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Anxiety and the Effects of Sodium Lactate Assessed Clinically and Physiologically

Published online by Cambridge University Press:  29 January 2018

Desmond Kelly ,
Nita Mitchell-Heggs  and
Daniel Sherman
Desmond Kelly
Affiliation:
St. George's Hospital Medical School, Atkinson Morley's Hospital, 31 Copse Hill, London, S.W.20 (Department of Psychological Medicine, St. Thomas' Hospital)
Nita Mitchell-Heggs
Affiliation:
St. Thomas' Hospital, London, S.E.1
Daniel Sherman
Affiliation:
The Johns Hopkins Hospital, Baltimore, Maryland, U.S.A.
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Extract

Anxiety neurosis has been the subject of intensive study during the past ten years. Renewed interest in this syndrome has arisen both from the stimulus of new methods of treatment and from attempts to classify anxiety more accurately. Recently Pitts and McClure (1967) reported that anxiety symptoms and anxiety attacks could be produced by a specific biochemical stimulus: sodium lactate. This work was prompted by the finding that 'standard exercise’ tends to produce an excess amount of lactic acid in patients with anxiety neurosis (Cohen and White, 1950; Jones and Mellersh, 1946; Linko, 1950; Holmgren and Strom, 1959). Pitts and McClure found that an intravenous infusion of 10 ml. of half-Molar sodium (DL) lactate per kilogram of body weight, given over a twenty minute period, produced an anxiety attack in patients suffering from anxiety neurosis. The symptoms began a minute or two after the infusion was started and developed rapidly, and some patients reported ‘exacerbations of their characteristic symptom profiles for two to five days after the sodium lactate infusion’. In their double-blind study, many fewer symptoms were produced when calcium ion was added to the lactate infusion, and almost no symptoms were produced by an infusion of glucose in saline of similar osmolarity. Many fewer and less severe symptoms were produced in normal controls than in the patient group, both in response to sodium lactate and to lactate with added calcium, and almost no symptoms during the glucose and saline infusion. Pitts and McClure postulated that anxiety symptoms may have a common determining biochemical end-mechanism, involving the complexing of ionized calcium at the surface of excitable membranes by lactate ion with resulting interference ‘with the normal functioning of calcium in transmitting nerve impulses' (Pitts, 1969). They concluded that ‘there may be something highly specific about lactate ion in producing the naturally occurring hypocalcaemic anxiety symptoms in human beings'.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 119 , Issue 549 , August 1971 , pp. 129 - 141
Copyright
Copyright © The Royal College of Psychiatrists, 1971 

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References

Cohen, M. E., and White, P. D. (1950). ‘Life situations, emotions, and neurocirculatory asthenia (anxiety neurosis, neurasthenia, effort syndrome).’ Association for Research into Nervous and Mental Disorders, Proceedings, 29, 832–69.Google Scholar
Cronin, R. F. P. (1967). ‘Haemodynamic and metabolic effects of beta-adrenergic blockade in exercising dogs.’ Journal of Applied Physiology, 22, 211–16.CrossRefGoogle ScholarPubMed
Crown, S., and Crisp, A. H. (1966). ‘A short clinical diagnostic self-rating scale for psychoneurotic patients.’ British Journal of Psychiatry, 112, 917–23.Google Scholar
de la Lande, I. S., and Whelan, R. F. (1962). ‘The role of lactic acid in the vasodilator action of adrenaline in the human limb.’ Journal of Physiology (London), 162, 151–4.Google Scholar
Eysenck, H. J. (1959). Manual of the Maudsley Personality Inventory. London.Google Scholar
Furberg, C. (1966). ‘Adrenergic beta-receptor blockade and anaerobic metabolism.’ Nature, 211, 888.Google Scholar
Grosz, H. J., and Farmer, B. B. (1969). ‘Blood lactate in the development of anxiety symptoms. A critical examination of Pitts and McClure's hypothesis and experimental study.’ Archives of General Psychiatry, 21, 611–19.CrossRefGoogle Scholar
Holmgren, A., and Strom, G. (1959). ‘Blood lactate concentration in relation to absolute and relative work load in normal men, and in mitral stenosis, atrial septal defect and vasoregulatory asthenia.’ Acta Medica Scandinavica, 163, 185–93.Google Scholar
Jones, M., and Mellersh, V. (1946). ‘Comparison of exercise response in anxiety states and normal controls.’ Psychosomatic Medicine, 8, 180–7.Google Scholar
Kelly, D. H. W. (1966). ‘Measurement of anxiety by forearm blood flow.’ British Journal of Psychiatry, 112, 789–98.Google ScholarPubMed
Kelly, D. H. W. (1967). ‘The technique of forearm plethysmography for assessing anxiety.’ Journal of Psychosomatic Research, 10, 373–82.CrossRefGoogle ScholarPubMed
Kelly, D. H. W., Brown, C. C., and Shaffer, J. W. (1970). ‘A comparison of physiological and psychological measurements on anxious patients and normal controls.’ Psychophysiology, 6, 429–41.Google Scholar
Kelly, D. H. W., Guirguis, W., Frommer, E., Mitchell-Heggs, N., and Sargant, W. (1970). ‘Treatment of phobic states with antidepressants: a retrospective study of 246 patients.’ British Journal of Psychiatry, 116, 387–98.CrossRefGoogle ScholarPubMed
Kelly, D. H. W., Guirguis, W., Frommer, E., Mitchell-Heggs, N., and Walter, C. J. S. (1968). ‘The relationship between clinical diagnosis and anxiety assessed by forearm blood flow and other measurements.’ British Journal of Psychiatry, 114, 611–26.Google Scholar
Linko, E. (1950). ‘Lactic acid response to muscular exercise in neurocirculatory asthenia.’ Annates Medicinae Internae Fenniae, 39, 161–76.Google Scholar
Pitts, F. N. (1969). ‘The biochemistry of anxiety.’ Scientific American, 220, 69–75.Google Scholar
Pitts, F. N. and McClure, J. N. (1967). ‘Lactate metabolism in anxiety neurosis.’ New England Journal of Medicine, 277, 1329–36.CrossRefGoogle ScholarPubMed
Taylor, J. A. (1953). ‘A personality scale of manifest anxiety.’ Journal of Abnormal and Social Psychology, 48, 285–90.CrossRefGoogle ScholarPubMed
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