Information for clinicians


bcalm is a medical device for the relief of panic. It has been created and developed by a team of doctors in the US, UK, and Finland. The original idea was conceived by Dr Stephen Cox, a researcher, university professor and a clinical anxiety specialist with 30 years’ experience treating tens of thousands of anxiety and panic disorder patients, and David Sinclair, PhD, an expert on addiction science.

The science behind bcalm suggest that:

  • panic attacks are directly caused by external factors like CO2 rather than psychosocial ones
  • some people have a lower tolerance for high CO2 levels than others

bcalm is therefore an effective treatment for panic attacks because it ‘scrubs’ the air of high CO2, thus removing the main cause of panic. Reports by clinicians and patients also suggest that bcalm may be effective for general anxiety.

quote Anxiety is not always psychological but rather a disease that can now be controlled. The symptoms are devastating: sudden unprovoked attacks of anxiety-accompanied by skipping and racing of the heart, shortness of breath, lightheadedness, dizzy spells. Even worse is the fear that you are losing your mind. But here's the good news. The more unexpected and unprovoked the attacks or the symptoms, the more likely that the victim is suffering from a biologically beset disease. quote


From an abstract of The Anxiety Disease (Bantam, 1986) by David Sheehan, formerly of the Harvard Medical School, now the Director of Research of the College of Medicine at the University of South Florida in Tampa.

The main evidence for a biological cause of panic is as follows:


  • Elevated serum lactate levels
  • genetic / twin studies
  • Age of onset data
  • double-blind provocation studies
  • PET scans
  • favorable response to medical treatment
  • nocturnal non-REM panic attacks
  • level catecholamine, ACTH & cortisol studies in anxiety
  • CO2 in Agoraphobic Environments
  • Gene Link CCK (Journal of Molecular Psychiatry,Jacques Bradwejn,May 99)


These key research papers establish a link between external triggers like CO2 and panic attacks:


“False suffocation alarms, spontaneous panics, and related conditions. An integrative hypothesis”, Archives of General Psychiatry (Impact Factor: 13.75). 05/1993; 50(4):306-17, Klein DF.

“Measurement of lactate-induced panic and anxiety”, Psychiatry Research (Impact Factor: 2.68). 03/1987; DOI: 10.1016/0165-1781(87)90002-3, Dillon DJ, Gorman JM, Liebowitz MR, Fyer AJ, Klein DF.

“Ventilatory physiology of patients with panic disorder”, Archives of General Psychiatry (Impact Factor: 13.75). 02/1988; 45(1):31-9, Gorman JM, Fyer MR, Goetz R, Askanazi J, Liebowitz MR, Fyer AJ, Kinney J, Klein DF.

“CO2 challenge of patients with panic disorder”, American Journal of Psychiatry (Impact Factor: 13.56). 09/1987; 144(8):1080-2, Fyer MR, Uy J, Martinez J, Goetz R, Klein DF, Fyer A, Liebowitz MR, Gorman J.

“Carbon dioxide hypersensitivity, hyperventilation, and panic disorder”, American Journal of Psychiatry (Impact Factor: 13.56). 09/1993; 150(8):1149-57, Papp LA, Klein DF, Gorman JM.

“In a rat model of panic, corticotropin responses to dorsal periaqueductal gray stimulation depend on physical exertion.” Psychoneuroendocrinology (Impact Factor: 5.59). 01/2015; 53C:136-147, de Souza Armini R, Bernabé CS, Rosa CA, Siller CA, Schimitel FG, Tufik S, Klein DF, Schenberg LC.


These are key research papers that Dr Cox has authored on the subject of panic disorder:


“An In Vivo, Controlled Study of the Clinical Benefit for Persons with Panic Disorder of Breathing Air Purified of Elevated Environmental Carbon Dioxide By a Pregnancy Safe, Handheld, Respiratory CO2 Scrubber. Evidence of a Causal Relationship in Panic Disorder between (a.) the High Carbon Dioxide Levels in Indoor or Vehicular Environments and (b.) Panic Attacks Provoked by Claustrophobia/Agoraphobia”, co-authored with Lowell J. Lawrence, 2005, Poster Session, NCDEU (New Clinical Drug Evaluation Unit) Meeting NIMH, National Institutes of Health, Boca Raton, Florida.

“Single Ion Gas Chromatographic/Mass Spectroscopic Quantitative Analysis of Environmental CO2 in Agoraphobic Environments”, Anxiety, 1:275-277 (1994-1995) Wiley-Liss, Inc / div of John Wiley & Sons, New York, 1995.

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