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Benzodiazepine Sensitivity in Panic Disorder-Reply

Peter P. Roy-Byrne, MD; Deborah S. Cowley, MD; Daniel Hommer, MD
Arch Gen Psychiatry. 1991;48(7):670-671. doi:10.1001/archpsyc.1991.01810310088021.
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In Reply.—  We appreciate Dr Hoehn-Saric's letter, which provides us the opportunity to discuss an arousalrelated explanation for reduced benzodiazepine sensitivity in patients with panic disorder. We did not mean to rule out this explanation, and are continuing to pursue it with various investigative strategies. Contrary to Dr Hoehn-Saric's statement, we used standard, nonanalog anxiety rating scales (Spielberger and Hamilton Anxiety Scales) to compute correlations between anxiety level and the effective dose required to reduce saccadic eye velocity by 30% (SEV ED30), and still found no correlation.1 In addition to the analog scales he noted, this suggests that even anchored, nonanalog self-ratings may not be a sensitive enough reflection of arousal level.We recently examined the relationship between benzodiazepine sensitivity and multiple physiologic measures of arousal obtained at baseline. In a larger sample of patients with panic disorder (N = 18) and control subjects (n = 18), individual sensitivity values measured by


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