EFFECT OF CHLORIDE OR GLUCOSE ON THE INCIDENCE OF LACTATE-INDUCED PANIC ATTACKS

Objective: This study was designed to test. the hypothesis that the ad dition of chloride to a lactate infusion would reduce the frequency of panic attacks. Method: The subjects included 14 healthy volunteers an d 20 patients meeting the DSM-IV criteria for panic disorder. All subj ects received an infusion of lactate dissolved in 0.9% sodium chloride and an infusion of lactate dissolved in 5% dextrose in water on separ ate days in a random-order, double-blind procedure. Blood pressure, he art rate, and panic symptoms were measured at 3-minute intervals durin g the infusions. The occurrence organic attacks was ascertained throug h the subjects' reports of losing control, panicking, or ''going crazy '' and the presence of at least four Research Diagnostic Criteria symp toms of a panic attack. Results: Fifteen (75%) of the patients with pa nic disorder reported a panic attack during one of the infusions or bo th; no healthy volunteers had a panic attack. The patients with panic disorder were significantly more likely to have a panic attack during the lactate/sodium chloride infusion than during the infusion of lacta te/5% dextrose in water. The number of panic attack symptoms reported at 3-minute intervals did not differ between the two types of infusion . Conclusions: The coadministration of glucose resulted in a reduced s ensitivity to the panicogenic effects of lactate. The hypothesis that adding chloride to the infusion would reduce the frequency of lactate- induced panic attacks was not supported.