Relationship between central and peripheral serotonin indexes in depressed and suicidal psychiatric inpatients.
Serious suicidal behavior, affective disorders, and a variety of other psychopathologic behaviors and syndromes have been found to correlate with measures of the serotonin system. Clinical studies have employed a range of serotonin indexes, including the cerebrospinal fluid level of 5-hydroxyindoleacetic acid, the prolactin response to serotonin agonists, such as fenfluramine hydrochloride, and platelet serotonin-related proteins or serotonin content. Many of these indexes are correlated with suicidal behavior, but the interrelationship of these biologic measures has been uncertain. We studied the relationship of a series of serotonin indexes in patients in whom these measures were correlated with suicidal behavior. A positive correlation was found between cerebrospinal fluid 5-hydroxyindoleacetic acid and the maximal prolactin response to fenfluramine but not with platelet serotonin2 receptor indexes. The fenfluramine-stimulated maximal prolactin response correlated with platelet serotonin2 receptor number, particularly in older patients. We conclude that cerebrospinal fluid 5-hydroxyindoleacetic acid measurements cannot be replaced but can be complemented by less invasive procedures, such as a fenfluramine challenge test or platelet serotonin2 measures, in the study of the relationship of the serotonin system to psychiatric disorders.
Mann
J J
JJ
Department of Psychiatry, University of Pittsburgh, PA 15213.
McBride
P A
PA
Brown
R P
RP
Linnoila
M
M
Leon
A C
AC
DeMeo
M
M
Mieczkowski
T
T
Myers
J E
JE
Stanley
M
M
D000328:Adult; D001792:Blood Platelets / Q000737:chemistry; D003866:Depressive Disorder / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005277:Fenfluramine / Q000494:pharmacology; D006760:Hospitalization; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid; D008297:Male; D001523:Mental Disorders / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000503:physiopathology*; D011388:Prolactin / Q000097:blood; D011985:Receptors, Serotonin / Q000032:analysis / Q000378:metabolism / Q000502:physiology; D012701:Serotonin / Q000032:analysis / Q000378:metabolism / Q000502:physiology*; D013406:Suicide, Attempted / Q000523:psychology*
D011985:Receptors, Serotonin; D005277:Fenfluramine; D012701:Serotonin; D006897:Hydroxyindoleacetic Acid; D011388:Prolactin