EFFECTS OF CITALOPRAM TREATMENT ON BEHAVIORAL, CARDIOVASCULAR AND NEUROENDOCRINE RESPONSE TO CHOLECYSTOKININ TETRAPEPTIDE CHALLENGE IN PATIENTS WITH PANIC DISORDER

Eight patients with panic disorder were administered 20 mu g of cholec ystokinin tetrapeptide (CCK-4) before and after 8 weeks of treatment w ith the selective serotonin reuptake inhibitor (SSRI) citalopram. All patients responded to treatment by showing a significant general impro vement and reaching a panic-free state for 2 weeks. At the rechallenge with CCK-4, patients displayed a marked reduction in the intensity an d number of panic symptoms. The frequency of panic attacks induced wit h CCK-4 decreased by 50% after treatment. Citalopram treatment had no substantial effect on cardiovascular (heart rate and blood pressure) o r hormonal (cortisol, prolactin and growth hormone) responses to CCK-4 . Patients who still had panic attacks after treatment demonstrated a blunted growth hormone response to CCK-4 that was not seen in those wh o did not have panic attacks. This study suggests that treatment with an SSRI can reduce an enhanced sensitivity to CCK-4 without modifying cardiovascular and neuroendocrine responses to CCK-4 in patients with panic disorder.