Carbon dioxide provocation of anxiety and respiratory response in bipolar disorder

Research output: Contribution to journalArticlepeer-review


Background: Frequent bipolar/panic comorbidity implies bipolar individuals may experience CO2-provoked anxiety and changes in respiratory patterns similar to those experienced by individuals with panic disorder. Methods: 16 euthymic bipolar individuals breathed air and air combined with 5% CO2 for 15 min each. Respiratory and subjective anxiety measures were collected. Results: On CO2 subjects were more anxious and breathed more deeply and rapidly than with air; the degree of increase in anxiety attributable to CO2 was directly correlated with the degree of increase in minute ventilation. Five individuals were assessed as having a panic attack. Panic response to CO2 was predicted by the degree of anxiety experienced with air alone. Conclusions: Comparison with the results of similar panic studies shows bipolar disorder is associated with enhanced respiratory response to CO2. Hypersensitivity to CO2 among bipolar individuals suggests a possible pathological mechanism common to both bipolar and panic disorders. These preliminary data support the expanded application of CO2 challenges in bipolar subjects.

Original languageEnglish (US)
Pages (from-to)45-49
Number of pages5
JournalJournal of Affective Disorders
Issue number1-3
StatePublished - Apr 2007


  • Affective disorders
  • Hypercapnia
  • Hyperventilation
  • Panic disorder
  • Psychophysiology

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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