Attenuation of carbon dioxide‐induced panic after clonazepam treatment

Abstract

Ten patients meeting the DSM-III-R criteria for panic disorder were treated with clonazepam. Prior to clonazepam treatment and after a 5-week treatment period, patients underwent a 35% carbon dioxide challenge procedure. Following clonazepam treatment, a significant reduction in carbon dioxide vulnerability was observed.

Carbon dioxide induced panic attacks and short term clonazepam treatment: preliminary study

“…This finding is consistent with the observation that acute 3 and long term 9 alprazolam treatment and 5-week treatment with clonazepam 10,11 are effective in reducing CO2 induced panic attacks. Perhaps the most essential part in every CO2 study is the criteria used to define laboratory panic attacks and the CO2 concentrations.…”

“…A significant reduction in 35% CO2 vulnerability was observed in ten panic disorder patients after a 5-week treatment with clonazepam 10 -mean dose 2.1 mg/day. There is also a case report 11 of a 30-year-old woman with panic disorder and phobic avoidance who responded partially to treatment with alprazolam but recovered fully while receiving clonazepam. After 5 weeks of alprazolam she had still spontaneous panic attacks but not after a 8-weeks treatment with clonazepam.…”

“…The effect of antipanic drus on the anxiogenic response to 35% CO2 may help to elucidate the mechanism of CO2-induced panic attacks 11,12 . It is important to determine if pretreatment with antipanic drugs would alter the anxiogenic response to CO2.…”

Carbon dioxide test as an additional clinical measure of treatment response in panic disorder

“…Our finding is consistent with the observation that acute alprazolam 19 , 10 days treatment with clonazepam 21 , long term alprazolam 20 treatment and 5-week treatment with clonazepam 18,25 are effective in reducing CO 2 induced panic attacks. Perhaps the most essential point in every CO 2 study is the criteria used to define laboratorial panic attacks and the CO 2 concentrations.…”

“…We also expect that the CO 2 challenge-test could be a useful addition tool for measuring the pharmacological response during the initial phase (6 weeks) in the treatment of PD patients. It is expected that clonazepam should block CO 2 induced anxiety attacks and other studies have reported similar results with chronic administration of clonazepam 18 and acute 19 and long term administration of alprazolam. 20 In a preliminary report 21 clonazepam was effective in blocking CO 2 panic attacks after 10 days of treatment.…”