The Effects of Alcohol Consumption on Laboratory-Induced Panic and State Anxiety

Kushner, Matt G.; Mackenzie, Thomas B.; Fiszdon, Joanna M.; Valentiner, David P.; Foa, Edna B.; Anderson, Nicole; Wangensteen, D.

doi:10.1001/archpsyc.1996.01830030086013

Cited by 106 publications

(73 citation statements)

References 41 publications

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“…''; ''Are you afraid of dying?''). This inventory, including the abbreviated version, has been used extensively in panic provocation studies [e.g., Kushner et al, 1996;Rassovsky et al, 2004;Schmidt et al, 1996].…”

Section: Methodsmentioning

confidence: 99%

Evidence for respiratory and nonrespiratory subtypes in panic disorder

2006

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Recently researchers have posited a "respiratory" subtype of panic disorder (PD), which differs from "nonrespiratory" subtypes in phenomenology and perhaps treatment response. This study was designed to further examine evidence for the existence of a respiratory subtype in PD. Individuals with PD with prominent respiratory symptoms (PD-R; n=10) and without prominent respiratory symptoms (PD-NR; n=23), as well as healthy controls (n=27), underwent a standardized 5% CO(2) rebreathing challenge. Ventilatory response and subjective sensation of suffocation were continuously recorded. The PD-R group exhibited greater subjective suffocation levels, rates of respiration, and propensity to terminate the procedure voluntarily than did the other two groups, which in turn did not differ on these measures. Findings are consistent with the existence of a respiratory subtype of PD, which differs from nonrespiratory subtypes in CO(2) sensitivity.

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Section: Methodsmentioning

confidence: 99%

Evidence for respiratory and nonrespiratory subtypes in panic disorder

2006

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“…(54) Monoamine oxidase inhibitors also reduce CO 2 reactivity. (55) It is noteworthy that consumption of alcohol diminishes CO 2 sensitivity in panic disorder patients, (56) a finding that sheds light on the high rates of alcohol abuse in panic disorder. pate completely in a matter of seconds.…”

Section: Pharmacologic Implicationsmentioning

confidence: 99%

Respiratory manifestations of panic disorder: causes, consequences and therapeutic implications

et al. 2009

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Multiple respiratory abnormalities can be found in anxiety disorders, especially in panic disorder (PD). Individuals with PD experience unexpected panic attacks, characterized by anxiety and fear, resulting in a number of autonomic and respiratory symptoms. Respiratory stimulation is a common event during panic attacks. The respiratory abnormality most often reported in PD patients is increased CO 2 sensitivity, which has given rise to the hypothesis of fundamental abnormalities in the physiological mechanisms that control breathing in PD. There is evidence that PD patients with dominant respiratory symptoms are more sensitive to respiratory tests than are those who do not manifest such symptoms, and that the former group constitutes a distinct subtype. Patients with PD tend to hyperventilate and to panic in response to respiratory stimulants such as CO 2 , triggering the activation of a hypersensitive fear network. Although respiratory physiology seems to remain normal in these subjects, recent evidence supports the idea that they present subclinical abnormalities in respiration and in other functions related to body homeostasis. The fear network, composed of the hippocampus, the medial prefrontal cortex, the amygdala and its brain stem projections, might be oversensitive in PD patients. This theory might explain why medication and cognitive-behavioral therapy are both clearly effective. Our aim was to review the relationship between respiration and PD, addressing the respiratory subtype of PD and the hyperventilation syndrome, with a focus on respiratory challenge tests, as well as on the current mechanistic concepts and the pharmacological implications of this relationship.Keywords: Panic disorder; Anxiety; Respiration; Hyperventilation; Carbon dioxide. ResumoMúltiplas anormalidades respiratórias podem ser encontradas em pacientes com transtornos de ansiedade, particularmente no transtorno de pânico (TP). Indivíduos com TP experimentam ataques de pânico inesperados, caracterizados por ansiedade, medo e diversos sintomas autonômicos e respiratórios. A estimulação respiratória é um fenômeno comum durante os ataques de pânico. A anormalidade respiratória mais citada em pacientes com TP é a sensibilidade aumentada para o CO 2 , que originou a hipótese de uma disfunção fundamental nos mecanismos fisiológicos de controle da respiração no TP. Há evidências de que pacientes com TP com sintomas respiratórios predominantes são mais sensíveis a testes respiratórios do que aqueles sem a manifestação de tais sintomas, representando um subtipo distinto. Pacientes com TP tendem a hiperventilar e a reagir com pânico como resposta a estimulantes respiratórios como o CO 2 , gerando uma ativação de um circuito de medo hipersensível. Apesar de a fisiologia respiratória desses pacientes permanecer normal, algumas evidências recentes apontam a presença de disfunções subclínicas na respiração e em outras funções relacionadas à homeostase corporal. O circuito do medo, composto pelo hipocampo, córtex pré-frontal medial, amígd...

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“…The relaxing, tension-and stress-reducing, and sedating effects of alcohol in particular are well established. Short-term consumption of alcohol or benzodiazepines diminishes anxiety in patients with PD (Kushner et al 1996). Although the chronological relationship or primary-secondary distinction between the onset of anxiety symptoms and substance use varies considerably, many studies indicate that the onset of anxiety precedes substance use in many cases (Falk et al 2008;Merikangas et al 1998).…”

Section: Reasons For Comorbidity Of Anxiety Disorders and Substance Umentioning

confidence: 99%

“…Studies have found that individuals with a comorbid anxiety and substance use disorder have a poorer treatment response and outcome, have more personal and social problems and impairment and generate greater costs than other patients (Farris et al 2012;Kushner et al 1996); however, not all studies came to the same conclusions (Marquenie et al 2006).…”

Section: Prevention and Therapymentioning

confidence: 99%

Comorbidity of Anxiety Disorders and Substance Use

Soyka

2014

Co-Occurring Addictive and Psychiatric Disorders

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The Effects of Alcohol Consumption on Laboratory-Induced Panic and State Anxiety

Cited by 106 publications

References 41 publications

Evidence for respiratory and nonrespiratory subtypes in panic disorder

Evidence for respiratory and nonrespiratory subtypes in panic disorder

Respiratory manifestations of panic disorder: causes, consequences and therapeutic implications

Comorbidity of Anxiety Disorders and Substance Use

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