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Effect of Acute βAdrenergic Blockade on Lactate-lnduced Panic

John M. Rainey Jr, MD, Phd; Eva Ettedgui, MD; Robert B. Pohl, MD; Mary Bridges, MD
Arch Gen Psychiatry. 1985;42(1):104-105. doi:10.1001/archpsyc.1985.01790240106013.
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To the Editor.—  In the article titled "Effect of Acute βAdrenergic Blockade on Lactate-Induced Panic,"1 Gorman et al reported that treatment with propranolol hydrochloride did not prevent lactate-induced panic, and suggested this was evidence against βadrenergic hyperactivity or hyperresponsiveness in the generation of panic attacks. Another possibility is that βadrenergic agonists and sodium lactate produce anxiety states by different mechanisms.Both of these possibilities depend on the assumption that βadrenergic blockade remains effective during infusions of sodium lactate. However, Scebat et al have reported that infusions of sodium lactate can reverse βadrenergic receptor blockade.2 They used 0.1 mg/kg of propranolol hydrochloride to establish βadrenergic blockade in eight dogs and found that the cardiac index decreased by 22.4% and the heart rate decreased by 24.5%. This was followed by an infusion of 0.1 ug/kg/min of isoproterenol for ten minutes, with an increase in the cardiac index to near baseline levels and

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