The Benzodiazepine Alprazolam Dissociates Contextual Fear from Cued Fear in Humans as Assessed by Fear-potentiated Startle

Christian Grillon, Johanna M.P. Baas, Daniel S. Pine, Shmuel Lissek, Megan Lawley, Valerie Ellis, Jessica Levine

Research output: Contribution to journalArticlepeer-review

107 Scopus citations

Abstract

Background: The startle reflex is potentiated by aversive states. It has been proposed that phasic startle potentiation to a threat cue and sustained startle potentiation to contextual stimuli reflect distinct processes mediated by different brain structures. The present study tested the hypothesis that alprazolam would reduce the sustained startle potentiation to contextual threats but not the startle potentiation to a threat cue. Methods: Sixteen healthy subjects received each of four treatments: placebo, .5 mg of alprazolam, 1 mg of alprazolam, and 50 mg of diphenhydramine (Benadryl) in a crossover design. Participants were exposed to three conditions, including one in which predictable aversive shocks were signaled by a cue, a second in which shocks were administered unpredictably, and a third condition in which no shocks were anticipated. Acoustic startle were delivered regularly across conditions. Results: Phasic startle potentiation to the threat cue in the predictable condition was not affected by alprazolam. In contrast, the sustained increase in startle in the predictable and unpredictable conditions was reduced significantly by the high dose of alprazolam. Conclusions: Startle responses to an explicit threat cue and to an aversive context are psychopharmacologically distinct, suggesting that they may represent functionally dissociable aversive states.

Original languageEnglish (US)
Pages (from-to)760-766
Number of pages7
JournalBiological Psychiatry
Volume60
Issue number7
DOIs
StatePublished - Oct 1 2006
Externally publishedYes

Keywords

  • Alprazolam
  • anxiety
  • benzodiazepine
  • context
  • fear
  • startle reflex

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