The Lactate Theory of Anxiety: A Review and Reevaluation

Pitts and McClure proposed the hypothesis that alterations in serum lactate play a crucial role in the pathogenesis of anxiety, both in its psychic and somatic aspects. The authors critically reevaluate this hypothesis in the light of conceptual and methodological issues pertinent to psychobiological studies of emotion. Data are summarized that indicate significant defects in the theory from biochemical, physiological, and psychological points of view. The authors conclude that, while lactate infusions do precipitate anxiety attacks in patients with a certain type of anxiety neurosis, the mechanism cannot be that proposed by Pitts and McClure. An alternate hypothesis, which may better fit the data, involves a conditioned phobic response by some anxiety neurotics to certain of their somatic symptoms of anxiety.