We read with interest the article by Leibenluft and colleagues1 in the October 1994 issue of the Archives, which summarized the clinical data on how menstrual cycles can influence biochemical responses to biological challenges. Although the review emphasized mood disorder studies, the authors' conclusions can be extended to biological research in panic disorder. An overlooked area in biological studies of panic disorder is the influence of menstrual cycles and premenstrual syndrome on behavioral sensitivity to panicogenic agents. In this regard, we conducted a study to compare the behavioral response of normal women with and without premenstural dysphoric disorder (PDD) to systemic administration of cholecystokinin-tetrapeptide (CCK-4), a well-validated panicogenic agent. We present herein preliminary data collected from 12 women with PDD and 13 women without PDD.
All of our subjects were screened with the Structured Clinical Interview for DSM-III-R, Non-Patient Editor2 to exclude those with Axis I disorders. The