Hjgm. Vanmegen et al., EFFECT OF THE SELECTIVE SEROTONIN REUPTAKE INHIBITOR FLUVOXAMINE ON CCK-4 INDUCED PANIC ATTACKS, Psychopharmacology, 129(4), 1997, pp. 357-364
Data from animal studies suggest a functional relationship between the
cholecystokinin-ergic (CCK) and the serotonergic (5-HT) system. There
is increasing evidence that the cholecystokinin-4 (CCK4) challenge te
st could be a valid experimental model for panic attacks in man. The a
im of the present study is twofold; 1) to validate this model further
and 2) to shed more light on the putative CCK\5-HT interaction. To thi
s end, we studied the effect of the selective serotonin reuptake inhib
itor (SSRI) fluvoxamine on CCK4-induced panic attacks. Twenty-six pani
c disorder (PD) patients received, before and after a double blind 8-w
eek treatment period with fluvoxamine (n = 17) or placebo (n = 9), a s
ingle blind bolus injection with 50 mu g CCK4. Treatment with fluvoxam
ine (150 mg daily) significantly decreased the sensitivity of PD patie
nts for CCK4 while placebo was without effect. Of the patients who res
ponded to treatment, 83% no longer experienced a panic attack when rec
hallenged with CCK4, whereas in the non-responders group this was only
28%. In the fluvoxamine group the treatment response evaluated by the
Hamilton Anxiety Scale (HAS) showed a statistically significant treat
ment effect. The results of this study strengthen the validity of the
CCK4 test as an experimental human model for panic attacks and yield e
vidence supporting the hypothesis that both CCK and serotonin are impl
icated in the regulation of anxiety.