Cowley D S, Dager S R, Roy-Byrne P P, Avery D H, Dunner D L
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98195.
Biol Psychiatry. 1991 Jul 1;30(1):49-56. doi: 10.1016/0006-3223(91)90069-x.
Thirty-six patients with panic disorder underwent sodium lactate infusion before and after 8 weeks of treatment with alprazolam or placebo. With reinfusion, those patients panic-free with chronic alprazolam treatment displayed significantly decreased reactivity to lactate, as measured by subjective symptom ratings, duration of infusion before developing peak lactate-induced symptoms, and the proportion of patients experiencing lactate-induced anxiety or panic. Patients panic-free on placebo, as well as nonresponders to alprazolam treatment, displayed some, although less striking, decreases in reactivity to lactate with reinfusion. As a group, patients clinically unchanged with placebo treatment showed no systematic change in lactate response with reinfusion. Although the small numbers of patients in each treatment outcome group prohibit drawing definitive conclusions, these findings suggest that decreases in lactate-induced panic after successful alprazolam treatment of panic may result from a combination of changes in clinical state and direct effects of the medication.
36名惊恐障碍患者在接受阿普唑仑或安慰剂治疗8周前后接受了乳酸钠输注。再次输注时，那些通过长期阿普唑仑治疗已无惊恐发作的患者，通过主观症状评分、出现乳酸诱导症状高峰前的输注持续时间以及经历乳酸诱导焦虑或惊恐的患者比例来衡量，对乳酸的反应性显著降低。在安慰剂治疗下无惊恐发作的患者，以及对阿普唑仑治疗无反应者，再次输注时对乳酸的反应性也有一些降低，尽管不太明显。作为一个整体，接受安慰剂治疗临床症状未改变的患者再次输注时乳酸反应无系统性变化。尽管每个治疗结果组的患者数量较少，无法得出明确结论，但这些发现表明，阿普唑仑成功治疗惊恐后乳酸诱导的惊恐发作减少可能是临床状态变化和药物直接作用共同作用的结果。
