Cholecystokinin and anxiety: promises and pitfalls

In the past 5 years, considerable interest has been expressed in the possible involvement of cholecystokinin (CCK) receptor mechanisms in anxiety disorders. Stemming from early clinical observations in the 1960s and electrophysiological findings some twenty years later, this interest now encompasses research on the behavioral effects of CCK receptor agonists and antagonists at both clinical and preclinical levels. The results to date have been encouraging enough to prompt a number of pharmaceutical companies to "fast track" the development of CCK receptor antagonists as antipanic agents. The present review critically assesses research findings in this area and concludes that the field is rife with inconsistency, the date are subject to a variety of methodological and interpretative pitfalls, and, unfortunately, the promise of therapeutic advance through CCK receptor antagonists may be illusory.