Serotonergic function in obsessive-compulsive disorder. Behavioral and neuroendocrine responses to oral m-chlorophenylpiperazine and fenfluramine in patients and healthy volunteers.
To evaluate serotonergic (5-hydroxytryptamine) function in obsessive-compulsive disorder, behavioral and neuroendocrine responses to m-chlorophenylpiperazine (m-CPP; 0.5 mg/kg orally) and fenfluramine hydrochloride (60 mg orally) were examined in 20 patients and 10 healthy controls under double-blind, placebo-controlled conditions. Following m-CPP, but not fenfluramine or placebo, 55% (11/20) of the patients with obsessive-compulsive disorder experienced a transient exacerbation of obsessive-compulsive disorder. Prolactin response was blunted in patients following m-CPP but not following fenfluramine. Patients with greater behavioral response to m-CPP had smaller prolactin responses. Cortisol response to m-CPP and fenfluramine did not significantly differ between the groups. Behavioral and neuroendocrine responses appeared divergent. This does not suggest simply upregulation or downregulation of 5-hydroxytryptamine receptors, but rather complex mechanisms involving multiple neurotransmitter and neuromodulator systems.
Hollander
E
E
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York.
DeCaria
C M
CM
Nitescu
A
A
Gully
R
R
Suckow
R F
RF
Cooper
T B
TB
Gorman
J M
JM
Klein
D F
DF
Liebowitz
M R
MR
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D004311:Double-Blind Method; D015536:Down-Regulation / Q000187:drug effects; D005260:Female; D005277:Fenfluramine / Q000494:pharmacology*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D010879:Piperazines / Q000008:administration & dosage / Q000494:pharmacology*; D010919:Placebos; D011388:Prolactin / Q000097:blood; D011985:Receptors, Serotonin / Q000187:drug effects; D012701:Serotonin / Q000378:metabolism / Q000502:physiology*; D015854:Up-Regulation / Q000187:drug effects
D010879:Piperazines; D010919:Placebos; D011985:Receptors, Serotonin; D005277:Fenfluramine; D012701:Serotonin; D011388:Prolactin; C015068:1-(3-chlorophenyl)piperazine; D006854:Hydrocortisone