Serotonin function and antiaggressive response to fluoxetine: a pilot study.
BACKGROUND
The reported inverse relationship between indices of central serotonin (5-HT) function and indices of impulsive aggression in human subjects suggests the possibility that enhancement of 5-HT activity will reduce impulsive aggressive behavior. Although evidence for this hypothesis is emerging, the relationship between baseline central 5-HT system function and antiaggressive responses to treatment with 5-HT agents has not yet been examined in human subjects.


METHODS
In this pilot study, we examined the relationship between: a) pretreatment prolactin responses to d-fenfluramine (PRL[d-FEN]) challenge; and b) antiaggressive responses to 12 weeks of treatment with either fluoxetine or placebo in 15 impulsively aggressive personality disordered subjects as observed in a 12-week, double-blind, placebo-controlled trial.


RESULTS
Among all subjects there were positive correlations between the pretreatment PRL[d-FEN] response and the percent improvement in Overt Aggression Scale-Modified scores for "Aggression" and "Irritability." These correlations were present in the fluoxetine (n = 10), but not in the placebo (n = 5), treated subjects.


CONCLUSIONS
These data suggest the possibility that the antiaggressive response to fluoxetine is directly, rather than inversely, dependent on the responsiveness of central 5-HT synapses in the brain of impulsive aggressive personality disordered subjects.
Coccaro
E F
EF
Department of Psychiatry, MCP, Hahnemann School of Medicine, Philadelphia, PA 19129, USA.
Kavoussi
R J
RJ
Hauger
R L
RL
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D000374:Aggression / Q000187:drug effects*; D004311:Double-Blind Method; D005277:Fenfluramine; D005473:Fluoxetine / Q000494:pharmacology*; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000188:drug therapy / Q000523:psychology; D010554:Personality Disorders / Q000188:drug therapy / Q000523:psychology; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D012701:Serotonin / Q000502:physiology*; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology*
D005277:Fenfluramine; D005473:Fluoxetine; D012701:Serotonin; D017367:Selective Serotonin Reuptake Inhibitors