sodium-lactate and Anxiety-Disorders

Topics: Anxiety Disorders; Comorbidity; Disease Susceptibility; Female; Humans; Infusions, Intravenous; Panic Disorder; Premenstrual Syndrome; Sodium Lactate; Stress, Psychological

Despite the considerable revisions to diagnostic criteria, recent data indicate that generalized anxiety disorder (GAD) is one of the most common anxiety disorders. Growing evidence also indicates that GAD is a serious illness, which frequently causes moderate impairment and often requires prolonged treatment. Thus, investigation of the biological correlates of GAD may be helpful in the development of effective treatments for this disorder. Recent data suggest possible abnormalities in the regulatory mechanisms of several important biological components in GAD patients. Maladaptive responses to stressful stimuli have been observed in the locus-ceruleus-norepinephrine-sympathetic nervous system, the hypothalamic-pituitary-adrenocortical axis, and the cholecystotin system. Abnormalities in other important CNS modulators, such as 5-HT and gamma-aminobutyric acid, may also be involved in the biology of GAD. In the following article, the authors will review the existing information regarding these potential biological abnormalities in GAD.

Topics: Anxiety Disorders; Carbon Dioxide; Humans; Hypothalamo-Hypophyseal System; Models, Biological; Models, Neurological; Neurotransmitter Agents; Norepinephrine; Panic Disorder; Pituitary-Adrenal System; Psychiatric Status Rating Scales; Sodium Lactate; Terminology as Topic

Premenstrual symptoms are common among young menstruating women, but the psychiatric disorder premenstrual dysphoric disorder (PMDD) is seen only in approximately 3% of this group. The symptom profile of PMDD has been empirically derived from a number of investigations including a large data base from five university centers. The most commonly reported symptoms are depression and mood swings, but a substantial number of women report tension and anxiety. Lifetime psychiatric illness is also common in women with PMDD, and although mood disorders predominate, past histories of anxiety disorders are also common, further suggesting an association between PMDD and anxiety disorders. The strongest data supporting such an association lie with challenge studies that have been used to provoke panic in panic patients and are effective in precipitating panic attacks in women with PMDD. Finally, treatments that are effective for anxiety disorders are also useful in the treatment of PMDD. In this paper, the above outlined relationship between anxiety disorders and PMDD is reviewed.

Topics: 1-Naphthylamine; Adult; Age of Onset; Anxiety; Anxiety Disorders; Buspirone; Carbon Dioxide; Comorbidity; Depressive Disorder; Diagnosis, Differential; Female; Humans; Mental Disorders; Panic Disorder; Piperazines; Premenstrual Syndrome; Psychotherapy; Risk Factors; Sertraline; Sodium Lactate; Triazoles

Panic patients are vulnerable to induction of panic attacks by sub-threshold interoceptive stimuli such as intravenous (i.v.) sodium lactate infusions. Facilitation of serotonergic signaling with selective serotonin reuptake inhibitors can suppress anxiety and panic-like responses, but the mechanisms involved are not clearly defined. We investigated the effects of i.v. 0.5 M sodium lactate or saline, in control and panic-prone rats on c-Fos expression in serotonergic neurons within subdivisions of the midbrain/pontine raphe nuclei. Rats were chronically infused with either the GABA synthesis inhibitor l-allylglycine into the dorsomedial hypo thalamus to make them panic-prone, or the enantiomer d-allylglycine (d-AG) in controls. Lactate increased c-Fos expression in serotonergic neurons located in the ventrolateral part of the dorsal raphe nucleus (DRVL) and ventrolateral periaqueductal gray (VLPAG) of control, but not panic-prone, rats. The distribution of lactate-sensitive serotonergic neurons in d-AG-treated rats is virtually identical to previously defined pre-sympathomotor serotonergic neurons with multisynaptic projections to peripheral organs mediating 'fight-or-flight'-related autonomic and motor responses. We hypothesized that serotonergic neurons within the DRVL/VLPAG region represent a 'sympathomotor control system' that normally limits autonomic/behavioral responses to innocuous interoceptive and exteroceptive stimuli, and that dysfunction of this serotonergic system contributes to an anxiety-like state and increases vulnerability to panic in animals and humans.

Topics: Allylglycine; Animals; Anxiety Disorders; gamma-Aminobutyric Acid; Male; Neurons; Panic Disorder; Proto-Oncogene Proteins c-fos; Rats; Rats, Sprague-Dawley; Serotonin; Sodium Lactate

This unit describes a putative animal model for panic disorder. The basic premise is that pharmacological disruption of critical brain regions implicated in the circuitry of anxiety will lead to a condition similar to that of the human disorder. A clinically relevant test, the sodium lactate challenge, is utilized to assess parallels between the human condition and this rat model.

Topics: Amygdala; Animals; Anxiety Disorders; Biomedical Research; Disease Models, Animal; Disease Susceptibility; Infusions, Intravenous; Male; Neurosciences; Panic Disorder; Rats; Rats, Wistar; Sodium Lactate; Urocortins