Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Maddock, R. J. Search for Related Content PubMed Citation Articles by Maddock, R. J. Panic Disorder

The Lactic Acid Response to Alkalosis in Panic Disorder

An Integrative Review

Received October 1, 1999; revised March 11, 2000; accepted March 17, 2000. From the Department of Psychiatry, University of California Davis School of Medicine, Davis, California. Address correspondence to Dr. Maddock, Department of Psychiatry, U.C. Davis Medical Center, 2230 Stockton Boulevard, Sacramento, CA 95817; e-mail: rjmaddock{at}ucdavis.edu

Panic patients consistently show exaggerated lactic acid response to alkalosis, whether produced by hyperventilation or by sodium lactate infusion. Understanding why this occurs may provide important clues to the pathogenesis of panic disorder. Although brain hypoxia from excessive hypocapnia-induced cerebral vasoconstriction is often cited as the mechanism of elevated brain lactic acid in panic disorder, studies of brain metabolism show that hypocapnia rarely leads to brain hypoxia. Increased lactic acid production is a normal response to intracellular alkalosis and to intracellular cyclic AMP. Thus, other possible mechanisms of the exaggerated lactic acid response in panic disorder include a disturbance of mechanisms regulating intracellular pH and factors increasing intracellular cyclic AMP. Both mechanisms are consistent with the suffocation false alarm theory of panic disorder. This review suggests a theoretical framework for future magnetic resonance spectroscopy studies that can test some of the predictions of these competing models.

Key Words: Hypocapnia • Alkalosis • Panic Disorder • Lactic Acid

This article has been cited by other articles:

				S. D. Friedman, C. M. Mathis, C. Hayes, P. Renshaw, and S. R. Dager Brain pH Response to Hyperventilation in Panic Disorder: Preliminary Evidence for Altered Acid-Base Regulation Am J Psychiatry, April 1, 2006; 163(4): 710 - 715. [Abstract] [Full Text] [PDF]

				D. G. Rainnie, R. Bergeron, T. J. Sajdyk, M. Patil, D. R. Gehlert, and A. Shekhar Corticotrophin Releasing Factor-Induced Synaptic Plasticity in the Amygdala Translates Stress into Emotional Disorders J. Neurosci., April 7, 2004; 24(14): 3471 - 3479. [Abstract] [Full Text] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 2001 American Neuropsychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us