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