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January 1985

Effect of Acute βAdrenergic Blockade on Lactate-lnduced Panic-Reply

Author Affiliations

Anxiety Disorders Clinic New York State Psychiatric Institute 722 W 168th St New York, NY 10032

Arch Gen Psychiatry. 1985;42(1):105. doi:10.1001/archpsyc.1985.01790240107014

In Reply.—  We appreciate the work of Rainey et al in bringing to our attention the previously untranslated French manuscript of Scebat et al. While interesting, however, the findings of the French group hardly indicate that lactate works to increase heart rate or cardiac index (cardiac output divided by surface area) via a βadrenergic mechanism.First, Jose and Taylor1 specifically found that 0.2 mg/kg of intravenous propranolol hydrochloride is needed to saturate βreceptors in dogs, not the 0.1 mg/kg given by Scebat et al. If isoproterenol causes an increase in the cardiac index after propranolol hydrochloride administration within ten to 20 minutes, by definition full βblockade was not achieved.Furthermore, there are a variety of ways to increase cardiac rate and output other than by stimulation of βreceptors. These include parasympathetic inhibition and peripheral vasodilation. The study by Scebat et al cannot answer the question of the interaction between lactate and

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