Serotonergic function during lithium augmentation of refractory depression.
Serotonergic mechanisms have been implicated in the pathophysiology of depression and in the neuropharmacology of antidepressant treatment. One measure of central serotonergic function is the prolactin (PRL) response to IV L-tryptophan (L-TRP). We used the L-TRP test to assess the role of serotonin in the mechanism of action of lithium augmentation in refractory major depression. Twenty-six patients with antidepressant-refractory major depression each received three L-TRP tests (after 2 weeks of placebo, after 4 weeks of active primary antidepressant, and after 1 week of lithium augmentation). Primary antidepressant treatment did not increase the PRL response, but lithium augmentation resulted in a statistically significant increase in PRL response as compared to both placebo pretreatment (P less than 0.04) and antidepressant treatment alone (P less than 0.025). This study supports a role for serotonergic mechanisms in the action of lithium augmentation.
McCance-Katz
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Clinical Neuroscience Research Unit, Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven.
Price
L H
LH
Charney
D S
DS
Heninger
G R
GR
D000328:Adult; D000368:Aged; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008094:Lithium / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000097:blood; D011569:Psychiatric Status Rating Scales; D011863:Radioimmunoassay; D012701:Serotonin / Q000502:physiology*; D014364:Tryptophan
D012701:Serotonin; D014364:Tryptophan; D011388:Prolactin; D008094:Lithium