Clomipramine Treatment of Hyperventilation Syndrome

Abstract

Six patients suffered from a hyperventilation syndrome for 3.4 +/- 1.2 years. They had a lowered PAco2 at rest and an abnormal CO2 response curve. During the entire period they had received unsuccessful treatment with anxiolytics, and had also undergone behaviour therapy for the last 1 -- 2 years without success. Both treatments were discontinued and the patients were placed on clomipramine, 25 mg t.i.d. for 9 months. Their anxiety and hyperventilation attacks diminished after one month of clomipramine, and their fear of attacks an their phobias subsided after two months. Eighteen months after clomipramine therapy had been initiated, they were feeling well without medication. The possible mode of action of clomipramine on the hyperventilation syndrome via central serotonergic mechanism is discussed.

False Suffocation Alarms, Spontaneous Panics, and Related Conditions

“…Severe "hyperventi¬ lation syndromes" refractory to intensive respiratory management techniques benefited markedly from clomi¬ pramine hydrochloride. 174 The suffocation false-alarm theory received unexpected support from A. C. Briggs (written communication, July 18,1990) who compared alprazolam, imipramine, and place¬ bo. A cluster analysis of panic symptoms indicated two groups.…”

Xanthurenic Acid Excretion in Urine After Oral Intake of 5 Gram L-Tryptophan by Healthy Volunteers: Standardisation of the Reference Values

“…2) Some authors have administered L-tiyptophan in a mg/kg body-weight dose (5,6,11) and others in a fixed dose (3,4,7,8,9). Even within each of these administrat ion modes the dose used by different authors was not identical.…”

“…3) Some authors considered the urine collected during 6 hours after Ζ,-tryptophan intake (12), others during 8 hours (4), 12 hours (6) or 24 hours (7,8,9,11).…”

“…4) The L-tryptophan was administered either in the morning (3,4,6) or in the evening (7,8,9). In.animal experiments it was shown, however, that there is a considerable circadian variability in the activity of the pyrrolase (13).…”

“…traceptives with (3) or without (4) depression, mental Disorders of this'biosynthesis can be quantified by retardation (5,6), depression (7,8), hyperventilation synmeasuring the excretion of xanthurenic acid in urine drome (9) and anxiety state (7). At a biochemical level, The mitochondrial aminotransferase is the less sensitive and the supernatant kynureninase the most sensitive enzyme to a deficiency or competetive inhibition of vitamin 65.…”