Modulation by muscarinic antagonists of the response to carbon dioxide challenge in panic disorder

M. Battaglia, S. Bertella, A. Ogliari, L. Bellodi, E. Smeraldi

Research output: Contribution to journalArticle

Abstract

Background: Panic attacks can be induced in persons with panic disorder by inhalation of carbon dioxide. Hypercapnia also elicits a reflex hyperventilation, which is controlled in part by cholinergic mechanisms. This study investigated whether the exaggerated response to carbon dioxide in panic disorder (PD) can be modulated by antagonists of muscarinic cholinergic receptors. Methods: Twelve patients with PD received biperiden hydrochloride (a muscarinic antagonist that crosses the blood-brain barrier), pirenzepine hydrochloride (a muscarinic antagonist that does not cross the blood-brain barrier), or placebo 2 hours before a 35% carbon dioxide-65% oxygen respiratory challenge (vs air as a placebo) on 3 separate days, in a double-blind, random crossover design. Results: According to patients' self-ratings of subjective anxiety, inhalation of the carbon dioxide/oxygen mixture provoked a significant and intense response after treatment with pirenzepine and placebo. After biperiden treatment, however, hypercapnia elicited a response profile similar to that elicited by air, whereby subjective anxiety remained similar to preinhalation levels. Conclusions: Consistent with the hypothesis of the study, a centrally active muscarinic antagonist can block the response to carbon dioxide commonly observed in subjects with PD.

Original languageEnglish
Pages (from-to)114-119
Number of pages6
JournalArchives of General Psychiatry
Volume58
Issue number2
Publication statusPublished - 2001

Fingerprint

Muscarinic Antagonists
Panic Disorder
Carbon Dioxide
Biperiden
Pirenzepine
Hypercapnia
Placebos
Blood-Brain Barrier
Inhalation
Anxiety
Air
Oxygen
Hyperventilation
Muscarinic Receptors
Cross-Over Studies
Cholinergic Agents
Reflex
Modulation
Antagonist
Panic

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Battaglia, M., Bertella, S., Ogliari, A., Bellodi, L., & Smeraldi, E. (2001). Modulation by muscarinic antagonists of the response to carbon dioxide challenge in panic disorder. Archives of General Psychiatry, 58(2), 114-119.

Modulation by muscarinic antagonists of the response to carbon dioxide challenge in panic disorder. / Battaglia, M.; Bertella, S.; Ogliari, A.; Bellodi, L.; Smeraldi, E.

In: Archives of General Psychiatry, Vol. 58, No. 2, 2001, p. 114-119.

Research output: Contribution to journalArticle

Battaglia, M, Bertella, S, Ogliari, A, Bellodi, L & Smeraldi, E 2001, 'Modulation by muscarinic antagonists of the response to carbon dioxide challenge in panic disorder', Archives of General Psychiatry, vol. 58, no. 2, pp. 114-119.
Battaglia, M. ; Bertella, S. ; Ogliari, A. ; Bellodi, L. ; Smeraldi, E. / Modulation by muscarinic antagonists of the response to carbon dioxide challenge in panic disorder. In: Archives of General Psychiatry. 2001 ; Vol. 58, No. 2. pp. 114-119.
@article{e5c46c2aeb31461195c302994f6ba6a7,
title = "Modulation by muscarinic antagonists of the response to carbon dioxide challenge in panic disorder",
abstract = "Background: Panic attacks can be induced in persons with panic disorder by inhalation of carbon dioxide. Hypercapnia also elicits a reflex hyperventilation, which is controlled in part by cholinergic mechanisms. This study investigated whether the exaggerated response to carbon dioxide in panic disorder (PD) can be modulated by antagonists of muscarinic cholinergic receptors. Methods: Twelve patients with PD received biperiden hydrochloride (a muscarinic antagonist that crosses the blood-brain barrier), pirenzepine hydrochloride (a muscarinic antagonist that does not cross the blood-brain barrier), or placebo 2 hours before a 35{\%} carbon dioxide-65{\%} oxygen respiratory challenge (vs air as a placebo) on 3 separate days, in a double-blind, random crossover design. Results: According to patients' self-ratings of subjective anxiety, inhalation of the carbon dioxide/oxygen mixture provoked a significant and intense response after treatment with pirenzepine and placebo. After biperiden treatment, however, hypercapnia elicited a response profile similar to that elicited by air, whereby subjective anxiety remained similar to preinhalation levels. Conclusions: Consistent with the hypothesis of the study, a centrally active muscarinic antagonist can block the response to carbon dioxide commonly observed in subjects with PD.",
author = "M. Battaglia and S. Bertella and A. Ogliari and L. Bellodi and E. Smeraldi",
year = "2001",
language = "English",
volume = "58",
pages = "114--119",
journal = "Archives of General Psychiatry",
issn = "0003-990X",
publisher = "American Medical Association",
number = "2",

