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Relationship of Panic Disorder to Posttraumatic Stress Disorder-Reply

Steven M. Southwick, MD; John H. Krystal, MD; Dennis S. Charney, MD
Arch Gen Psychiatry. 1995;52(1):77-78. doi:10.1001/archpsyc.1995.03950130077012.
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In reply  As pointed out by Safadi and Bradwejn, panic attacks can be difficult to differentiate from flashbacks because flashbacks are frequently accompanied by symptoms of autonomic arousal and anxiety. Safadi and Bradwejn wonder whether the panic attacks in the intravenous lactate PTSD study by Rainey et al were mislabeled and instead "simply represented associated features of flashbacks." Further, the work of Mellman and Davis is cited, in which flashbacks are viewed as the equivalent of panic attacks.Safadi and Bradwejn suggest that our yohimbine study,1 like the study by Rainey et al, suffered from a lack of specificity in assessment and they wonder whether the panic attacks experienced after yohimbine infusion were "true" panic attacks. Additionally, they wonder whether Yohimbineinduced panic attacks and flashbacks really differed from one another. It is not clear what they mean by true panic attacks. As detailed in the "Procedures" section of our article,1 we


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