OBJECTIVE:Flumazenil is a benzodiazepine receptor antagonist that has been reported to provoke panic attacks in patients with panic disorder. This study was undertaken to compare the effects of flumazenil and sodium lactate, the most widely studied panic provocation agent. METHOD:Ten patients with panic disorder were given infusions of saline, sodium lactate, and flumazenil in randomized order. Panic attacks, psychopathological changes, heart rate, and cortisol and ACTH secretion were recorded. RESULTS: Eight of the 10 patients experienced a panic attack after sodium lactate, but none did after flumazenil or saline. Cortisol and ACTH secretion were not enhanced by any of the treatments. Sodium lactate increased heart rate, whereas flumazenil had the opposite effect. CONCLUSIONS: These findings do not lend support to the view that the benzodiazepine receptors of lactate-susceptible patients with panic disorder are hypersensitive and that flumazenil can therefore act as an inverse agonist.
RCT Entities:
OBJECTIVE:Flumazenil is a benzodiazepine receptor antagonist that has been reported to provoke panic attacks in patients with panic disorder. This study was undertaken to compare the effects of flumazenil and sodium lactate, the most widely studied panic provocation agent. METHOD: Ten patients with panic disorder were given infusions of saline, sodium lactate, and flumazenil in randomized order. Panic attacks, psychopathological changes, heart rate, and cortisol and ACTH secretion were recorded. RESULTS: Eight of the 10 patients experienced a panic attack after sodium lactate, but none did after flumazenil or saline. Cortisol and ACTH secretion were not enhanced by any of the treatments. Sodium lactate increased heart rate, whereas flumazenil had the opposite effect. CONCLUSIONS: These findings do not lend support to the view that the benzodiazepine receptors of lactate-susceptible patients with panic disorder are hypersensitive and that flumazenil can therefore act as an inverse agonist.
Authors: Joseph L Hunt; Dmitry V Zaretsky; Sumit Sarkar; Joseph A Dimicco Journal: Am J Physiol Regul Integr Comp Physiol Date: 2009-11-18 Impact factor: 3.619
Authors: Borwin Bandelow; David Baldwin; Marianna Abelli; Blanca Bolea-Alamanac; Michel Bourin; Samuel R Chamberlain; Eduardo Cinosi; Simon Davies; Katharina Domschke; Naomi Fineberg; Edna Grünblatt; Marek Jarema; Yong-Ku Kim; Eduard Maron; Vasileios Masdrakis; Olya Mikova; David Nutt; Stefano Pallanti; Stefano Pini; Andreas Ströhle; Florence Thibaut; Matilde M Vaghi; Eunsoo Won; Dirk Wedekind; Adam Wichniak; Jade Woolley; Peter Zwanzger; Peter Riederer Journal: World J Biol Psychiatry Date: 2016-07-15 Impact factor: 4.132