{"id":"https://openalex.org/W7220846391","doi":"https://doi.org/10.3389/fdsfr.2026.1880796","title":"Case Report: Panic attacks after tirzepatide injection in two female patients with recurrent depressive disorder","display_name":"Case Report: Panic attacks after tirzepatide injection in two female patients with recurrent depressive disorder","publication_year":2026,"publication_date":"2026-10-07","ids":{"openalex":"https://openalex.org/W7220846391","doi":"https://doi.org/10.3389/fdsfr.2026.1880796","pmid":"https://pubmed.ncbi.nlm.nih.gov/42909188","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13683810"},"language":"en","primary_location":{"id":"doi:10.3389/fdsfr.2026.1880796","doi":"https://doi.org/10.3389/fdsfr.2026.1880796","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fdsfr.2026.1880796","pdf_url":"https://www.frontiersin.org/journals/drug-safety-and-regulation/articles/10.3389/fdsfr.2026.1880796/pdf","source":{"id":"https://openalex.org/S4210181589","display_name":"Frontiers in Drug Safety and Regulation","issn_l":"2674-0869","issn":["2674-0869"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Drug Safety and Regulation","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/journals/drug-safety-and-regulation/articles/10.3389/fdsfr.2026.1880796/pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5081203934","display_name":"Ulrich Palm","orcid":"https://orcid.org/0000-0002-5446-8237","observed_orcids":["https://orcid.org/0000-0002-5446-8237"]},"institutions":[{"id":"https://openalex.org/I3018771216","display_name":"LMU Klinikum","ror":"https://ror.org/02jet3w32","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I3018771216","https://openalex.org/I8204097"]},{"id":"https://openalex.org/I8204097","display_name":"Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen","ror":"https://ror.org/05591te55","country_code":"DE","type":"education","lineage":["https://openalex.org/I8204097"]}],"countries":["DE"],"is_corresponding":true,"raw_author_name":"Ulrich Palm","raw_affiliation_strings":["Department of Psychiatry and Psychotherapy, Klinikum der Universit\u00e4t M\u00fcnchen","P3 Klinik, Private Clinic for Psychiatry, Psychotherapy and Psychosomatics"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Psychiatry and Psychotherapy, Klinikum der Universit\u00e4t M\u00fcnchen","institution_ids":["https://openalex.org/I3018771216","https://openalex.org/I8204097"]},{"raw_affiliation_string":"P3 Klinik, Private Clinic for Psychiatry, Psychotherapy and Psychosomatics","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5082182568","display_name":"Markus Backmund","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I3018771216","display_name":"LMU Klinikum","ror":"https://ror.org/02jet3w32","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I3018771216","https://openalex.org/I8204097"]},{"id":"https://openalex.org/I8204097","display_name":"Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen","ror":"https://ror.org/05591te55","country_code":"DE","type":"education","lineage":["https://openalex.org/I8204097"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Markus Backmund","raw_affiliation_strings":["Department of Psychiatry and Psychotherapy, Klinikum der Universit\u00e4t M\u00fcnchen","P3 Klinik, Private Clinic for Psychiatry, Psychotherapy and Psychosomatics","PIT, Praxiszentrum im Tal"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Psychiatry and Psychotherapy, Klinikum der Universit\u00e4t M\u00fcnchen","institution_ids":["https://openalex.org/I3018771216","https://openalex.org/I8204097"]},{"raw_affiliation_string":"P3 Klinik, Private Clinic for Psychiatry, Psychotherapy and Psychosomatics","institution_ids":[]},{"raw_affiliation_string":"PIT, Praxiszentrum im Tal","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5008264973","display_name":"Hubertus Himmerich","orcid":"https://orcid.org/0000-0003-1209-6073","observed_orcids":["https://orcid.org/0000-0003-1209-6073"]},"institutions":[{"id":"https://openalex.org/I183935753","display_name":"King's College