We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Chronic Use of Alcohol and/or Benzodiazepines May Account for Evidence of Altered Benzodiazepine Receptor Sensitivity in Panic Disorder-Reply

David J. Nutt, DM, MRCP, MRCPSYCH; Paul Glue, MRCPsych
Arch Gen Psychiatry. 1992;49(4):330-331. doi:10.1001/archpsyc.1992.01820040047007.
Text Size: A A A
Published online


—Stewart et al raise an im- portant point, namely, the reason patients with panic disorders have abnormal benzodiazepine receptor sensitivity. However, their suggestion that previous alcohol or benzodiazepine exposure could result in anxiogenic responses to flumazenil are but two in a range of possible causes. Before considering these, we can offer some more direct support for their contention that alcoholism may be of relevance. Their bibliography of clinical studies in this area could be usefully expanded to include a recent review that directly addresses the alcoholism/panic disorder comorbidity question and postulates several neurochemical mechanisms for this.1 Moreover, the marked similarity between the symptoms of withdrawal and panic attacks has been documented.2 A possible explanation for this is provided by recent neurochemical studies that demonstrated that acute and long-term ethanol exposure increases the sensitivity of the benzodiazepine receptor to the inverse agonist dimethoxy-methyl-β carboline-3-carboxylate (DMCM).3,4 Since ethanol exposure


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.