To the Editor.—
Gorman and associates found that 15 minutes before a lactate infusion patients with PD had a lower inorganic phosphate (PO4) level than controls. Moreover, using a cutoff point of 0.73 mmol/L (2.25 mg/dL), post hoc analysis revealed a significantly greater proportion of low baseline PO4 levels among the lactate panicker patient group than in the nonpanicker group. The authors conclude that (1) low PO4 level is associated with PD and (2) the level of PO4 before a lactate infusion may be a predictor of subsequent lactate vulnerability. Rather than to a metabolic disturbance, the authors ascribe this hypophosphatemia to the HV, which occurred both during the lactate-induced panic attack and before the infusion.In a retrospective examination of 32 patients with PD, as determined by DSM III-R,1 we failed to find any hypophosphatemia. Mean venous PO4 level was 1.18 mmol/L (3.65 mg/dL) (SD, 0.18
Griez E, Pols H. Blood Gas Changes and Hypophosphatemia in Lactate-Induced Panic. Arch Gen Psychiatry. 1988;45(1):96. doi:10.1001/archpsyc.1988.01800250112015
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