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August 1984

Lactate Provocation of Panic Attacks: I. Clinical and Behavioral Findings

Author Affiliations

From the New York State Psychiatric Institute (Drs Liebowitz, Fyer, Gorman, Dillon, Appleby, Levy, Anderson, Levitt, Palij, and Klein and Ms Davies), and the Department of Psychiatry, College of Physicians and Surgeons, Columbia University (Drs Liebowitz, Fyer, Gorman, Dillon, Appleby, Anderson, Levitt, and Klein), New York.

Arch Gen Psychiatry. 1984;41(8):764-770. doi:10.1001/archpsyc.1984.01790190038004

• To assess the pharmacologic and phenomenologic comparability of lactate-induced and naturally occurring panic attacks, patients meeting DSM-III criteria for panic disorder or agoraphobia with panic attacks were infused with 0.5M racemic sodium lactate before and after successful drug treatment. Lactate-induced and naturally occurring panic attacks were symptomatically similar. Following treatment, the patients' response to lactate did not differ from that of normal controls, whereas the pretreatment panic rate was much higher. These data suggest that lactate acts, by as yet unidentified mechanisms, to trigger the same panic attacks as occur spontaneously in vulnerable persons.