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Enhanced Sensitivity to Cholecystokinin Tetrapeptide in Panic Disorder:  Clinical and Behavioral Findings

Jacques Bradwejn, MD, FRCPC; Diana Koszycki, MA; Christian Shriqui, MD, FRCPC
Arch Gen Psychiatry. 1991;48(7):603-610. doi:10.1001/archpsyc.1991.01810310021005.
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• We studied the action of cholecystokinin tetrapeptide (CCK-4) in patients with panic disorder and normal controls. Subjects received, in random order, one injection of CCK-4 and one injection of placebo (saline) on two separate days in a double-blind crossover design. Two doses of CCK-4, 50 and 25 μg, were administered to two different samples of subjects. The panic rate with 50 μg of CCK-4 was 100% (12/12) for patients and 47% (7/15) for controls. The panic rate with 25 μg of CCK-4 was 91% (10/11) for patients and 17% (2/12) for controls. Nine percent of patients compared with 0% of controls panicked with placebo. These findings concur with previous reports of a panicogenic effect of CCK-4 and suggest that patients with panic disorder are more sensitive to the panicogenic effect of the peptide than are normal controls.

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