The diagnosis and treatment of panic disorder in alcoholics: three cases.

It has been postulated that many alcoholics use alcohol to "self-mediate" symptoms of anxiety or panic. Early diagnosis and treatment in this population are both complicated by symptoms of alcohol withdrawal and controversial because of the belief that alcoholics will abuse anxiolytics. The authors present three patients with alcoholism in whom diagnosis of panic was facilitated by intravenous lactate infusion, and whose symptoms were alleviated by clonazepam. All three patients were able to maintain sobriety during treatment. The authors conclude that in a subpopulation of alcoholics, pharmacotherapy for panic may be indicated and not lead to anxiolytic abuse.