London","ror":"https://ror.org/0220mzb33","country_code":"GB","type":"education","lineage":["https://openalex.org/I124357947","https://openalex.org/I183935753"]},{"id":"https://openalex.org/I200323923","display_name":"South London and Maudsley NHS Foundation Trust","ror":"https://ror.org/015803449","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I200323923"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Hubertus Himmerich","raw_affiliation_strings":["Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology & Neuroscience, King\u2019s College London","South London and Maudsley NHS Foundation Trust"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology & Neuroscience, King\u2019s College London","institution_ids":["https://openalex.org/I183935753"]},{"raw_affiliation_string":"South London and Maudsley NHS Foundation Trust","institution_ids":["https://openalex.org/I200323923"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":4,"corresponding_author_ids":["https://openalex.org/A5081203934"],"corresponding_institution_ids":["https://openalex.org/I3018771216","https://openalex.org/I8204097"],"apc_list":{"value":1950,"currency":"CHF","value_usd":2353},"apc_paid":{"value":1950,"currency":"CHF","value_usd":2353},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.71011108,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"6","issue":null,"first_page":"1880796","last_page":"1880796"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12539","display_name":"Pharmacology and Obesity Treatment","score":0.7559000253677368,"subfield":{"id":"https://openalex.org/subfields/2736","display_name":"Pharmacology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12539","display_name":"Pharmacology and Obesity Treatment","score":0.7559000253677368,"subfield":{"id":"https://openalex.org/subfields/2736","display_name":"Pharmacology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11071","display_name":"Treatment of Major Depression","score":0.08709999918937683,"subfield":{"id":"https://openalex.org/subfields/2736","display_name":"Pharmacology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11943","display_name":"Pharmacovigilance and Adverse Drug Reactions","score":0.052400000393390656,"subfield":{"id":"https://openalex.org/subfields/3005","display_name":"Toxicology"},"field":{"id":"https://openalex.org/fields/30","display_name":"Pharmacology, Toxicology and Pharmaceutics"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/tirzepatide","display_name":"tirzepatide","score":1.0},{"id":"https://openalex.org/keywords/panic-attacks","display_name":"panic attacks","score":0.9559999704360962},{"id":"https://openalex.org/keywords/recurrent-depressive-disorder","display_name":"recurrent depression","score":0.9769999980926514},{"id":"https://openalex.org/keywords/glp-1-receptor-agonists","display_name":"GLP-1 receptor agonists","score":0.8849999904632568},{"id":"https://openalex.org/keywords/psychiatric-adverse-effects","display_name":"psychiatric adverse effects","score":0.6819999814033508},{"id":"https://openalex.org/keywords/weight-loss","display_name":"weight loss","score":0.5429999828338623},{"id":"https://openalex.org/keywords/medication-discontinuation","display_name":"drug discontinuation","score":0.6140000224113464},{"id":"https://openalex.org/keywords/delayed-gastric-emptying","display_name":"delayed gastric emptying","score":0.9620000123977661},{"id":"https://openalex.org/keywords/nucleus-tractus-solitarius","display_name":"nucleus tractus solitarius","score":0.9580000042915344},{"id":"https://openalex.org/keywords/hypothalamic-pituitary-adrenal-axis","display_name":"hypothalamic-pituitary-adrenal axis","score":0.9309999942779541},{"id":"https://openalex.org/keywords/obesity-treatment","display_name":"obesity