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Effects of alprazolam on cholecystokinin-tetrapeptide (CCK-4) induced panic and hypothalamic-pituitary-adrenal (HPA) axis activity
A reduction of CCK-4 induced panic has been demonstrated after treatment with antidepressants and after selective GABAergic treatment with vigabatrin1. Although benzodiazepines are widely used as anxiolytics, no controlled study on their effects on CCK-4 induced panic is available so far. Therefore, we investigated the effects of alprazolam and placebo on CCK-4 induced panic in a double-blind study in 30 healthy volunteers. 26 subjects showed a marked panic response to CCK-4. These were rechallenged after pretreatment with 1mg alprazolam or placebo one hour prior to the second CCK-4 challenge. We found a significant reduction of the API and PSS-score after alprazolam treatment compared to placebo. Moreover, compared to placebo CCK-4 induced ACTH and cortisol release was significantly attenuated during the second CCK-4 challenge. However, also placebo treatment reduced CCK-4 induced anxiety and HPA-axis activation to a certain extent. In conclusion, our data show that alprazolam reduces CCK-4 induced panic, which supports the hypothesis of a possible interaction of the GABA and the CCK system.
1Zwanzger P. Neuropsychopharmacology 2001,25:699–703