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The effects of opioid receptor blockade on experimental panic provocation with CO 2

School for Mental Health and Neurosciences and Academic Anxiety Center, Maastricht University, Maastricht, The Netherlands, gabriel.esquivel{at}pn.unimaas.nl

O. Fernández-Torre

Department of Psychiatry, University Hospital Marqués de Valdecilla, Santander, Spain

KRJ Schruers

School for Mental Health and Neurosciences and Academic Anxiety Center, Maastricht University, Maastricht, The Netherlands

LLW Wijnhoven

School for Mental Health and Neurosciences and Academic Anxiety Center, Maastricht University, Maastricht, The Netherlands

EJL Griez

4 School for Mental Health and Neurosciences and Academic Anxiety Center, Maastricht University, Maastricht, The Netherlands

Several reports have linked, among other aspects, the role of an opioid system in respiratory physiology with underlying mechanisms of panic attacks. The involvement of the opioid system in experimental panic is to be further probed. This study aimed to determine whether opioid blockade would increase panic-related symptomatology on provocation with 35% CO₂ inhaled by healthy volunteers. Participants in a double-blind, randomised crossover design orally received either 50 mg of naltrexone or placebo. Most subjects undertook a double inhalation of 35% CO₂ one hour after pre-medication, and a separate group did so after five hours. The reactivity to CO₂ and the symptoms elicited by naltrexone alone were measured. Among other findings, naltrexone pre-medication alone elicited significant increments in panic-related symptoms. Responses to CO₂ were not significantly different between conditions in either group. These preliminary findings suggest that exposure to opioid blockade alone can potentially elicit symptoms that resemble panic, however, without modifying the response to experimental panic provocation with 35% CO₂.

Key Words: 35% CO2 inhalation • anxiety • naltrexone • opioids • panic

This version was published on November 1, 2009

Journal of Psychopharmacology, Vol. 23, No. 8, 975-978 (2009)
DOI: 10.1177/0269881108093844


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