title: The effect of doxapram on brain imaging in patients with panic disorder.
abstract: Administration of doxapram hydrochloride, a respiratory stimulant, is experienced by panic disorder patients to be similar to panic attacks but has reduced emotional effect in normal volunteers, thus providing a laboratory model of panic for functional imaging. Six panic patients and seven normal control subjects underwent positron emission tomography with (18)F-deoxyglucose imaging after a single-blinded administration of either doxapram or a placebo saline solution. Saline and doxapram were administered on separate days in counterbalanced order. Patients showed a greater heart rate increase on doxapram relative to saline than controls, indicating differential response. On the saline placebo day, patients had greater prefrontal relative activity than controls. In response to doxapram, patients tended to decrease prefrontal activity more than controls, and increased cingulate gyrus and amygdala activity more than controls. This suggests that panic disorder patients activate frontal inhibitory centers less than controls, a tendency that may lower the threshold for panic.
authors.affiliation: Laboratory of Clinical Psychobiology, Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA. amir.garakani@mssm.edu
authors.forename: Amir
authors.initials: A
authors.lastname: Garakani
authors.forename: Monte S
authors.initials: MS
authors.lastname: Buchsbaum
authors.forename: Randall E
authors.initials: RE
authors.lastname: Newmark
authors.forename: Chelain
authors.initials: C
authors.lastname: Goodman
authors.forename: Cindy J
authors.initials: CJ
authors.lastname: Aaronson
authors.forename: Jose M
authors.initials: JM
authors.lastname: Martinez
authors.forename: Yuliya
authors.initials: Y
authors.lastname: Torosjan
authors.forename: King-Wai
authors.initials: KW
authors.lastname: Chu
authors.forename: Jack M
authors.initials: JM
authors.lastname: Gorman
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001921:Brain / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D000697:Central Nervous System Stimulants / Q000008:administration & dosage*; D004315:Doxapram / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016584:Panic Disorder / Q000188:drug therapy / Q000473:pathology*; D049268:Positron-Emission Tomography; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013997:Time Factors
chemical_list: D000697:Central Nervous System Stimulants; D004315:Doxapram