patients None of these studies was designed to define the role of CCK-4 in the development of naturally occurring panic attacks. If cholecystokinin is involved in ethiology of naturally occuring panic attacks, then treatment with CCK-B antagonists should have clinical effect on patients with panic disorder and modulate their level of anxiety. Clinical studies with CCK-4 antagonistsTo test this hypothesis a pilot study was undertaken by Mark S. Kramer and colleagues (MS Kramer et al., 1995).6 In a placebo-controlled, double -blind study the PD patients were given either L-365,260 or placebo for six weeks. Eighty three patients out of total eighty eight from six cities in the US completed the study. Patients did not receive any psychotropic medication during the study. The experiment lasted a total of eignt weeks, including the first and last week of the single-blind placebo treatment. Unlike in Dr. Bradwejns studies, the effectiveness of L-365,260 was evaluated with the help of Physician's Global Improvement Scale (PGIS) and Hamilton Anxiety and Depression Scales. Participants were taking 120 mg of L-365,260 daily in the form of capsules, of the maximum size and frequency acceptable to them. The researchers anticipated at least 40% difference between placebo group and antagonist group. These expectations were based on the study of Ballenger et al9, which tested efficacy of the benzodiazepin class drug alprazolam and also used the PGIS as evaluation tool. Though L-365,260 had a higher response rate than placebo (13% difference), it was not enough to assign this antagonist clinically significant anxiolytic properties. However, researchers noticed that there were some numerical trends in favor of the drug upon the completion of the study. L-365,260 reduced panic attack frequency in comparison with the mean baseline, and demonstrated improvement of Work, Social and Family Disability Scales scores. The total anxiety and panic ...
