Abstract
Background: Based on the induction of panic-like symptoms by infusion of cholecystokinin
(CCK) peptide in normals and panic disorder patients, it has been proposed that CCK
may play a role in the disease mechanisms underlying anxiety disorders. Selective
antagonists of CCK-B receptors can block the challenge-induced symptoms in a dose-dependent
manner, leading to the hypothesis that these compounds may have anxiolytic effects.
Methods: A randomized, double-blind study was carried out to compare the effects of
placebo with CI-988, a selective antagonist of the CCK-B receptors. Following a one-week
placebo lead-in, patients with Panic Disorder with or without Agoraphobia received
either placebo or CI-988 100 mg TID for six weeks. Panic attacks were recorded by
a daily diary method.
Results: A total sample of 88 patients was planned but and interim analysis was carried
out when about half the patients had been enrolled (n = 41). All patients improved during treatment and no difference in the weekly rate
of panic attacks was seen between the treatment groups. The study was terminated at
this point due to the remote likelihood of showing a treatment difference.
Conclusions: CI-988 was not superior to placebo in reducing panic attacks. Several
explanations are possible, including the poor pharmacokinetic characteristics of CI-988
which may make it unsuitable to test the CCK hypothesis of anxiety.
Keywords
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Article info
Publication history
Accepted:
April 6,
1999
Received in revised form:
March 22,
1999
Received:
September 10,
1997
Identification
Copyright
© 1999 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