}

TY - JOUR

T1 - Modulation by muscarinic antagonists of the response to carbon dioxide challenge in panic disorder

AU - Battaglia, M.

AU - Bertella, S.

AU - Ogliari, A.

AU - Bellodi, L.

AU - Smeraldi, E.

PY - 2001

Y1 - 2001

N2 - Background: Panic attacks can be induced in persons with panic disorder by inhalation of carbon dioxide. Hypercapnia also elicits a reflex hyperventilation, which is controlled in part by cholinergic mechanisms. This study investigated whether the exaggerated response to carbon dioxide in panic disorder (PD) can be modulated by antagonists of muscarinic cholinergic receptors. Methods: Twelve patients with PD received biperiden hydrochloride (a muscarinic antagonist that crosses the blood-brain barrier), pirenzepine hydrochloride (a muscarinic antagonist that does not cross the blood-brain barrier), or placebo 2 hours before a 35% carbon dioxide-65% oxygen respiratory challenge (vs air as a placebo) on 3 separate days, in a double-blind, random crossover design. Results: According to patients' self-ratings of subjective anxiety, inhalation of the carbon dioxide/oxygen mixture provoked a significant and intense response after treatment with pirenzepine and placebo. After biperiden treatment, however, hypercapnia elicited a response profile similar to that elicited by air, whereby subjective anxiety remained similar to preinhalation levels. Conclusions: Consistent with the hypothesis of the study, a centrally active muscarinic antagonist can block the response to carbon dioxide commonly observed in subjects with PD.

AB - Background: Panic attacks can be induced in persons with panic disorder by inhalation of carbon dioxide. Hypercapnia also elicits a reflex hyperventilation, which is controlled in part by cholinergic mechanisms. This study investigated whether the exaggerated response to carbon dioxide in panic disorder (PD) can be modulated by antagonists of muscarinic cholinergic receptors. Methods: Twelve patients with PD received biperiden hydrochloride (a muscarinic antagonist that crosses the blood-brain barrier), pirenzepine hydrochloride (a muscarinic antagonist that does not cross the blood-brain barrier), or placebo 2 hours before a 35% carbon dioxide-65% oxygen respiratory challenge (vs air as a placebo) on 3 separate days, in a double-blind, random crossover design. Results: According to patients' self-ratings of subjective anxiety, inhalation of the carbon dioxide/oxygen mixture provoked a significant and intense response after treatment with pirenzepine and placebo. After biperiden treatment, however, hypercapnia elicited a response profile similar to that elicited by air, whereby subjective anxiety remained similar to preinhalation levels. Conclusions: Consistent with the hypothesis of the study, a centrally active muscarinic antagonist can block the response to carbon dioxide commonly observed in subjects with PD.

UR - http://www.scopus.com/inward/record.url?scp=0035130494&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035130494&partnerID=8YFLogxK

M3 - Article

C2 - 11177112

AN - SCOPUS:0035130494

VL - 58

SP - 114

EP - 119

JO - Archives of General Psychiatry

JF - Archives of General Psychiatry

SN - 0003-990X

IS - 2

ER -