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Cholecystokinin-4 and Panic

JAMES L. ABELSON, MD, PHD; RANDOLPH M. NESSE, MD
Arch Gen Psychiatry. 1990;47(4):395-395. doi:10.1001/archpsyc.1990.01810160095016
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To the Editor.—  The report by de Montigny1 that cholecystokinin-4 (CCK-4) can provoke paniclike attacks in normal subjects prompts us to report preliminary observations of responses to pentagastrin infusions in patients with panic disorder. Our interest in neuropeptides and anxiety was initially aroused by a group of endocrine clinic patients with "idiopathic flushing syndrome" who had symptoms similar to those of patients with panic disorder. Review of a previously described cohort2 of patients with flushing syndrome revealed three who met DSM-III-R criteria for panic disorder and had abnormalities in one or more neuropeptides (substance P, vasoactive intestinal peptide, somatostatin, or gastrin).We decided to look for abnormalities in endocrine responses to pentagastrin in patients with panic disorder to search for possible neuropeptide mediators of panic symptoms. Pentagastrin stimulates the release of a number of peptides from endocrine-containing tumors and can produce paniclike symptoms in some of these patients.

REFERENCES

de Montigny C.  Cholecystokinin tetrapeptide induces paniclike attacks in healthy volunteers: preliminary findings . Arch Gen Psychiatry . 1989;;46:511-517.
Aldrich LB, Moattari AR, Vinik A.  Distinguishing features of idiopathic flushing and carcinoid syndrome . Arch Intern Med . 1988;;148:2614-2618.
Dillon DJ, Gorman JM, Liebowitz MR, Fyer AJ, Klein DF.  Measurement of lactate-induced panic and anxiety . Psychiatry Res . 1987;;20:97-105.
Barrington EJW.  Evolutionary and comparative aspects of gut and brain peptides . Br Med Bull . 1982;;38:227-232.

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de Montigny C.  Cholecystokinin tetrapeptide induces paniclike attacks in healthy volunteers: preliminary findings . Arch Gen Psychiatry . 1989;;46:511-517.
Aldrich LB, Moattari AR, Vinik A.  Distinguishing features of idiopathic flushing and carcinoid syndrome . Arch Intern Med . 1988;;148:2614-2618.
Dillon DJ, Gorman JM, Liebowitz MR, Fyer AJ, Klein DF.  Measurement of lactate-induced panic and anxiety . Psychiatry Res . 1987;;20:97-105.
Barrington EJW.  Evolutionary and comparative aspects of gut and brain peptides . Br Med Bull . 1982;;38:227-232.

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