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[Panic attack caused by biguanides].

H Gin¹, R Viala, F Rigal

¹Clinique médicale et des maladies infectieuses, hôpital Pellegrin, Bordeaux.

La Revue De Medecine Interne

|July 1, 1989

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Metformin treatment in a patient born in 1923 was linked to elevated lactic acid levels and panic attacks. Discontinuing metformin resolved psychiatric symptoms, suggesting a role for lactic acid in panic attack triggers.

Area of Science:

Endocrinology
Psychiatry
Clinical Pharmacology

Background:

Long-term metformin use is common for type 2 diabetes management.
Panic attacks are a significant psychiatric concern with various potential etiologies.

Observation:

A patient with long-term metformin exposure (since 1977) experienced recurrent panic attacks.
Lactic acid levels were measured during panic attacks and found to be elevated on two separate occasions.

Findings:

Elevated lactic acid levels correlated with panic attack episodes in this patient.
Discontinuation of metformin led to the complete resolution of psychiatric symptoms over a 9-month follow-up.

Implications:

This case suggests a potential link between metformin-induced lactic acidosis and panic attacks.

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Further research is warranted to explore the role of lactic acid in the pathophysiology of panic disorders.

Clinicians should consider monitoring lactic acid levels in patients on long-term metformin therapy who present with unexplained panic attacks.