Prolactin response to d-fenfluramine in obsessive-compulsive patients, and outcome of fluvoxamine treatment.
BACKGROUND
Although several studies have directly explored serotonin (5-HT) transmission in patients with obsessive-compulsive disorder (OCD), their results have been inconsistent and their clinical relevance is doubtful.


METHODS
According to a double-blind placebo-controlled design, plasma prolactin (PRL) response to a specific serotonergic probe, d-fenfluramine, was measured in 20 drug-free obsessive-compulsive patients and in 20 matched healthy controls. After the neuroendocrine test, 15 patients completed a 10-week treatment with fluvoxamine. Psychopathological assessment was performed before and after therapy.


RESULTS
PRL response in OCD patients was blunted under the drug-free condition; correlated inversely with pretreatment ratings of obsessive-compulsive and depressive symptomatology; and correlated inversely with the improvement in obsessive-compulsive score observed after fluvoxamine treatment.


CONCLUSIONS
These results support the idea of a dysfunction of 5-HT transmission in OCD, and suggest that the greater this impairment, the better the response to drugs which selectively block the reuptake of 5-HT.
Monteleone
P
P
Institute of Psychiatry, University of Naples, Italy.
Catapano
F
F
Di Martino
S
S
Ferraro
C
C
Maj
M
M
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D005277:Fenfluramine / Q000627:therapeutic use*; D016666:Fluvoxamine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000097:blood / Q000188:drug therapy*; D011388:Prolactin / Q000097:blood*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D015415:Biomarkers; D005277:Fenfluramine; D016666:Fluvoxamine; D011388:Prolactin; D017367:Selective Serotonin Reuptake Inhibitors