Am J Psychiatry 1995; 152:692-697
Copyright © 1995 by American Psychiatric Association
Effect of chloride or glucose on the incidence of lactate-induced panic attacks
DT George, T Lindquist, DJ Nutt, PW Ragan, T Alim, V McFarlane, J Leviss, MJ Eckardt and M Linnoila
Laboratory of Clinical Studies, NIAAA, Bethesda, MD 20892, USA.
OBJECTIVE: This study was designed to test the hypothesis that the addition
of chloride to a lactate infusion would reduce the frequency of panic
attacks. METHOD: The subjects included 14 healthy volunteers and 20
patients meeting the DSM-IV criteria for panic disorder. All subjects
received an infusion of lactate dissolved in 0.9% sodium chloride and an
infusion of lactate dissolved in 5% dextrose in water on separate days in a
random-order, double-blind procedure. Blood pressure, heart rate, and panic
symptoms were measured at 3-minute intervals during the infusions. The
occurrence of panic attacks was ascertained through the subjects' reports
of losing control, panicking, or "going crazy" and the presence of at least
four Research Diagnostic Criteria symptoms of a panic attack. RESULTS:
Fifteen (75%) of the patients with panic disorder reported a panic attack
during one of the infusions or both; no healthy volunteers had a panic
attack. The patients with panic disorder were significantly more likely to
have a panic attack during the lactate/sodium chloride infusion than during
the infusion of lactate/5% dextrose in water. The number of panic attack
symptoms reported at 3-minute intervals did not differ between the two
types of infusion. CONCLUSIONS: The coadministration of glucose resulted in
a reduced sensitivity to the panicogenic effects of lactate. The hypothesis
that adding chloride to the infusion would reduce the frequency of
lactate-induced panic attacks was not supported.
