2022 · Fernández-Serrano et al. — Effects of Hydrogen Water and Psychological Treatment in a Sample of Women with Panic Disorder: A Randomized and Controlled Clinical Trial
Super-Abstract
In women with panic disorder who all received psychological treatment, adding hydrogen-rich water (1.5 L, for three months) did not give significantly better results than a placebo drink. The abstract adds that there was a further reduction in pro-inflammatory cytokine scores, with improvements in body pain and physical health, but gives no numbers or p-values for it. Once between-group effects were removed, psychological treatment significantly decreased the measured variables, including cytokines and cortisol. The abstract does not state how many women took part. (Health Psychology Research, 2022.)
Commentary
Inflammation is thought to mediate anxiety disorders, and this trial asked whether hydrogen-rich water, described as antioxidant and anti-inflammatory, adds to psychological treatment in women with panic disorder. The authors describe a completely randomised, placebo-controlled study. The treatment group received psychological treatment together with 1.5 L of hydrogenated water for three months. The abstract does not say whether this was a daily amount, and it gives no hydrogen concentration. The control group received psychological treatment and a placebo, which is not described further. Outcomes were the severity of anxiety and depression, pro-inflammatory cytokine levels, the cortisol awakening response and general health state. The abstract does not report the number of participants, blinding, a primary endpoint, the measuring instruments or adverse events.
Key quotes
- „The results show that the treatment group was not significantly better than the control group.“ — the main between-group result, no statistically significant advantage for hydrogen water
- „But there was a further reduction in measured pro-inflammatory cytokine scores, improving body pain and physical health.“ — secondary observations, reported without numbers or statistical tests
- „The results support the presence of a maladaptive inflammatory process in women with panic disorder.“ — the authors' conclusion, which concerns inflammation in panic disorder rather than hydrogen
Our assessment
The trial was randomised and used a placebo drink. The main comparison showed no statistically significant benefit of hydrogen-rich water over placebo. The further reduction in cytokines and the gains in body pain and physical health come without numbers, p-values or a statement that they were planned endpoints, so they do not change the null result. Limitations: the abstract gives no sample size, hydrogen concentration or primary endpoint, and no information on blinding or on the placebo. Whether 1.5 L was a daily or a total amount is unclear. Only women were studied, and both groups received psychological treatment, which the authors name as the source of the significant decreases in cytokines and cortisol. Many outcomes were measured. The authors' conclusion concerns an inflammatory process in panic disorder, not an effect of hydrogen.
Study design
- Type: randomised, placebo-controlled trial, blinding not stated · n: not given in the abstract (women with panic disorder) · H₂ delivery: hydrogenated water, 1.5 L for three months (not stated whether daily), concentration not given, added to psychological treatment
- Comparator: psychological treatment plus placebo
- Result: treatment group not significantly better than control. A further reduction in pro-inflammatory cytokine scores, with improvement in body pain and physical health, reported without figures. With between-group effects removed, psychological treatment significantly decreased the measured variables, including cytokines and cortisol
Abstract
Research suggests that inflammation is an important mediator in the pathophysiology of anxiety disorders. In addition, women are more likely to develop an anxiety and depression disorder, in comorbidity with a wide spectrum of diseases related to the immune system. In recent years, hydrogen-rich water has emerged as a promising therapeutic strategy to prevent and intervene in stress-related disorders, due to its antioxidant and anti-inflammatory properties. The present study aims to analyze the effects of psychological treatment and a hydrogen-rich drink on the severity of anxiety and depression, pro-inflammatory cytokine levels, the cortisol awakening response, and general health state in a sample of women with panic disorder. This is a completely randomized, placebo-controlled study. The treatment group simultaneously received psychological treatment and 1.5 L of hydrogenated water for three months, compared to the control group that received psychological treatment and placebo. The results show that the treatment group was not significantly better than the control group. But there was a further reduction in measured pro-inflammatory cytokine scores, improving body pain and physical health. When between-group treatment effects were removed, psychological treatment significantly decreased measured variables, including cytokines and cortisol. The results support the presence of a maladaptive inflammatory process in women with panic disorder.
Source & links
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