Acute panicogenic, anxiogenic and dissociative effects of carbon dioxide inhalation in patients with post-traumatic stress disorder (PTSD)

Background

Increased anxiety and panic to inhalation of carbon dioxide (CO₂) has been described in patients with anxiety disorders, especially panic disorder, compared to healthy subjects. Post-traumatic stress disorder (PTSD) has been hypothesised to resemble panic disorder and is currently classified as an anxiety disorder in DSM-IV. However, there are only very few data available about the sensitivity of patients with PTSD to CO₂.

Methods

In 10 patients with PTSD, 10 sex- and age-matched healthy subjects and 8 patients with panic disorder we assessed anxiety, panic, dissociative and PTSD symptoms before and after a single vital capacity inhalation of 35% CO₂.

Results

Patients with PTSD showed an increased anxiety, panic and dissociative reaction to the inhalation of 35% CO₂ compared to healthy participants. PTSD subjects’ responses were indistinguishable from those of panic patients. Additionally, PTSD-typical symptoms like post-traumatic flashbacks were provoked in patients with PTSD after the inhalation of CO₂.

Conclusions

In our sample, PTSD was associated with an increased CO₂ reactivity, pointing to an increased susceptibility of PTSD patients to CO₂ challenge.