title: Hemodynamic, ventilatory, and biochemical responses of panic patients and normal controls with sodium lactate infusion and spontaneous panic attacks.
abstract: Hemodynamic, ventilatory, and biochemical variables were measured in ten healthy adults and ten panic patients during infusion of 0.5 mol/L of sodium lactate. Physical activity, fitness level, and ambulatory electrocardiograms were also recorded. Lactate infusion doubled cardiac output, increased blood lactate levels by sixfold, and produced hypernatremia, hypocalcemia, and decreased serum bicarbonate levels in both groups but raised arterial pressure only in the patients. The patients hyperventilated before and during the infusion. Physiological responses and somatic complaints with the infusion differed little between the groups, but emotional complaints were six times more frequent among the panic patients. Eight patients but no control subjects interpreted their symptoms as a panic attack. Heart rate increased with only 14 of 31 recorded spontaneous outpatient panic attacks. Sodium lactate infusions appear to produce panic by mimicking the physiology of spontaneous panic. Treatment with cardioactive agents is not indicated in the absence of cardiopulmonary or autonomic nervous system abnormalities.
authors.affiliation: Department of Medicine, University of Texas Health Science Center, Southwestern Medical School, Dallas 75235-9034.
authors.forename: F A
authors.initials: FA
authors.lastname: Gaffney
authors.forename: B J
authors.initials: BJ
authors.lastname: Fenton
authors.forename: L D
authors.initials: LD
authors.lastname: Lane
authors.forename: C R
authors.initials: CR
authors.lastname: Lake
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D001008:Anxiety Disorders / Q000097:blood / Q000139:chemically induced* / Q000503:physiopathology; D002302:Cardiac Output / Q000187:drug effects; D005080:Exercise Test; D005239:Fear; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous; D007773:Lactates / Q000008:administration & dosage / Q000097:blood* / Q000494:pharmacology; D019344:Lactic Acid; D008297:Male; D010200:Panic; D012119:Respiration / Q000187:drug effects*
chemical_list: D007773:Lactates; D019344:Lactic Acid