Disorders in serotonin transmission and/or metabolism are associated with various psychiatric diseases. In recent years evidence has emerged that serotonin may play a role in the pathogenesis of panic disorder. After an introduction into basic physiology, this evidence is reviewed. The possible meaning of these data is discussed in the context of some… (More)
Results of an earlier study in healthy volunteers suggest that the serotonergic system is involved in anxiety-related mechanisms. We studied the influence of tryptophan depletion on the response to a 35% carbon dioxide challenge. Twenty-four panic disorder patients received a mixture of amino acids, either with or without tryptophan, under double-blind… (More)
Naturally occurring panic attacks and various interventions which trigger anxiety in panic patients are accompanied by disturbances in the acid-base balance. Carbon dioxide appears to play an important role in many experimental panic provoking conditions. The influence of respiratory and metabolic pH disturbances on cerebral physiology is discussed and… (More)
BACKGROUND The authors investigated whether 6 weeks of treatment with fluvoxamine would decrease the anxiogenic response to the 35% CO2 challenge in 11 patients with DSM-III-R panic disorder with agoraphobia. METHOD The patients underwent a 35% CO2 challenge at baseline and again after 6 weeks of fluvoxamine treatment. RESULTS The anxiogenic effect of… (More)
In a double-blind randomized placebo-controlled cross-over design trial, the effects of a 4 week fluvoxamine versus a 4 week placebo treatment regimen on panic symptomatology were studied. Fluvoxamine seems to have specific antipanic properties, as a significant decrease in the number of panic attacks was observed. Other components of the disorder, like… (More)
Eleven patients with panic disorder were administered ritanserin, a post-synaptic serotonin S2 antagonist, during a 4 week period at a daily dose of 10-20 mg. The treatment resulted in a decrease in the number of panic attacks, and a diminution of agoraphobic avoidance. The possible practical and theoretical signification of these findings is discussed.
The objective of this study was to determine the test-retest reliability of the 35% carbon dioxide (CO2) panic provocation challenge. Thirty patients with panic disorder were included in this study. Twenty-four patients were challenged twice, with 1 week between the two challenges. Six patients dropped out after the first test. The 35% CO2 challenge… (More)
One inhalation of 35% CO2 in oxygen was administered to 36 patients with anxiety disorders and 14 healthy controls. Eighteen patients had a diagnosis of panic disorder (PD) and 18 of obsessive-compulsive disorder (OCD). As a placebo control for CO2, compressed air was administered in a double-blind design. Immediately before and after the inhalation, levels… (More)
One inhalation of 35% CO2 was administered to each of 32 patients with high anxiety ratings. Only patients with panic disorder had increases in reported anxiety upon CO2 intake. CO2-triggered anxiety appears specific for panic disorder and independent of baseline anxiety.
In order to assess the efficacy of a high-potency benzodiazepine in the treatment of panic disorder, an open trial was conducted with clonazepam. Clonazepam was administered in relatively low doses and, after four weeks, was shown to be effective in reducing the number of panic attacks and associated features of the disorder.