treatment","score":0.37299999594688416}],"concepts":[{"id":"https://openalex.org/C2780712732","wikidata":"https://www.wikidata.org/wiki/Q208450","display_name":"Panic","level":3,"score":0.869700014591217},{"id":"https://openalex.org/C558461103","wikidata":"https://www.wikidata.org/wiki/Q154430","display_name":"Anxiety","level":2,"score":0.6074000000953674},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.6068999767303467},{"id":"https://openalex.org/C137627325","wikidata":"https://www.wikidata.org/wiki/Q156318","display_name":"Etiology","level":2,"score":0.5382999777793884},{"id":"https://openalex.org/C2777529043","wikidata":"https://www.wikidata.org/wiki/Q741713","display_name":"Panic disorder","level":3,"score":0.5292999744415283},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5099999904632568},{"id":"https://openalex.org/C197934379","wikidata":"https://www.wikidata.org/wiki/Q2047938","display_name":"Adverse effect","level":2,"score":0.4943999946117401},{"id":"https://openalex.org/C2777014857","wikidata":"https://www.wikidata.org/wiki/Q1383410","display_name":"Exacerbation","level":2,"score":0.48809999227523804},{"id":"https://openalex.org/C2776317618","wikidata":"https://www.wikidata.org/wiki/Q544006","display_name":"Anxiety disorder","level":3,"score":0.41940000653266907},{"id":"https://openalex.org/C2776641880","wikidata":"https://www.wikidata.org/wiki/Q944142","display_name":"Suicidal ideation","level":4,"score":0.4034999907016754},{"id":"https://openalex.org/C2776867660","wikidata":"https://www.wikidata.org/wiki/Q1814941","display_name":"Depression (economics)","level":2,"score":0.35359999537467957},{"id":"https://openalex.org/C2780051608","wikidata":"https://www.wikidata.org/wiki/Q42844","display_name":"Major depressive disorder","level":3,"score":0.3208000063896179},{"id":"https://openalex.org/C3454156","wikidata":"https://www.wikidata.org/wiki/Q1144241","display_name":"Side effect (computer science)","level":2,"score":0.30379998683929443},{"id":"https://openalex.org/C70410870","wikidata":"https://www.wikidata.org/wiki/Q199906","display_name":"Clinical psychology","level":1,"score":0.30230000615119934},{"id":"https://openalex.org/C2776412080","wikidata":"https://www.wikidata.org/wiki/Q7431605","display_name":"Schizophrenia (object-oriented programming)","level":2,"score":0.3018999993801117},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.30149999260902405},{"id":"https://openalex.org/C3019858935","wikidata":"https://www.wikidata.org/wiki/Q4340209","display_name":"Depressive symptoms","level":3,"score":0.29260000586509705},{"id":"https://openalex.org/C2779727114","wikidata":"https://www.wikidata.org/wiki/Q170082","display_name":"Psychosis","level":2,"score":0.2892000079154968},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.28700000047683716},{"id":"https://openalex.org/C2779145073","wikidata":"https://www.wikidata.org/wiki/Q58396","display_name":"Imipramine","level":3,"score":0.2827000021934509}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.3389/fdsfr.2026.1880796","doi":"https://doi.org/10.3389/fdsfr.2026.1880796","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fdsfr.2026.1880796","pdf_url":"https://www.frontiersin.org/journals/drug-safety-and-regulation/articles/10.3389/fdsfr.2026.1880796/pdf","source":{"id":"https://openalex.org/S4210181589","display_name":"Frontiers in Drug Safety and Regulation","issn_l":"2674-0869","issn":["2674-0869"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Drug Safety and Regulation","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13683810","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13683810/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13683810/pdf/fdsfr-06-1880796.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Front Drug Saf Regul","raw_type":"Text"},{"id":"pmid:42909188","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42909188","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in drug safety and regulation","raw_type":"Case Reports"},{"id":"pmh:oai:doaj.org/article:3e1ccc2a14c54db8a7acdb6337ee1b50","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/3e1ccc2a14c54db8a7acdb6337ee1b50","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in Drug Safety and Regulation, Vol 6 