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Panic, suffocation false alarms, separation anxiety and endogenous opioids.
Maurice Preter1, Donald F Klein
1New York State Psychiatric Institute, Columbia University College of Physicians & Surgeons, 1160 Fifth Avenue, Suite 112, New York, NY 10029, USA. MP2285@columbia.edu
Progress in Neuro-Psychopharmacology & Biological Psychiatry
|September 4, 2007
Summary
The suffocation false alarm (SFA) theory explains panic attacks as a maladaptive response of an evolved suffocation alarm system. Opioid system dysfunction may lower this alarm, contributing to panic disorders.
Area of Science:
- Neuroscience
- Psychiatry
- Respiratory Medicine
Background:
- Spontaneous panic attacks are distinct from fear responses, characterized by air hunger and abnormal breathing.
- The suffocation false alarm (SFA) theory proposes panic arises from a misfiring, evolved suffocation alarm system.
- Panic attacks lack the typical hypothalamic-pituitary-adrenal (HPA) axis activation seen in fear.
Purpose of the Study:
- To amplify the suffocation false alarm (SFA) theory of spontaneous panic.
- To integrate the role of opioid system dysfunction in panic disorders.
- To present evidence supporting the endorphinergic defect hypothesis in panic.
Main Methods:
- Review of the suffocation false alarm theory.
- Analysis of physiological distinctions between fear and panic.
- Laboratory challenge using naloxone-lactate in healthy individuals.
Main Results:
- Panic is linked to suffocation indicators like pCO2 and brain lactate fluctuations.
- Opioidergic dysfunction is implicated in lowering the suffocation alarm threshold.
- Naloxone-lactate challenge induced hyperventilation, supporting the endorphinergic defect hypothesis.
Conclusions:
- The SFA theory provides a framework for understanding panic attacks, including respiratory and environmental triggers.
- Opioid system dysfunction plays a crucial role in the pathophysiology of panic.
- Further research into opioidergic mechanisms can inform panic disorder treatment.
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