Panic Disorder

Panic Attack

Panic Disorder

Recurrent Panic Attacks

Anticipatory Anxiety

Agoraphobia

Hypochondriasis

Demoralisation

Epidemiology

Age of Onset

Situation of Onset

Stressful Life Events

Early Life Events

Maternal Over-Protection

Separation Anxiety

Short and Long-term Outcomes

Comorbidity

Panic Disorder: Pathogenesis

Biological Findings

Provocative Agents

Neurotransmitter Systems

Neuroanatomical Models

Brain Imaging

Psychological Models

Psychodynamic Models

Behavioural Models

Cognitive Models

Areas of Controversy and Debate

The Evolutionary Perspective

Panic Disorder: Treatment

Pharmacotherapy

Benzodiazepines

Tricyclic Antidepressants

Monoamine Oxidase Inhibitors

Selective Serotonin Re-uptake Inhibitors

Other Drugs

Psychotherapy

Overcoming Anxiety (Home) > Panic Disorder > Provocative Agents

Provocative Agents

Intravenous infusion of sodium lactate 0.5–1M has been reported to reliably induce panic attacks in PD patients . Twenty minutes inhalation of air containing 5% CO2 or a single inhalation of 35% CO2 induces panic attacks in PD patients. Many hypotheses have been offered to explain the panicogenic effect of lactate and CO2. One is that CO2 and lactate, after being metabolised to CO2, induce panic attacks by stimulating the respiratory centres, which are hypersensitive in PD patients. This hypothesis is consistent with the ‘‘false suffocation alarm’’ theory of Klein . This theory supposes that PD patients have a low Anxiety Disorders.

Patients with PD are more sensitive to the panicogenic effects of caffeine than normal controls. Also, m-chlorophenylpiperazine, a mixed 5-HT agonist-antagonist, and fenfluramine, a 5-HT releasing drug, have both been reported to provoke panic attacks in challenge paradigms suggesting a role for 5-HT in PD pathogenesis. Cholecystokinin-tetrapeptide (CCK- 4), a CCK agonist, is panicogenic in man

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