TY - JOUR
T1 - Cortisol and Sodium Lactate—Induced Panic
AU - Hollander, Eric
AU - Liebowitz, Michael R.
AU - Gorman, Jack M.
AU - Cohen, Barry
AU - Fyer, Abby
AU - Klein, Donald F.
N1 - Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 1989/2
Y1 - 1989/2
N2 - Sodium lactate infusions induce panic attacks in patients with panic disorder, but not in normal controls, by an unknown mechanism. We studied the plasma cortisol response to infusion of O.5 mol/L of sodium lactate in 103 patients with panic disorder or agoraphobia with panic attacks, and 32 normal controls. Baseline cortisol levels did not distinguish early panickers from nonpanickers and controls, but late panickers had significantly elevated baseline cortisol levels. In addition, a higher percentage of late panickers manifested an increase in cortisol during the baseline period compared with the other groups. Despite the fact that late panickers manifested elevated baseline cortisol levels, early panickers had significantly greater somatic distress as measured by the Acute Panic Inventory. There was no increase in cortisol with lactate-induced panic, and cortisol levels fell significantly during the lactate infusion in all groups. Cortisol elevation occurred with moderate anxiety but not with severe panic anxiety. These results suggest different pathophysiologic mechanisms of early and late panic, and differences between anticipatory anxiety and panic anxiety.
AB - Sodium lactate infusions induce panic attacks in patients with panic disorder, but not in normal controls, by an unknown mechanism. We studied the plasma cortisol response to infusion of O.5 mol/L of sodium lactate in 103 patients with panic disorder or agoraphobia with panic attacks, and 32 normal controls. Baseline cortisol levels did not distinguish early panickers from nonpanickers and controls, but late panickers had significantly elevated baseline cortisol levels. In addition, a higher percentage of late panickers manifested an increase in cortisol during the baseline period compared with the other groups. Despite the fact that late panickers manifested elevated baseline cortisol levels, early panickers had significantly greater somatic distress as measured by the Acute Panic Inventory. There was no increase in cortisol with lactate-induced panic, and cortisol levels fell significantly during the lactate infusion in all groups. Cortisol elevation occurred with moderate anxiety but not with severe panic anxiety. These results suggest different pathophysiologic mechanisms of early and late panic, and differences between anticipatory anxiety and panic anxiety.
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U2 - 10.1001/archpsyc.1989.01810020037007
DO - 10.1001/archpsyc.1989.01810020037007
M3 - Article
C2 - 2913972
AN - SCOPUS:0024565922
SN - 0003-990X
VL - 46
SP - 135
EP - 140
JO - Archives of General Psychiatry
JF - Archives of General Psychiatry
IS - 2
ER -