August 1997

Anterior Paralimbic Mediation of Procaine-lnduced Emotional and Psychosensory Experiences-Reply

Author Affiliations

Department of Psychiatry and Behavioral Sciences Stanford University School of Medicine Stanford, CA 94305-5543
National Institutes of Health Bethesda, MD 20892-1272
Departments of Psychiatry Radiology and Neurology Medical University of South Carolina Charleston, SC 29425-0720

Arch Gen Psychiatry. 1997;54(8):764-765. doi:10.1001/archpsyc.1997.01830200098017

In Reply  We appreciate Dr Saravay's comments regarding similarities between the acute clinical responses of some of our healthy volunteers to intravenous procaine1 and the psychopathological features observed in some medical patients receiving more sustained intravenous lidocaine therapy.2Dr Saravay raises the important issue of whether the perceptual changes induced by short-term procaine challenge in our subjects are of peripheral vs central origin. He describes the visual and auditory experiences of our subjects as unformed sensory perceptions and, hence, suggests that they may be of peripheral origin. However, these experiences were, in fact, more heterogeneous, and in some cases more complex, than Dr Saravay suggests. Some subjects did have unformed auditory (buzzing and ringing) and visual (flashing lights) experiences while others noted partially formed auditory (electronic music) and visual (swirls of color, thumbprintlike patterns) symptoms. Fully formed auditory (spoken words) or visual (faces, landscapes) hallucinations did not occur in our

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