CONSISTENCIES BETWEEN RECALLED PANIC AND LACTATE-INDUCED PANIC

This study investigated the frequency and severity of symptoms during naturally occurring panic attacks recollected as ''usual'' and during sodium lactate-induced attacks. Seventy-six male and 126 female patien ts with panic disorder or agoraphobics with panic attack (DSM-III crit eria) underwent lactate infusion studies and were serially administere d the Acute Panic Inventory (API). Fifty-nine percent of the subjects were rated by an attending psychiatrist to have experienced lactate-in duced panic attacks. Patients were also asked to API symptom rate thei r ''usual'' panic attacks. For panic recollected as usual, the most fr equently reported symptoms (greater than or equal to 75%) at the moder ate to severe levels included: afraid in general, difficulty concentra ting, difficulty performing a job, desire to flee, afraid of losing co ntrol, palpitations, feeling hot or cold or both, dyspnea, dizzy-light headed. During lactate infusion , 25 of 29 API symptoms increased sign ificantly from prelactate to point of panic; however, particularly rob ust effect sizes were exhibited for the desire to flee, dyspnea, tingl ing, twitching/trembling and difficulty doing a job. Comparison of pan ic recollected as usual and lactate-induced panic showed that more tha n half of the symptoms did not differ after Bonferroni correction; how ever, the most notable were fear in general, dyspnea, chest pain/disco mfort, difficulty swallowing, feeling weak, desire to flee, and feelin g hot/cold or both. These data point to a very distinctive role during both recollected and lactate-induced panic attacks for fearfulness th e desire to flee (by definition), and for dyspnea, difficulty performi ng a job and fear of losing control. During lactate-induced panic, dys pnea exhibited the most robust effect size of all physical symptoms. ( C) 1994 Wiley-Liss, Inc.