the short-term potentiation of startle to explicit threatening cues, and the other the long-term potentiation of startle by contextual cues. We have shown that the benzodiazepines alprazolam act preferentially on FPS to contextual cues. The objectives of the following studies are to further test the psychopharmacological validity of the model using recognized anxiolytics (the SSRI citalopram), to test the anxiolytic properties of compounds that are hypothesized to be anxiolytic (the angiotensin receptor blocker candesartan) based on pre-clinical data, and to examine the role of cortisol in startle potentiation. |
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| Study Phase | |||||||||
| Study Type † | Observational | ||||||||
| Study Design † | |||||||||
| Primary Outcome Measure † | |||||||||
| Secondary Outcome Measure † | |||||||||
| Condition † | Healthy | ||||||||
| Intervention † | |||||||||
| MEDLINE PMIDs | 10512076, 11605094, 8136044 | ||||||||
| Links | NIH Clinical Center Detailed Web Page  |
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| Recruitment Information Fields | |||||||||
| Recruitment Status † | Recruiting | ||||||||
| Enrollment † | 166 | ||||||||
| Start Date † | August 2002 | ||||||||
| Completion Date | |||||||||
| Eligibility Criteria † |
Subjects will be healthy volunteers between 18-45 years old and free of current psychopathology and organic central nervous system disorders. EXCLUSION CRITERIA:
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| Gender | Both | ||||||||
| Ages | 18 Years to 45 Years | ||||||||
| Accepts Healthy Volunteers | Yes | ||||||||
| Contacts †† |
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| Location Countries † | United States | ||||||||
| Administrative Information Fields | |||||||||
| NCT ID † | NCT00044096 | ||||||||
| Organization ID | 020263 | ||||||||
| Secondary IDs †† | 02-M-0263 | ||||||||
| Study Sponsor † | National Institute of Mental Health (NIMH) | ||||||||
| Collaborators †† | |||||||||
| Investigators † | |||||||||
| Information Provided By | National Institutes of Health Clinical Center (CC) | ||||||||
| Verification Date | June 2008 | ||||||||
| First Received Date † | August 16, 2002 | ||||||||
| Last Updated Date | July 18, 2008 | ||||||||