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3389/fdsfr.2026.1880796","doi":"https://doi.org/10.3389/fdsfr.2026.1880796","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fdsfr.2026.1880796","pdf_url":"https://www.frontiersin.org/journals/drug-safety-and-regulation/articles/10.3389/fdsfr.2026.1880796/pdf","source":{"id":"https://openalex.org/S4210181589","display_name":"Frontiers in Drug Safety and Regulation","issn_l":"2674-0869","issn":["2674-0869"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Drug Safety and Regulation","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7220846391.pdf","grobid_xml":"https://content.openalex.org/works/W7220846391.grobid-xml"},"referenced_works_count":20,"referenced_works":["https://openalex.org/W2058416358","https://openalex.org/W2123907272","https://openalex.org/W2127613875","https://openalex.org/W2510643344","https://openalex.org/W3096746160","https://openalex.org/W4213337343","https://openalex.org/W4386035099","https://openalex.org/W4388524094","https://openalex.org/W4391170552","https://openalex.org/W4392658789","https://openalex.org/W4392749140","https://openalex.org/W4394934166","https://openalex.org/W4403479516","https://openalex.org/W4412107818","https://openalex.org/W4416099077","https://openalex.org/W4416295041","https://openalex.org/W4416864332","https://openalex.org/W7119199036","https://openalex.org/W7124273048","https://openalex.org/W7124291437"],"related_works":["https://openalex.org/W4400149943","https://openalex.org/W7223469316","https://openalex.org/W7124170901","https://openalex.org/W7124273048","https://openalex.org/W7210283187","https://openalex.org/W2074719989","https://openalex.org/W4417108613","https://openalex.org/W4411014785","https://openalex.org/W2565020239","https://openalex.org/W1993143722"],"abstract_inverted_index":{"Tirzepatide":[0],"was":[1,145],"introduced":[2],"several":[3],"years":[4],"ago":[5],"for":[6,36,54,88,112,118,177],"the":[7,94,119,135,159,162,169],"management":[8],"of":[9,30,96,102,121,158,161,168],"obesity.":[10],"Its":[11],"side-effect":[12],"profile":[13],"includes":[14],"gastrointestinal":[15],"symptoms":[16],"and":[17,43,67,137],"hormonal":[18],"shifts":[19],"similar":[20],"to":[21,82,134],"other":[22],"glucagon-like":[23],"peptide-1":[24],"receptor":[25],"agonists":[26],"(GLP-1RAs).":[27],"This":[28],"class":[29],"medications":[31],"is":[32],"currently":[33],"being":[34],"investigated":[35],"its":[37],"potential":[38,175],"utility":[39],"in":[40,130,148],"treating":[41],"depressive":[42,64,103,124],"anxiety":[44],"disorders.":[45],"While":[46],"safety":[47],"data":[48],"generally":[49],"indicate":[50],"a":[51,71],"low":[52],"risk":[53],"adverse":[55],"psychiatric":[56],"events":[57],"-":[58,66],"such":[59],"as":[60,174],"suicidal":[61],"ideation":[62],"or":[63,166],"episodes":[65],"some":[68],"evidence":[69,87],"suggests":[70],"beneficial":[72],"impact":[73],"on":[74],"mood,":[75],"anecdotal":[76],"reports":[77],"have":[78],"linked":[79],"these":[80],"agents":[81],"panic":[83,107,127,178],"attacks.":[84,179],"However,":[85],"scientific":[86],"this":[89],"remains":[90],"limited.":[91],"We":[92],"present":[93],"cases":[95],"two":[97],"female":[98],"patients":[99],"with":[100],"histories":[101],"disorder":[104],"who":[105],"experienced":[106],"attacks":[108,128],"following":[109],"tirzepatide":[110],"injections":[111,136],"weight":[113],"loss.":[114],"Both":[115],"required":[116],"hospitalization":[117],"exacerbation":[120],"moderate-to-severe":[122],"recurrent":[123],"disorder.":[125],"The":[126],"occurred":[129],"close":[131],"temporal":[132],"proximity":[133],"resolved":[138],"upon":[139],"discontinuation.":[140],"No":[141],"clear":[142],"medical":[143],"aetiology":[144],"identified.":[146],"Changes":[147],"pharmacokinetics":[149],"by":[150],"delayed":[151],"gastric":[152],"emptying,":[153],"GABAergic":[154],"deficits,":[155],"an":[156],"activation":[157,167],"nucleus":[160],"solitary":[163],"tract":[164],"(NTS)":[165],"hypothalamus-pituitary-adrenal":[170],"axis":[171],"are":[172],"considered":[173],"mechanisms":[176]},"counts_by_year":[],"updated_date":"2026-11-05T12:25:35.769452","created_date":"2026-10-08T00:00:00"}