Lithium in tricyclic-resistant depression. Correlation of increased brain 5-HT function with clinical outcome.
The addition of lithium to the tricyclic antidepressant medication of 23 patients with major depression resulted in an increase in the prolactin response to intravenous L-tryptophan after both four days and four weeks of treatment. The extent of this increase did not distinguish the ten patients who were classified as clinical responders (greater than 50% reduction in score on the HRSD). Among the responders there was a modestly significant correlation between the decrease in score on the HRSD and the enhancement of tryptophan-induced prolactin release. Some responders, however, showed very little change in this endocrine response over the four weeks of lithium treatment. Lithium may increase brain 5-HT function in tricyclic-resistant depression but there is only limited support for the hypothesis that changes in brain 5-HT function are involved in the antidepressant effect of this treatment combination.
Cowen
P J
PJ
Psychopharmacology Research Unit, Littlemore Hospital, Oxford.
McCance
S L
SL
Ware
C J
CJ
Cohen
P R
PR
Chalmers
J S
JS
Julier
D L
DL
D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D001921:Brain / Q000187:drug effects* / Q000503:physiopathology; D003866:Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016651:Lithium Carbonate / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D011388:Prolactin / Q000097:blood; D011569:Psychiatric Status Rating Scales; D011985:Receptors, Serotonin / Q000187:drug effects* / Q000502:physiology; D009435:Synaptic Transmission / Q000187:drug effects / Q000502:physiology; D014364:Tryptophan
D000929:Antidepressive Agents, Tricyclic; D011985:Receptors, Serotonin; D016651:Lithium Carbonate; D014364:Tryptophan; D011388:Prolactin