Enhanced sensitivity to cholecystokinin tetrapeptide in panic disorder. Clinical and behavioral findings

Arch Gen Psychiatry. 1991 Jul;48(7):603-10. doi: 10.1001/archpsyc.1991.01810310021005.


We studied the action of cholecystokinin tetrapeptide (CCK-4) in patients with panic disorder and normal controls. Subjects received, in random order, one injection of CCK-4 and one injection of placebo (saline) on two separate days in a double-blind crossover design. Two doses of CCK-4, 50 and 25 micrograms, were administered to two different samples of subjects. The panic rate with 50 micrograms of CCK-4 was 100% (12/12) for patients and 47% (7/15) for controls. The panic rate with 25 micrograms of CCK-4 was 91% (10/11) for patients and 17% (2/12) for controls. Nine percent of patients compared with 0% of controls panicked with placebo. These findings concur with previous reports of a panicogenic effect of CCK-4 and suggest that patients with panic disorder are more sensitive to the panicogenic effect of the peptide than are normal controls.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety Disorders / chemically induced*
  • Anxiety Disorders / physiopathology
  • Anxiety Disorders / psychology
  • Cholecystokinin / physiology
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Humans
  • Middle Aged
  • Panic / drug effects*
  • Placebos
  • Tetragastrin / administration & dosage
  • Tetragastrin / pharmacology*


  • Placebos
  • Tetragastrin
  • Cholecystokinin