Cholecystokinin and panic disorder--three unsettled questions

Abstract

The serendipitously discovered panicogenic effect of the cholecystokinin fragment, the C-terminal tetrapeptide amide (CCK-4), has suggested that the widespread network of CCK neurons and corresponding CCK-B receptors in the brain are in some way involved in pathogenesis panic disorders in man. Two decades of research have now established that exogenous CCK-4 in a reproducible, dose-dependent and sensitive manner indeed evokes panic attacks in both healthy subjects and at even lower doses in anxiety patients. But several questions about the molecular mechanisms by which endogenous CCK peptides may precipitate panic attacks remain to be answered. This review focuses on three immediate questions. (1) Does endogenous CCK-4 exist? (2) Is the panicogenic effect mediated only through CCK-B receptors? (3) Are measurements of CCK peptides in cerebrospinal fluid of use in elucidating the pathogenesis and/or diagnosis? This review concludes that the answers to these questions may further the understanding of panic disorder substantially, and hence contribute to improved diagnosis and therapy of the disease.

Original languageEnglish
JournalRegulatory Peptides
Volume93
Issue number1-3
Pages (from-to)79-83
Number of pages5
ISSN0167-0115
DOIs
Publication statusPublished - 25 Sept 2000
Externally publishedYes

Keywords

  • Amino Acid Sequence
  • Animals
  • Cholecystokinin/cerebrospinal fluid
  • Humans
  • Molecular Sequence Data
  • Panic Disorder/metabolism
  • Receptor, Cholecystokinin B
  • Receptors, Cholecystokinin/metabolism
  • Tetragastrin/metabolism

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