title: Lactate-induced panic attacks: possible involvement of serotonin reuptake stimulation.
abstract: In panic disorder patients, panic attacks can be precipitated with great regularity by intravenous infusion of lactate. The mechanism behind this effect, as well as the mechanism behind the spontaneously occurring panic attacks, are unknown, however. The author draws attention to the fact that lactate as well as pyruvate stimulate serotonin uptake in human blood platelets, and suggests that lactate infusion may stimulate serotonin reuptake also in central serotonergic neurons, thereby decreasing serotonergic activity. This may possibly induce anxiety by reducing the inhibitory serotonergic influence on locus ceruleus. This mechanism--which may not be the only one involved in lactate-induced panic attacks--would easily explain the effect of tricyclic antidepressants, like imipramine, against lactate-induced panic.
mesh_terms: D001792:Blood Platelets / Q000187:drug effects; D001921:Brain / Q000187:drug effects; D005239:Fear / Q000187:drug effects*; D006801:Humans; D007773:Lactates / Q000378:metabolism / Q000494:pharmacology*; D019344:Lactic Acid; D010200:Panic / Q000187:drug effects*; D011985:Receptors, Serotonin / Q000187:drug effects*; D012701:Serotonin / Q000378:metabolism*
chemical_list: D007773:Lactates; D011985:Receptors, Serotonin; D012701:Serotonin; D019344:Lactic Acid