title: Flumazenil challenge in social phobia.
abstract: The benzodiazepine antagonist, flumazenil, can provoke panic attacks in some panic disorder patients. It has been predicted that panic responses to flumazenil may be associated with situational fear. Patients with social phobia frequently experience situational anxiety and panic attacks. The current study tested whether flumazenil induces panic in patients with social phobia. Fourteen patients with social phobia (DSM-III-R) and 14 age- and sex-matched controls were tested in a single session, double blind crossover challenge design, using intravenous flumazenil 2 mg/20 ml or matched placebo infusions 1 hour apart. Panic attacks occurred during flumazenil challenge in 2/14 subjects with social phobia. The rate of panic attacks and the severity of panic symptoms following flumazenil were not significantly greater in patients than in controls. Situational fears that are provoked by social cues therefore do not predict panic responses to flumazenil.
authors.affiliation: Psychopharmacology Unit, University of Bristol, School of Medical Sciences, United Kingdom. nc2@ualberta.ca
authors.forename: N J
authors.initials: NJ
authors.lastname: Coupland
authors.forename: C
authors.initials: C
authors.lastname: Bell
authors.forename: J P
authors.initials: JP
authors.lastname: Potokar
authors.forename: E
authors.initials: E
authors.lastname: Dorkins
authors.forename: D J
authors.initials: DJ
authors.lastname: Nutt
mesh_terms: D000328:Adult; D001007:Anxiety / Q000139:chemically induced / Q000503:physiopathology; D001569:Benzodiazepines / Q000037:antagonists & inhibitors*; D001794:Blood Pressure / Q000187:drug effects; D016022:Case-Control Studies; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005442:Flumazenil / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D016584:Panic Disorder / Q000139:chemically induced* / Q000503:physiopathology / Q000523:psychology*; D010698:Phobic Disorders / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D015990:Placebo Effect; D011569:Psychiatric Status Rating Scales
chemical_list: D001569:Benzodiazepines; D005442:Flumazenil