Question CO2 to induce panic attacks for treatments?

[Akimbo]

I have been reading In the Waves: My Quest to Solve the Mystery of a Civil War Submarine at @Duke Dive Medicine's recommendation. There is an interesting statement indicating that CO2 is used to induce panic attacks in clinical settings. Can anyone expand on this?

 

[Duke Dive Medicine]

@Akimbo , I think it's used primarily in studies of panic disorder and panic attacks, though I'm by no means an expert and I only know about this because I found it using a lit search:

The carbon dioxide challenge test in panic disorder: a systematic review of preclinical and clinical research - PubMed

This systematic review assesses the current state of clinical and preclinical research on panic disorder (PD) in which the carbon dioxide (CO2) challenge was used as a trigger for panic attacks (PAs). A total of 95 articles published from 1984 to 2012 were selected for inclusion. Some hypotheses...

pubmed.ncbi.nlm.nih.gov

 

[BoundForElsewhere]

CO2 is used to induce panic attacks in clinical settings.

That sounds absolutely terrifying. Why would you do that to someone? No one is triggering a brain seizure to check it out clinically. Each one of these incidents, much like a bipolar episode, physiologically changes the human brain.

Sorry, this hits a little close to home for me. As someone who has watched his wife suffer debilitating anxiety attacks and be hospitalized more than a handful of times for manic and psychotic episodes, this just breaks my heart.

 

[Akimbo]

Why would you do that to someone?

I wasn't clear if it is used as a diagnostic or treatment tool, which is why I asked. It depends on the mix — 3-5% isn't that bad. Just like in diving, awareness is a valuable skill to manage panic. Maybe they use it for habituation or to teach patients deep ventilation techniques?

I made the mistake of trying to suck the gas out in a Mae West/horse collar style vest that was inflated with a CO2 cartridge. A quarter lung full of near pure CO2 was pretty horrible.

 

[Akimbo]

@Akimbo , I think it's used primarily in studies of panic disorder and panic attacks,

Yikes:

"The 35% CO2 protocol was the method chosen by the majority of studies. Results of the test report specific sensitivity to hypercapnia in PD patients of the respiratory PD subtype."

That seems really high. I doubt I have experienced more than about 8%, other that momentary bit of stupidity in the previous post.

 

[BoundForElsewhere]

Whatever the reason, inducing panic or anxiety attacks could be very dangerous and more than a little sadistic.

Now, sucking helium balloons at the school fair... different story.

 

[michael-fisch]

AFAIK CO2 is used in slaughterhouses to sedate birds and mammals (cows, piqs, sheep) before being killed.

Michael

 

[Lorenzoid]

AFAIK CO2 is used in slaughterhouses to sedate birds and mammals (cows, piqs, sheep) before being killed.

Michael

That's been my understanding, too. Emphasis on "sedate"--as in, with the humane goal of minimizing the likelihood of panic, anxiety or whatever the avian, bovine, etc., analog might be.

 

[John C. Ratliff]

Yikes:

"The 35% CO2 protocol was the method chosen by the majority of studies. Results of the test report specific sensitivity to hypercapnia in PD patients of the respiratory PD subtype."

That seems really high. I doubt I have experienced more than about 8%, other that momentary bit of stupidity in the previous post.

Akimbo, I am a retired industrial hygienist, and the 2014 ACGIH* TLV Booklet* states that the "STEL" level (Short Term Exposure Limit) for carbon dioxide is 30,000 parts per million. That is 3/100, or 3%. The NIOSH Pocket Guide states that the IDLH level for CO2 (Immediately Dangerous to Life and Health) is 40,000 parts per million, or 4/100 which is 4% CO2.

CDC - NIOSH Pocket Guide to Chemical Hazards - Carbon dioxide

Carbonic acid gas, Dry ice [Note: Normal constituent of air (about 300 ppm)]. Colorless, odorless gas. [Note: Shipped as a liquefied compressed gas. Solid form is utilized as dry ice.]

www.cdc.gov

I am curious how this much CO2 could ethically be used on patients?

SeaRat

PS, here's some other quotes from NIOSH:

Basis for original (SCP) IDLH: The chosen IDLH is based on the statements by ACGIH [1971] that a 30-minute exposure at 50,000 ppm produces signs of intoxication, and a few minutes of exposure at 70,000 ppm and 100,000 ppm produces unconsciousness [Flury and Zernik 1931]. AIHA [1971] reported that 100,000 ppm is the atmospheric concentration immediately dangerous to life. In addition, Hunter [1975] noted that exposure to 100,000 ppm for only a few minutes can cause loss of consciousness.

Other human data: Signs of intoxication have been produced by a 30-minute exposure at 50,000 ppm [Aero 1953], and a few minutes exposure at 70,000 to 100,000 ppm produces unconsciousness [Flury and Zernik 1931]. It has been reported that submarine personnel exposed continuously at 30,000 ppm were only slightly affected, provided the oxygen content of the air was maintained at normal concentrations [Schaefer 1951]. It has been reported that 100,000 ppm is the atmospheric concentration immediately dangerous to life [AIHA 1971] and that exposure to 100,000 ppm for only a few minutes can cause loss of consciousness [Hunter 1975].

Revised IDLH: 40,000 ppm
Basis for revised IDLH: The revised IDLH for carbon dioxide is 40,000 ppm based on acute inhalation toxicity data in humans [Aero 1953; Flury and Zernik 1931; Schaefer 1951].

CDC - Immediately Dangerous to Life or Health Concentrations (IDLH): Carbon dioxide - NIOSH Publications and Products

www.cdc.gov

*"The TLVs(Registered) and BEIs(Registered) represent conditions under which ACGIH(Registered) believes that nearly all workers may be repeatedly exposed without adverse health effects. They are not fine lines between safe and dengerous exposures, nor are they a relative index of toxicology..."
For CO2, the ACGIH TLV is a TWA (Time-Weighted Average) of 5000 ppm, as of 2014 when I retired. This would change for divers according to Dalton's Law of partial pressures, and 5000 ppm at sea level will be multiplied by the number of atmospheres absolute the diver is diving at.

 

[BRT]

That's been my understanding, too. Emphasis on "sedate"--as in, with the humane goal of minimizing the likelihood of panic, anxiety or whatever the avian, bovine, etc., analog might be.

After enough CO2 they will be sedate.