title: Experimental panic provocation in healthy man-a translational role in anti-panic drug development?
abstract: Experimental neurochemical provocation of panic attacks in susceptible human subjects has considerably expanded our knowledge of the pathophysiology and psychopharmacology of panic disorder. Some panicogens also elicit short-lived panic-like states in healthy man. This offers the opportunity to assess the anti-panic action of drugs in proof-of-concept studies. However, from current data it is still unclear whether experimental panic in healthy man is a valid translational model. Most such studies in healthy volunteers have been performed using a cholecystokinin tetrapeptide (CCK-4) challenge. While CCK-4 panic was blocked by alprazolam pretreatment, escitalopram showed negative results in healthy man. Preliminary findings on novel investigational drugs and a few problematic results will be reviewed. Small sample sizes in many panic provocation studies, lack of dose-response aspects, and still-insufficient knowledge about the biological underpinning of experimental and spontaneous panic limit the interpretation of existing findings and should inspire further research.
authors.affiliation: University Hospital Hamburg-Eppendorf, Dept of Psychiatry and Psychotherapy, Anxiety Spectrum Disorders Unit, Hamburg, Germany. kellner@uke.uni-hamburg.de
authors.forename: Michael
authors.initials: M
authors.lastname: Kellner
mesh_terms: D000525:Alprazolam / Q000008:administration & dosage*; D014151:Anti-Anxiety Agents / Q000008:administration & dosage; D002986:Clinical Trials as Topic / Q000639:trends; D015195:Drug Design; D006801:Humans; D016584:Panic Disorder / Q000139:chemically induced* / Q000188:drug therapy*; D013758:Tetragastrin / Q000009:adverse effects*; D057170:Translational Research, Biomedical / Q000639:trends*
chemical_list: D014151:Anti-Anxiety Agents; D013758:Tetragastrin; D000525:Alprazolam