Summary
A group of 20 healthy volunteers underwent a 35% carbon dioxide / 65% oxygen air-placebo controlled challenge test twice, premedicated 1 h before with either 20 mg yohimbine or placebo, following a double-blind randomized crossover design. Contrary to expectation the anxiety response to carbon dioxide was not higher when premedicated with yohimbine compared to premedication with placebo. Possible implications of this finding are discussed, with reference to general chemical models of panic.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Albus M, Zahn T, Breier A (1992) Anxiogenic properties of yohimbine. I. Behavioral physiological and biochemical measures. Eur Arch Psychiatry Clin Neurosci 241:337–344
American Psychiatric Association (1987) DSM-III-R. Diagnostic and statistical manual of mental disorders (DSM-III-R), 3rd edn., revised. American Psychiatric Association, Washington DC
Bradwejn J, Koszycki D (1991) Comparison of the panicogenic effect of cholecystokinin 30–33 and carbon dioxide in panic disorder. Prog Neuropsychopharmacol Biol Psychiatry 15: 237–239
Charney DS, Heninger GR, Redmond DE Jr (1983) Yohimbine induced anxiety and increased noradrenergic function in humans: effects of diazepam and clonidine. Life Sci 33:19–29
Charney DS, Heninger GR, Breier A (1984) Noradrenergic function in panic anxiety. Arch Gen Psychiatry 41:751–763
Charney DS, Woods SW, Goodman WK et al. (1987) Neurobiological mechanisms of panic anxiety: biochemical and behavioral correlates of yohimbine-induced panic attacks. Am J Psychiatry 144(8):1030–1036
Clarck D (1986) A cognitive approach to panic. Beh Res Ther 24(4):461–470
Elam M, Yao T, Thoren P et al (1981) Hypercapnia and hypoxia: chemoreceptor-mediated control of locus coeruleus neurons and splanchnic sympathetic nerves. Brain Research 222:373–381
Fyer MR, Uy Jr, Goetz R et al. (1987) CO2 challenge of patients with panic disorder. Am J Psychiatry 24:1080–1082
Gorman J, Askanazi J, Liebowitz M et al. (1984) Response to hyperventilation in a group of patients with panic disorder. Am J Psychiatry 141:857–861
Gorman J, Fyer M, Liebowitz M et al. (1987) Pharmacologic provocation of panic attacks. In: Meltzer HY, Psychopharmacology: a third generation of progress. Raven Press, New York, pp 985–993
Gorman J, Liebowitz M, Fyer A et al (1989) A neuroanatomical hypothesis for panic disorder. Am J Psychiatry 146:148–161
Griez EJL, Lousberg H, van den Hout M et al. (1987) CO2 vulnerability in panic disorder. Psychiatry Res 20:87–95
Griez EJL, de Loof C, Pols H et al. (1990) Specific sensitivity of patients with panic attacks to carbon dioxide inhalation. Psychiatry Res 31:193–199
Griez EJL, Zandbergen J, Pols H et al. (1990) Response to 35% CO2 as a marker of panic in severe anxiety. Am J Psychiatry 145:796–797
Guttmacher LB, Murphy DL, Insel TR (1983) Pharmacologic models of anxiety. Compr Psychiatry 24:312–326
Hoehn-Saric R, Merchant A, Keyser M et al (1981) Effects of clonidine on anxiety disorder. Arch Gen Psychiatry 38:1278–1282.
Liebowitz M, Fyer A, McGrath P et al (1981) Clonidine treatment of panic disorder. Psychopharm Bull 17:122–123
Mason S, Fibiger H (1979) Current concepts in anxiety: the locus coeruleus disconnection. Life Sci 25:2141–2147
Mattila M, Seppala T, Mattila MJ (1988) Anxiogenic effects of yohimbine in healthy subjects: comparison with caffeine and antagonism by clonidine and diazepam. Int Clin Psychopharmacol 3:215–229
Papp LA, Klein DF, Martinez J et al. (1993) Diagnostic and substance specificity of carbon dioxide-induced panic. Am J Psychiatry 150:250–257
Pols H, Zandbergen J, de Loof C et al. (1991) Attenuation of carbon dioxide-induced panic after clonazepam treatment. Acta Psychiatr Scand 84:885–886
Pols H, Griez EJL, Zandbergen J (1989) Does buspirone have anxiogenic properties. Lancet II:682–683
Redmond D Jr (1977) Alterations in the function of the nucleus locus coeruleus: a possible model for studies of anxiety. In: Hanin, Usdin (eds) Animal models in psychiatry and neurology. Pergamon Press, Oxford
Spielberger CD, Gorsuch R, Lushene RN (1970) Manual for the state-trait anxiety inventory. Consulting Psychologists Press, Palo Alto, Calif.
Uhde TW, Tancer ME (1990) Chemical models of panic: a review and critique. In: Tyrer P (ed) Psychopharmacology of anxiety. University Press, London, Oxford, pp 109–131
Van den Hout M, Griez E (1984) Panic symptoms after inhalation of carbon dioxide. Brit J Psychiatry 144:503–507
Woods SW, Charney DS, Loke J et al. (1986) Carbon dioxide sensitivity in panic anxiety: ventilatory and anxiogenic responses to carbon dioxide in healthy subjects and patients with panic anxiety before and after alprazolam treatment. Arch Gen Psychiatry 43:900–909
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pols, H., Griez, E., Verburg, K. et al. Yohimbine premedication and 35% CO2 vulnerability in healthy volunteers. Eur Arch Psychiatry Clin Nuerosci 244, 81–85 (1994). https://doi.org/10.1007/BF02193523
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02193523