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Related Experiment Videos

Cortisol and sodium lactate-induced panic.

E Hollander1, M R Liebowitz, J M Gorman

  • 1Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY.

Archives of General Psychiatry
|February 1, 1989
PubMed
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Sodium lactate infusions trigger panic attacks. Elevated baseline cortisol distinguishes late panic disorder patients, but cortisol decreases during severe panic attacks, suggesting distinct mechanisms.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Endocrinology

Background:

  • Sodium lactate infusions are known to induce panic attacks in susceptible individuals via an unclear mechanism.
  • Panic disorder and agoraphobia with panic attacks represent significant psychiatric conditions requiring further understanding of their pathophysiology.

Purpose of the Study:

  • To investigate the plasma cortisol response to sodium lactate infusion in patients with panic disorder and healthy controls.
  • To explore potential differences in cortisol response between early and late-onset panic disorder.
  • To differentiate the physiological responses associated with anticipatory anxiety versus severe panic anxiety.

Main Methods:

  • A controlled study involving 103 patients with panic disorder or agoraphobia with panic attacks and 32 normal controls.

Related Experiment Videos

  • Administration of 0.5 mol/L sodium lactate infusions.
  • Measurement of plasma cortisol levels at baseline and during infusion, alongside assessment of somatic distress using the Acute Panic inventory.

    • Main Results:

    • Late-onset panic disorder patients exhibited significantly elevated baseline cortisol levels compared to early panickers and controls.
    • A higher percentage of late panickers showed cortisol increases during the baseline period.
    • Cortisol levels decreased significantly during lactate infusion in all groups; no cortisol increase was observed during lactate-induced panic. Cortisol elevation occurred with moderate anxiety, not severe panic.

    Conclusions:

    • The findings suggest distinct pathophysiological mechanisms underlying early and late panic disorder.
    • Differences exist in the physiological responses between anticipatory anxiety and severe panic anxiety.
    • Cortisol dynamics during panic attacks indicate a complex neuroendocrine response not directly linked to lactate-induced panic severity.