Plasma Cortisol Concentrations Preceding Lactate-Induced Panic

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Abstract
INCREASED ADRENAL secretion of glucocorticoids has been linked to acute stress and various anxiety states involving both clinical and preclinical samples.1 It is therefore striking that investigators have failed to find any increase in cortisol level during the acute panic attacks experienced by patients with panic disorder when undergoing infusion with sodium lactate, following inhalation of carbon dioxide, or when placed in a phobic situation.2-4 In an effort to further understand the role of glucocorticoids in lactate-induced panic, we evaluated plasma levels of cortisol during the period immediately preceding lactate-induced panic, presumably reflecting anticipatory anxiety. Data have been collected in our laboratory during the past decade from both patients with panic disorder and healthy volunteers.