Brain perfusion abnormalities in drug-naive, lactate-sensitive panic patients: a SPECT study.

Using single photon emission computed tomography (SPECT) and 99mTc-hexamethylpropyleneamine oxime (HM-PAO), we assessed brain perfusion in seven patients with panic disorder (PD) and in five age-matched normal subjects at rest. No patient had ever received drug treatment for panic. All patients were sensitive to lactate-induced panic. Computed tomography (CT) scans did not reveal any morphological abnormalities of the brain in any of the PD patients. Two indices of cerebral perfusion were calculated; these demonstrated alterations of brain perfusion in the PD group. Significant right-left asymmetry was found in the inferior frontal cortex of the PD patients. We also observed a significant blood flow increase in the left occipital cortex and a significant decrease in the hippocampal regions bilaterally. Although the changes seen in the inferior frontal cortex and occipital cortex may be related to anxiety experienced by the patients during the study, the pattern of hippocampal hypoperfusion appears to be characteristic of panic disorder. This suggests that the hippocampal structures may play an important role in the pathophysiology of panic disorder.

Discovery of antidepressant activity by forced swimming test may depend on pre-exposure of rats to a stressful situation.

Antidepressant-induced anti-immobility effects have been assessed in animals exposed or not to a pretest session using the forced swimming test. Desipramine, maprotiline, mianserine (15 and 30 mg/kg), nomifensine (2.5 and 5 mg/kg), d-amphetamine (1 and 2 mg/kg) and muscimol (1 and 2 mg/kg), unlike imipramine (15 and 30 mg/kg), LY-171555 (0.1 and 0.2 mg/kg) and scopolamine (0.5 and 0.1 mg/kg), did not reduce immobility time in rats which had not received the pretest session. On the other hand, all of the drugs tested reduced immobility time in rats exposed to a pretest session. In addition, the degree of antiimmobility effects of desipramine (20 mg/kg) and nomifensine (5 mg/kg) increased proportionally with the level of water (0, 4, 15 and 30 cm) to which animals were exposed at the time of pretest. Furthermore, desipramine reduced immobility time in rats pre-exposed to types of stress different from forced swimming, cold, restraint or foot-shock. All drugs were injected intraperitoneally three times, 24, 5 and 1 h before testing. The present findings suggest that a stressful pretest session may reveal pharmacological properties of antidepressants in the forced swimming test. This is also substantiated by the fact that diazepam (2.5 and 5 mg/kg) administered 30 min before the swimming pretest antagonized the anti-immobility effect of 15 mg/kg desipramine.

Viqualine in resistant depression: a double-blind, placebo-controlled trial.

Viqualine dihydrochloride is a new molecule, which possesses strong serotonin reuptake inhibition properties and, at the same time, diazepam-like actions, such as [3H]-diazepam-binding inhibition and antipunishment effect. The drug was administered double-blindly to 10 patients suffering from major depression resistant to previous treatments with tricyclics. The comparison group (10 patients) received placebo. Lorazepam (10 mg/day) was also given to both groups. Viqualine proved to be significantly superior to placebo in the 4th week of treatment on all the three rating scales which were used. Tolerability of viqualine was good both objectively and on subjective grounds.

Prevalence of traumatic early life events in 31 agoraphobic patients with panic attacks.

The rate of traumatic early life events in 31 agoraphobic subjects with panic attacks was significantly higher than that in matched control subjects. Experience of maternal separation, parental divorce, and events occurring after the age of 4 years was significantly more common.