January 1988

Hemodynamic, Ventilatory, and Biochemical Responses of Panic Patients and Normal Controls With Sodium Lactate Infusion and Spontaneous Panic Attacks

Author Affiliations

From the Departments of Medicine (Dr Gaffney and Ms Lane) and Psychiatry (Dr Fenton), University of Texas Health Science Center, Southwestern Medical School, Dallas; and Department of Psychiatry, Uniform Services University of the Health Sciences, Bethesda, Md (Dr Lake).

Arch Gen Psychiatry. 1988;45(1):53-60. doi:10.1001/archpsyc.1988.01800250063008

• Hemodynamic, ventilatory, and biochemical variables were measured in ten healthy adults and ten panic patients during infusion of 0.5 mol/L of sodium lactate. Physical activity, fitness level, and ambulatory electrocardiograms were also recorded. Lactate infusion doubled cardiac output, increased blood lactate levels by sixfold, and produced hypernatremia, hypocalcemia, and decreased serum bicarbonate levels in both groups but raised arterial pressure only in the patients. The patients hyperventilated before and during the infusion. Physiological responses and somatic complaints with the infusion differed little between the groups, but emotional complaints were six times more frequent among the panic patients. Eight patients but no control subjects interpreted their symptoms as a panic attack. Heart rate increased with only 14 of 31 recorded spontaneous outpatient panic attacks. Sodium lactate infusions appear to produce panic by mimicking the physiology of spontaneous panic. Treatment with cardioactive agents is not indicated in the absence of cardiopulmonary or autonomic nervous system abnormalities.