New Treatment for Panic Attacks: A Possible Role for Antibiotics

Panic attacks can be truly frightening and overwhelming, leaving those who experience them feeling utterly helpless. However, there may be a promising treatment on the horizon—an antibiotic.

Research has already indicated that carbon dioxide (CO₂) can trigger panic attacks, likely because the brain interprets this as a sign of suffocation. There’s also evidence suggesting that microglia, the immune cells in the brain, might play a role in initiating this panic response.

This is where minocycline, a common antibiotic, comes into play. It’s known for its ability to reduce inflammation and, more importantly, soothe hyperactive microglia.

In a recent study, researchers from Brazil sought to connect these dots by investigating whether minocycline could be an effective treatment for panic attacks. They administered minocycline to both mice and a group of 49 individuals—40 women and 9 men—suffering from panic disorder.

“In our experimental set-up, where mice inhaled CO₂ to induce panic attacks, those treated with minocycline for two weeks displayed a decrease in one of the panic-triggering responses,” noted Beatriz de Oliveira, a biologist from São Paulo State University (UNESP).

“Among the human participants, we observed a reduction in the intensity of panic attacks triggered by CO₂ inhalation.”

The study also involved testing minocycline alongside clonazepam (commonly sold as Klonopin or Rivotril), which is often prescribed for panic disorders. After the two-week treatment period, mice displayed significantly less jumpiness when exposed to CO₂. Moreover, those treated with minocycline exhibited calmer breathing patterns and notable metabolic changes.

Delving deeper into the analysis, researchers confirmed the decision to focus on microglia. CO₂ inhalation indeed spurred increased activity in these immune cells within the locus coeruleus, a brain region responsible for detecting CO₂ and regulating breathing. However, minocycline seemed to mitigate this activation.

Both minocycline and clonazepam proved effective in humans as well, decreasing the severity of panic attacks according to standard clinical evaluations. The minocycline group also showed signs of reduced inflammation marked by changes in specific proteins.

“It’s well established that some psychiatric disorders are linked to inflammation in nerve cells,” shared Luciane Gargaglioni, another biologist from UNESP. “Since minocycline acts as an anti-inflammatory at lower doses—though not solely as an antibiotic—the symptom improvements likely result from reduced inflammation, distinguishing it from clonazepam, which works by inhibiting certain brain receptors.”

Given that minocycline is already an approved antibiotic, the process for its application in treating panic disorders could be expedited. The doses used in this study were notably lower than those typically prescribed, helping to mitigate the risk of bacterial resistance.

The potential hope is that minocycline might emerge as an alternative to psychiatric drugs like clonazepam, which can have undesirable side effects, such as decreased heart and respiratory rates.

Nonetheless, more research is necessary before reaching that goal, including larger-scale clinical trials and a thorough examination of minocycline’s impact on microglia. Interestingly, the lack of similar anti-inflammatory protein shifts in mice compared to humans suggests there may be additional mechanisms at play, beyond just microglial activity modulation.

Nearly 5 percent of people in the U.S. are estimated to experience some form of panic disorder during their lives, meaning millions worldwide could gain from new treatment options.

“The findings from this study on the underlying mechanisms of panic attacks might lead to the development of more targeted and effective therapies,” the researchers concluded in their publication.

The study is detailed in Translational Psychiatry.