Replication of action of cholecystokinin tetrapeptide in panic disorder : clinical and behavioral findings

Eleven patients with panic disorder were challenged with cholecystokinin tetrapeptide (CCK-4) on two occasions. The effects of CCK-4 were consistent except symptom onset was more rapid with the second injection. Demonstrating that the effects of CCK-4 are reproducible in panic patients opens the door for studies ofthe effects ofdrug treatment on CCK-4-inducedpanic. (Am J Psychiatry 1992; 149:962-964) R ecent studies (1-3) suggest that cholecystokinin tetrapeptide (CCK-4) could provide a phanmacologic model of panic attacks in humans. This is supported by findings that CCK-4 satisfies four criteria for a panicogenic agent: it seems safe for use in humans, it elicits both somatic and affective symptoms of a panic attack, it induces attacks that are similar to patients’ usual attacks, and it precipitates panic attacks at a higher frequency in patients than in normal subjects. To further establish the relevance of CCK-4 as a model anxiety- and panic-inducing agent, it is impomtant to verify whether its effects are consistent and meproducible in multiple administrations. Fulfilling this criterion is essential for eventual studies of the effects of antipanic drugs, such as imipmamine and alprazolam, on CCK-4-induced symptoms.